If you are living with chronic kidney disease your doctor or registered dietitian may advise you to follow a renal diet. A renal diet is low in three nutrients: potassium, sodium and phosphorus. Normal healthy kidneys filter excesses of these nutrients from the bloodstream and excrete them from the body. For someone with CKD, the function of the kidneys is diminished, making it more difficult or impossible to get rid of these excesses. Some people with kidney disease also have difficulty with fluid balance. Depending on your particular case and kidney function, your doctor may add a fluid restriction -- usually 1,000 to 2,000 ml of total fluid per day. Consult your doctor before beginning a renal diet with or without a fluid restriction. Your registered dietitian can provide tips and information regarding specific aspects of your renal diet to suit your individual nutritional needs.
Benefits of a Renal Diet
Whether or not you will benefit from a renal diet will depend on your blood test values for sodium, potassium and phosphorus. If your laboratory values for these micronutrients are within the normal ranges, you may not need to follow the renal diet plan despite your CKD diagnosis. If your lab values are high, a renal diet prescription may be beneficial to slow the progression of kidney dysfunction. Your doctor can interpret your lab results to determine if a renal diet is right for you.
Sodium Restriction
Sodium, or salt, is a mineral in many sources of food, especially processed or prepackaged foods and meals. Restricting sodium intake while on a renal diet will mean cutting out most processed foods, including chips, canned soups and many boxed or frozen meals. Decreasing your intake of these and other salty foods will help keep your blood sodium level in a healthier range and reduce the stress on your kidneys. Most convenience and fast foods are excessively high in sodium, so you will need to avoid them. Other foods that are high in sodium include pickles and many condiments like ketchup, dressings and peanut butter.
Potassium Restriction
Potassium is in many foods, making it difficult to restrict potassium on a renal diet. With practice and education, you will be able to identify high-potassium foods and limit your intake of such foods. Potassium-rich foods include beans, apricots, artichokes, spinach, nectarines, mangoes and honeydew melons. Dried fruits such as prunes and raisins are also high in potassium.
Low-potassium foods include apples, blackberries, cucumbers, celery, corn and grapes. Choose these foods instead of high-potassium foods. Peaches, strawberries, mushrooms and lettuce are also low in potassium. Consult your registered dietitian for a full list of high- and low-potassium foods.
Phosphorus Restriction
Not as common in foods as potassium, you must also restrict phosphorus on a renal diet. Phosphorus is in dark sodas, such as Coke, Pepsi and Dr. Pepper, as well as in dairy products like cheese, milk and ice cream. Liver, organ meats, oysters and sardines also have a high phosphorus content. Limiting your intake of these foods will decrease the phosphorus in your body. This will then decrease the workload for your kidneys.
Fluid Restriction
In addition to filtering nutrients and wastes from the body, your kidneys also maintain fluid balance. When the functionality of your kidneys is compromised due to CKD or other kidney diseases, your body may start to retain water. By restricting fluids, you take the stress off the kidneys. Fluids include all beverages and also anything that is liquid at room temperature, such as ice, gelatin, soups, ice pops, ice cream and frozen yogurt. You may also need to exclude foods with a high water content, like many fruits and vegetables.
Not everyone on a renal diet will need to follow a fluid restriction. Ask your doctor before starting a fluid restriction. She can advise you on how much fluid you should get daily.
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