The National Kidney Foundation reports that 26 million adults in America suffer from chronic kidney disease. The kidneys function to cleanse the body of waste and excess fluids. When the kidneys do not function properly, as in chronic kidney disease, excess waste materials remain in the body. Extra fluid and waste can lead to conditions such as hyperkalemia, hyperphosphatemia and proteinuria. A physician may recommend following a renal diet during stages three and four of kidney disease. In the September/October 2004 edition of "Kidney Beginnings: The Magazine," author and dietitian Peggy Harum, RD, LD reports that a renal diet may help retain the function of the kidneys and delay further complications of renal disease. Following a renal diet will help reduce excess fluid and waste.
Protein Intake
During stages three and four of chronic kidney disease, dietary changes may help preserve kidney function, as noted by the National Kidney Foundation. In kidney disease, the kidneys have a difficult time removing protein waste products. Limiting protein intake will allow the kidneys to function without excess effort. The National Kidney Foundation recommends that people with stage three or four kidney disease limit protein intake to about 0.6 g to 0.75 g per kilogram of body weight per day. This calculates to about 41 g to 55 g of protein for a 150 lb. person. A registered dietitian can help explain individual needs. Good sources of protein come from meat, fish, poultry, pork and eggs. Peanut butter, nuts, seeds, beans and lentils are other non-animal sources of protein. An ounce of meat contains approximately 7 g of protein.
Phosphorus
Phosphorus is an important nutrient that the body uses for bones and teeth. An impairment in the function of the kidneys may lead some to retain high levels of phosphorus in the blood due to the limited ability of the kidneys to effectively remove the nutrient from the body, as noted by the National Kidney Foundation. Too much phosphorus in the blood results in low bone calcium levels. The National Kidney Foundation recommends people with stage three or four kidney disease limit phosphorus intake to 800 g to 1,000 mg per day when phosphorus levels are greater than 4.6 mg/dL. Signs of too much phosphorus intake include itchy skin or bone and joint pain. A blood test for phosphorus will indicate when blood levels are too high. Cola, beer, flavored water, ice tea, peanut butter, cheese, sardines, nuts, ice cream, milk and yogurt are food sources of phosphorus. Phosphorus content is not always available on a food label. Phosphorus is in many additives and may be found as an ingredient in the food list. Look for ingredients containing the letters "pho," such as phosphoric acid, sodium phosphate, aluminum phosphate, trisodium phosphate and monocalcium phosphate.
Potassium
The kidneys are responsible for ensuring proper potassium balance. Too much potassium may cause the heart to beat irregularly or even stop. A physician may recommend a low-potassium diet when blood levels are out of an acceptable range. The National Kidney Foundation recommends a daily intake of about 2 g to 4 g of potassium per day during stages three and four of kidney disease. Limit bananas, oranges, cantaloupe, raisins, fruit juices, broccoli, potatoes, tomatoes, chocolate and coffee. Check the food label before using salt substitutes as many contain potassium.
Limited Fluids
During the early stages of kidney disease, adjustments in fluid intake are not typically necessary, as reported by the National Kidney Foundation. However, if increases in swelling in the arms or legs or difficulty in breathing occurs, fluid retention may be a concern. Fluid retention can result from too much sodium in the diet. A physician will order a fluid restriction and advise on the specific requirements as indicated.
Sodium
As kidney function declines, fluid may build up in the body. In order to reduce fluid retention, limit sodium intake. The National Kidney Foundation recommends no more than 2.4 mg of sodium per day. Bacon, cold cuts, cheese, nuts, canned soups, potato chips, canned vegetables and processed dinners are all high in sodium. Review food labels to ensure the sodium level is not too high.
Considerations
Renal dietary needs differ from individual to individual based on lab values. A physician or dietitian will provide a specific plan based on lab values.
The renal diet for end-stage renal disease differs slightly from the diet for chronic kidney disease. Dialysis treatment given during end-stage renal disease affects blood levels of protein and therefore requires a higher protein intake.
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