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DIET in CKD

There is no single renal diet, and advice will vary depending on things such as body weight, blood tests and urine output. Here I can only give some general ideas and advice. For appropriate individual advice – consult your nephrologist

General guidelines:

Eat regular meals.
Include plenty of variety in your diet. This will provide you with essential nutrients such as protein, calories, vitamins and minerals. These nutrients keep you well nourished.
Eat some high-fiber foods such as whole-grain bread and cereals.
Eat only moderate amounts of fats.
Avoid adding extra salt

Reduce fat intake:

Avoid cakes, pastry, cream, mayonnaise, cream cheese, or other high fat foods.
Use butter or margarine sparingly.
Don’t fry food. Use non stick cookware
Cut the fat off meat.
Use skimmed or semi-skimmed milk in place of full cream milk.

Remember that a loss of appetite is one of the major symptoms of kidney failure. Weight loss and loss of appetite are important reasons for starting dialysis. Be sure to tell your doctor about changes in your appetite.

Protein Intake
Myth: “All protein should be stopped from diet” (This myth arises from the advise to restrict dietary protein in the western diets where meat forms a large part of their diet and moderate protein restriction may be advisable)
Unfortunately this is being applied to even Indian diet, which is predominantly vegetarian.

Protein should be consumed in normal amounts.
Dals and Pulses should be consumed in moderate amounts.
Occasional Egg, Fish or Chicken is acceptable (Preferable to avoid red meats)

Salt
Common salt is sodium chloride. Today’s diets contain too much salt, and weak kidneys cannot cope. A high salt intake can lead to high blood pressure and to fluid retention and overload. Many blood pressure medicines will only be effective if combined with a reduced salt intake.

In most patients with kidney disease keep salt intake to ‘no added salt’ levels of less than 100mmol/day (6g of salt, which is just over 2g of sodium – less than a teaspoon of salt per day). This diet allows small amounts of salt to be used in cooking, but means limiting very salty foods, and not adding salt to food at the table. The less salt the better!

Do not take salt substitutes such as ‘LoNa’ or other low sodium salts. These are not suitable for patients with renal failure, because they contain large amounts of potassium. These can cause life threatening hyperkalemia

Some Simple Rules to restrict salt:
Do not add salt to your food at the table.
Do not use flavoured salts, e.g. garlic salt or sea salt.
Use only a small amount of salt in cooking or none at all.
Do NOT use salt substitutes, e.g. Lo Na or low sodium salts
Use other herbs, spices and other flavourings as an alternative to salt.
Avoid tinned or packet soup, tomato juice, tinned vegetables in salt, baked beans, meats.
Avoid Crisps, salted nuts, peanut butter and other savoury snacks, pickles.

Potassium
High potassium levels can be very dangerous –if you do need to watch your
potassium intake, it is important. Blood tests will show how you are doing

High Potassium Foods
Fruit and Vegetable Juices,Coffee
All dried fruits
Fruit: Bananas, mango, grapes, apricots, rhubarb, fresh grapefruit, pineapple
Vegetables: beetroot, plantain, mushrooms, sweet corn, avocadoes, aubergine, spinach
Chocolate, toffee, liquorice

Not all patients with kidney disease need to cut down on potassium. Even on dialysis, a few lucky people don’t.