If you have a family member with kidney disease, meal planning can be difficult. Since there is no one "kidney diet," you need to know whether protein consumption is an issue and whether the patient should be on a high-protein or low-protein diet. These decisions are based on the patient's laboratory results, his glomerular filtration rate and his nephrologist's advice. GFR is a measure of how effectively the kidneys filter blood and is measured in mL/min/1.73 m2, or milliliters, per minute, per meter squared. The nephrologist's guidelines should give you information on meal planning.
Diabetic Kidney Disease
Diabetes is the leading cause of kidney failure in the United States. The National Institutes of Diabetes and Digestive and Kidney Diseases states that in 2007, diabetes was the cause of kidney failure in 197,037 of the 527,283 Americans being treated for end-stage kidney disease.
The National Kidney Foundation recommends that diabetics in stages one through four of chronic kidney disease should consume 0.8 g of protein per 1 kg body weight per day. This means that a 130 lb. women should consume approximately 47 g of protein.
Analysis and Planning
For many diabetic kidney patients, the 0.8 g/kg recommendation may seem like a low-protein diet because it is less protein than most people consume. It is important to remember that the recommended daily allowance of protein for adults is exactly 0.8 g/kg. Evaluated in this light, the recommendation isn't a true low-protein diet.
In terms of meal-planning, this protein can be consumed throughout the day to include half of a roasted chicken breast with 26.68 g protein and one poached egg with 6.25 g protein. In your planning, consider the protein content in other foods, such as whole-wheat bread.
Low-Protein Diet
The National Kidney Foundation suggests that patients with a GFR greater than 30 limit daily protein intake to 0.75 g/kg. Patients whose GFR is less than 30 who are not on dialysis might be advised to decrease daily protein intake down to 0.6 g/kg.
Using meat or other high-protein foods in small amounts, as is the practice in Chinese cooking, makes meal planning easier. Many of these patients have other dietary restrictions as well, so selectively combining white rice, small amounts of chicken or lean meat and other acceptable foods is a good meal-planning strategy.
Warning
When planning meals, don't assume that the patient should be on a low-protein diet. For example, patients on dialysis need greater amounts of protein because amino acids are often dialyzed away. In such instances, supplying high-protein foods that comply with other dietary restrictions is important because muscle wasting and malnutrition are associated with poor outcomes. Lean beef, chicken and pork are preferred to dried beans, legumes and other high-phosphorus foods on this type of diet.
References
- National Kidney Foundation: Potassium and Your CKD Diet
- National Kidney Foundation: Phosphorus and Your CKD Diet
- USDA Nutrient Data Laboratory: Chicken, Broilers or Fryers, Breast, Meat Only, Cooked, Roasted
- National Institute for Diabetes and Digestive and Kidney Diseases; Kidney and Urologic Diseases Statistics for the United States; April 2010
- USDA Nutrient Data Laboratory: Egg, Whole, Cooked, Poached
- National Kidney Foundation: KDOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification -- Part Four
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