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Diet for Diabetic Nephropathy

Mar 13, 2011 | By Catherine Cox

If you have diabetic nephropathy, or kidney disease, diet is an essential part of treatment. According to the National Kidney Disease Education Program (NKDEP), goals of diet therapy are to maintain good nutritional status, slow progression of kidney disease, and treat complications such as high blood potassium or phosphorus. Key components of the diet include managing blood sugar through carbohydrate control, managing blood pressure by decreasing sodium intake, and reducing protein intake.

Carbohydrate

Carbohydrate is your body's main energy source, but it is also the nutrient that has the greatest effect on blood sugar levels. To manage blood sugar, spread carbohydrate intake through the day into smaller meals and snacks and eat a consistent amount from day to day. Breads and grains, fruit, milk, starchy vegetables and sweets are the main sources of carbohydrate. A registered dietitian can recommend the ideal amount of carbohydrate for you, based on your weight, activity level, blood sugar and preferences. Achieving blood sugar control is essential for slowing progression of kidney damage and other diabetes complications.

Sodium

Sodium increases blood pressure, which in turn causes damage in the kidneys and increases risk of heart disease and stroke. Keep your blood pressure lower than 130/80. The 2010 Dietary Guidelines Advisory Committee report recommends limiting sodium intake to 1,500 mg daily. To lower your sodium intake, choose fresh or frozen fruits, vegetables and meats. Limit or avoid canned, cured, processed foods. Prepare more meals from scratch and limit restaurant, take-out and convenience meals. Read food labels for sodium content. Foods that have less than 5 percent the daily value (DV) for sodium are low sodium foods and those that have greater than 20 percent the DV are high sodium.

Protein

Protein is important for building and repairing body tissue. Most Americans eat about twice the recommended daily intake for protein, which increases the workload on the kidneys. The NKDEP recommends keeping daily protein intake to 0.36 to 0.45 g of protein per pound of body weight. For a 150 lb. person, this would be 54 to 67 g of protein daily. Eat smaller portions of meat and dairy, which also helps to lower phosphorus intake. Keep meat, poultry and fish to 2 to 3 oz. cooked, providing 14 to 21 g protein. One-half cup milk or yogurt or ½ oz. of cheese provides 4 g protein. Plant protein sources contain about 3 g protein, including ½ cup of cooked beans rice or noodles, a slice of bread or ¼ cup of nuts.

Potassium

Potassium helps counteract the effects of sodium on blood pressure. However, as the kidney damage progresses, excess potassium may build up in the blood. If your blood level exceeds 5 mEq/L, you will need to limit intake of high potassium foods, according to the NKDEP. High potassium can affect heart rhythm, although you may not feel any symptoms. Choose fruits and vegetables that are low in potassium such as apples, canned apricots or nectar, berries, grape, grapefruit, honeydew melon, mangoes, papayas, pears, peaches, plums, pineapple, watermelon, cranberry juice, bell peppers, fresh broccoli, cabbage, carrots, cauliflower, celery, onions, corn, cucumber, green beans, kale, lettuce, fresh mushrooms, okra and summer squash. Avoid or eat only a very small portion of high potassium foods like fresh apricots, bananas, cantaloupe, kiwi, prunes, oranges, raisins, winter squash, avocado, green, cooked broccoli, Brussels sprouts, chard, potatoes, spinach, legumes sweet potatoes, vegetable juice and tomato products.

Phosphorus

Phosphorus is a mineral important for healthy bones and keeping blood vessels and muscles working. With kidney disease, it can build up in your blood, making bones more brittle and causing itchy skin and bone and joint pain. If your blood level exceeds 4.6 mEq/L, you will need to limit phosphorus. Because phosphorus is found in many high protein foods, start by making sure you have your protein intake from meats, dairy and beans down to the recommended level. If your phosphorus level is still too high, the NKDEP recommends decreasing your intake of foods with added phosphorus, since phosphorus additives may be absorbed better than phosphorus found naturally in foods. To do this, read the ingredient list, looking for words like "phos" or pyrophosphate, for example. Other foods that are high in phosphorus include bran, oatmeal and colas.

References

Article reviewed by Mia Paul Last updated on: Mar 13, 2011

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