What food is best for people with kidney disease?

Kathleen Blanchard's picture
March is National Kidney Month: What diet is best for patients?
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March is National Kidney month, which brings a focus to anyone who is already suffering from kidney disease. If your doctor has reported your kidney function is less than optimal, it is important to understand there are specific foods that can help slow the progression of the disease, while other foods can cause more harm.

Kidney, or renal dysfunction, are terms used by your doctor that mean the filters in the kidneys are not removing waste products from the body properly. Another term is nephropathy. When the kidney is damaged, and if it worsens, weakness, loss of appetite, difficulty concentrating and sleeping and stomach upset can occur. Progression of kidney disease can lead to heart failure and hospitalization.

Causes of kidney dysfunction

• Trauma from injury, acute dehydration
• Viruses and infection
• Diabetes
• High blood pressure
• Family history
• Poor blood flow from heart disease
• Older age
• High cholesterol

Some medications can harm the kidneys, making it important to speak with your physician and pharmacist to find out if anything you are taking is contributing. Even over the counter medications like ibuprofen can cause the kidneys to work harder that can lead to renal failure. Other medications are designed to protect the kidneys including those known as ACE inhibitors and ARBs the keep blood pressure normal.

Diet and lifestyle

It’s important to stay active, keep your blood pressure under control, maintain a healthy weight, avoid tobacco and if you are diabetic, control blood sugar levels to prevent and manage existing kidney disease.

If you have already been diagnosed, focusing on foods that are good for the kidneys can help slow down how fast your kidney function might otherwise decline.

Cook fresh: Packaged and pre-prepared foods that contain salt are harmful to the kidneys, will worsen existing high blood pressure and can contribute to fluid retention and heart problems.

Focus on herbs and spices: When you use herbs and spices to cook you are doing more than avoiding salt. Spices can be anti-inflammatory and help aid healing.

For example, the herb rosemary can help get rid of excess fluid. Some patients with kidney disease retain fluid and take medications known as diuretics. Don’t focus on any one herbal remedy to treat your disease, but know that herbs and spices are much kinder to the body and may have mild medicinal effects that are beneficial. Use them for flavoring rather than a treatment.

Read packages: A simple way to know if the food you’re buying has too much sodium is to look for the daily percentage value. If the package says 20 percent or more (per serving), keep it on the grocery shelf and out of your food cart.

Choices on labels that are healthy include no salt, unsalted, low salt, lightly salted, salt free, low sodium, and no sodium, less sodium or reduced sodium.

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Find healthy quick meals: Look for low sodium frozen meals and pre-packaged foods. You don’t have to toil over making meals with the wide array of healthier options that can be found by scanning labels for those that are low in salt.

Rinse canned foods first: If you are buying canned foods like fish, beans or other vegetables, make sure you rinse them first. Canned goods tend to be higher in salt or sodium. You can also look for low salt options when choosing.

Eat low protein: Protein is difficult for the kidneys to filter because it is a large molecule. Too much in the diet that comes from meat, poultry, eggs, dairy and plants such as beans, nuts and grains can cause kidney function to worsen. Add small portions of protein to your meals to keep your kidneys healthy, especially if you have diabetes which is a leading cause of renal disease.

Cook your foods the ‘right’ way: Trim fat before cooking. Use non-stick pans to limit the amount of oils needed for cooking. Avoid frying foods and instead bake, roast, stew, grill, boil, broil or stir-fry. Fried foods and grease harm the blood vessels and raise cholesterol levels.

Eat for heart health: Choose low fat foods like yogurt, fruits, skinless poultry, vegetables and fish. Trim any fat from meat before cooking. Use olive oil instead of vegetable oil.

Low phosphorous may be important: Eat foods that are low in phosphorous. Ask the butcher for meat cuts that have no added “PHOS” that you can also find on food labels. Read the packaging on processed and fresh packaged meats to see if the ingredient has been added, which is often the case. Phosphorous can cause blood vessel and bone damage. Avoid dark colored drinks like sodas, teas and fruit punches that have extra phosphorous.

Watch your potassium intake: The right amount of potassium in your body is important for nerve function. Too much or too little can cause dangerous health problems, including heart rhythm disturbances, which could be lethal.

Never use salt substitute because it contains potassium iodide if your level is high. Many patients with kidney disease have potassium levels that are too high – though not all. Your doctor will perform regular blood work to check your levels.

Eating food that is high in potassium might be dangerous, depending on your individual situation. High potassium foods include bananas, white potatoes, tomatoes, wild rice, brown rice, dairy, beans, nuts (again, making it important to limit portions), bran cereal and whole wheat breads and pasta.

Lower potassium choices include apples, peaches, carrots, green beans, white bread and rice (limit if you are diabetic), grits, cooked rice and wheat cereals.

What to drink: Light colored soda or juice is lower in phosphorous if you have been told your level is too high. Homemade ice tea and lemonade are good choices.

If your potassium is high, avoid orange juice and choose grape, apple or cranberry juice. Speak with your doctor about whether it’s safe to drink alcohol, but limit the amount. Drink as much water as normal, taking care not to over hydrate or become dehydrated. If you are no getting enough fluids you will feel thirsty, dizzy and experience low blood pressure and decreased urine output. Your urine may be dark. Excessive colorless urine can also be a sign that you need to see the doctor, if it is a sudden change.

Too much fluid can cause difficulty breathing, unexplained weight gain, bloating and ankle and/or leg swelling that could be signs of heart failure or fluid overload.

Ask your doctor for a consult with a nutritionist if you have kidney disease to help tailor your individual diet to your specific needs. Some patients have low iron levels that can be replenished with the right foods also. Review your lab work with your healthcare provider so you can eat the diet specific to your results and level of renal dysfunction that can be minor and even reversible to late stage or advanced.

Resources:
National Kidney Disease Education Program
American Diabetes Association
Medline Plus: "Diet: Chronic Kidney Disease

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