People with kidney disease are often asked to follow a renal diet to improve their health and prevent progression of the disease. Renal diets are generally low in sodium, potassium and phosphorus and may have specific protein requirements depending on the stage of the disease. For those also on the medication Coumadin, additional diet restrictions are necessary. Because a Coumadin renal diet has several components, working closely with a registered dietitian may help you better understand and follow the guidelines.
Food-Drug Interactions
For people taking Coumadin, also known as warfarin, certain diet restrictions prevent the medication from having too strong an effect or from not working as effectively as it should. The foods that interact the most with Coumadin are those that contain vitamin K; examples are kale and spinach. People with kidney disease who are taking Coumadin daily should be aware of these foods to avoid dangerous food-drug interactions.
Protein
For people who have chronic kidney disease but have not yet started on dialysis, a diet low in protein is often prescribed to prevent the buildup of a waste called urea, which is filtered out in people with healthy kidneys. Adults who have started on dialysis may need to increase their protein intake to help replenish any protein that may be depleted during the procedure. A registered dietitian can help you determine exactly how much protein you should have each day. Because most protein foods are insignificant sources of vitamin K, interactions with proteins are usually not a concern for renal patients also on Coumadin.
Electrolytes
Most people with chronic kidney disease must follow a diet that is low in potassium, sodium and phosphorus. Potassium is present in fruits and vegetables such as bananas, tomatoes, potatoes and oranges. Although vegetables like broccoli and cabbage are generally low in potassium and allowable on a renal diet, kidney patients also on Coumadin should avoid these vegetables because of their high vitamin K content. Kidney patients are also advised to avoid canned foods and processed meats because of their high levels of sodium. Phosphorus is present in whole wheat foods, milk, chocolate and dark colas; clear sodas and white bread are lower-phosphorus alternatives that are acceptable on the renal diet.
Fluids
Adults with kidney disease may have fluid restrictions, but this varies from person to person based on age, weight and stage of disease. In addition to limiting fluids high in phosphorus and potassium, people on Coumadin need to avoid cranberry juice and alcohol because of their potential interaction with the medication.
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