Diet is so important in managing renal disease that many nephrologists routinely refer patients with advanced disease to renal dietitians. Any recommendations are based on the patient's laboratory results, blood pressure, age, concurrent diseases and other factors. The dietitian usually provides a wealth of information in helping the patient follow those recommendations.
Low-Protein Diet
Generally, nephrologists recommend low-protein diets for patients with high urine protein. Less protein is excreted through glomeruli, or kidney filters, if dietary protein is limited. By minimizing the wear-and-tear on the glomeruli, the life of the kidney is extended.
Patients often overdo it, however, when starting low-protein diets. It's still important to get some protein, which is why the National Kidney Foundation recommends that patients get 0.8 g of protein per kg body weight. Never start a low-protein diet without consulting your nephrologist. Low-protein diets are not for all kidney patients, especially children who need protein to grow.
High-Protein Diets
In some instances, high-protein diets are more appropriate. If you are on hemodialysis, your nephrologist may recommend a high-protein diet because dialysis removes certain amino acids from the blood. Likewise, high-protein diets are recommended for people recovering from transplantation. Double-check with your nephrologist to see what is right for you.
Low-Phosphorus Diets
The kidneys regulate levels of phosphorus in the blood. As kidneys become impaired, they are less able to perform this function and phosphorus levels begin to creep up. This is dangerous because the excess phosphorus starts to leach calcium from the bone. Uncontrollable itching is often one of the first symptoms that phosphorus levels are elevated.
If your phosphorus levels need to be controlled, your nephrologist can suggest a phosphorus binder that you take with food and recommend a low-phosphorus diet. Avoiding high-phosphorus foods, such as milk, cheese, beer, soy products and chocolate, is good for long-term bone health in patients with kidney disease.
Low-Potassium Diets
Patients with advanced disease also often have problems removing excess potassium from their bodies. High serum potassium levels can be life-threatening emergencies as they cause irregular heartbeats and heart attacks.
If serum potassium exceeds 5.0 mEq/L, nephrologists often recommend low-potassium diets to prevent these problems. If you have high serum potassium, consider using a potassium counter such as the one provided by the U.S. Department of Agriculture to help you keep track of your potassium intake.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Proteinuria
- National Institute for Diabetes and Digestive and Kidney Diseases: Eat Right to Feel Right on Hemodialysis
- National Kidney Foundation: K/DOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease
- DaVita: Dietary Protein and Chronic Kidney Disease (CKD)
- USDA: Nutrient Data Laboratory
- National Kidney Foundation: Phosphorus and Your CKD Diet
