Renal failure, also known as kidney failure, can occur as an acute one-time illness or as a chronic condition that develops over a number of years. Chronic renal failure often develops as a result of another disease process such as diabetes. Because people with acute renal failure are critically ill and usually hospitalized, diet isn't a factor in controlling symptoms and progression. People with chronic renal failure may need to make dietary changes that vary depending on the degree of renal failure. Approximately 19 million Americans suffer from chronic renal failure, Family Practice Notebook reports.
Types
Chronic renal failure can be mild, moderate or severe. People who have severe renal failure, also called end-stage renal failure, need dialysis to remove waste products from their blood, because the kidneys no longer function well enough to perform this major function. The measure for renal failure is the GFR, or glomerular filtration rate, which assesses the kidney's ability to remove waste from the urine. A GFR of 60 ml, stage 2 disease, represents around a 50 percent loss of kidney function, Family Practice Notebook explains. In end-stage renal failure, or stage 5, GFR drops to 15 ml or less. End-stage renal failure usually requires kidney transplant or dialysis. Dietary modification during different stages of renal failure will depend on your weight, nutritional status, disease processes and other factors.
Dietary Modifications
While modifications will differ depending on your specific disease, most renal failure patients need to restrict their sodium intake to a maximum of 2,000 mg per day. Protein is often restricted in mild to moderate renal failure, unless you're malnourished. Phosphorus, a component of dairy products, legumes, nuts and drinks such as beer and dark cola drinks may also need to be restricted. High phosphorus levels can interfere with calcium absorption. Bones can become weak and may fracture. If you have high blood pressure and fluid retention, you will need to restrict sodium, since it retains fluid, which raises blood pressure. Protein is very important for building muscles and tissues, but it can require the kidneys to work harder.
Dialysis
People on dialysis need a diet different than that followed by other patients with renal failure. When you are on dialysis, you will need to restrict fluids, since the kidneys aren't processing fluids at all between dialysis sessions. You will also need to restrict potassium, because if potassium builds up between dialysis, irregular heartbeat can develop. Many fruits and vegetables contain large amounts of potassium. Phosphorus will also be restricted to prevent bone loss. On the bright side, your protein intake can increase on dialysis. Because most people on dialysis need to gain weight, your calorie intake should be increased.
Risks
Improving nutrition may improve patient outcomes in renal failure. However, up to 40 percent of people with renal failure have protein-deficiency malnutrition, as registered dietitian Joe Krenitsky of the University of Virginia Health System reported in the September 2004 issue of "Practical Gastroenterology." Since a number of factors contribute to malnutrition in renal failure, dietary plans must be tailored to the individual.
