Chronic renal or kidney failure occurs when your kidneys gradually lose their ability to function. This often occurs because of kidney damage from chronic diseases such as diabetes. Mild chronic kidney failure may not require dietary modifications or treatments; if kidney disease progresses, however, you may need to change your diet or monitor fluid intake. Diet and fluid modifications become necessary to reduce the strain on the kidneys when they can no longer filter out waste products.
Timing
Chronic kidney disease is divided into five stages, with stage 1 being the mildest disease and stage 5 the most severe. Early stage kidney disease usually doesn't require dietary or fluid restrictions, but as kidney function decreases and especially if you need dialysis to filter waste from the blood, restrictions become necessary.
Purpose
The purpose of dietary restrictions in chronic kidney failure is to reduce the workload on the kidneys. Some substances, particularly proteins, are harder for the kidneys to break down, so decreasing protein can ease the workload on the kidneys. Proteins, however, are necessary for cell repair and keeping your immune system functioning, among other purposes, so you should not restrict protein unless specifically instructed to do so by your doctor. Fluid restrictions reduce the amount of fluid retained as the kidneys lose their ability to function. Fluid buildup can raise blood pressure and cause edema, which is fluid buildup in your tissues.
Dietary Restrictions
Sodium intake may be restricted to 2,000 mg per day, the Merck Manuals Online Medical Library states. Phosphate intake restricts of less than 1 g per day may be necessary in stage 3 and 4 disease, according to Merck. Elevated phosphorus can cause itching and can also lead to calcium loss, the National Kidney Foundation reports. In end-stage disease, potassium may be limited to less than 50 millimoles, or mmol. Elevated potassium levels in late stage kidney disease can cause heart arrhythmias. Because people differ, always follow your own doctor's recommendations for diet. A dietitian will help you devise a diet that meets your needs.
Fluid Restrictions
Fluid is restricted only when sodium levels fall below 135 mmol/L, the Merck Manuals report. If kidney disease progresses and you need kidney dialysis, your fluids may also be restricted, according to DaVita, which provides kidney dialysis. The amount of fluid you're allowed is determined by your doctor based on your situation.
Results
Dietary and fluid restrictions will not cure kidney disease, but they can reduce the risk of complications or acceleration of kidney disease.
References
- Merck Manuals Online Medical Library: Chronic Kidney Disease
- MedinePlus: Diet-Chronic Kidney Disease
- National Kidney Foundation: Nutrition and Chronic Kidney Disease
- Davita: Fluid control for Kidney Patients on Dialysis
- National Institute of Diabetes and Digestive and Kidney Disorders: The Kidneys and how They Work
- MayoClinic.com: Kidney Failure, Chronic
