Nutrition for CKD

(Stages 1, 2, 3, & 4)

Healthy kidneys get rid of food wastes and extra fluid. When your kidneys cannot do their job well, waste products may build up in your blood. In order to control these wastes, it is important to adjust the kind of food that you eat.

Following some simple guidelines will help you to:

• Meet your nutritional needs.
• Cut down the workload on your kidneys.
• Keep the kidney function that is left.
• Control the build-up of food wastes.
• Reduce symptoms like fatigue, nausea, and itching and bad taste in the mouth.
• Control the effects of high blood sugar if you have diabetes.

There are no standard kidney diets because the needs of each individual are different. You will need to eat foods that give you the right amount of protein, fats, sodium (salt), phosphorus, and potassium to keep you healthy. The amounts will differ from person to person. What you can eat will change over time, depending on how much kidney function you have. A renal dietitian will help you develop and maintain a healthy meal plan.

Energy | Fats | Protein | Sodium | Phosphorous | Potassium

Kidney Disease and Diabetes

If you have diabetes, you may need to make a few changes to your diabetes diet, with the help of your dietitian. Check your blood sugar levels often and try to keep your levels under control. Your doctor or pharmacist may adjust your insulin or other medications if your kidney disease gets worse.

Renal Dietitian

Your doctor or renal dietitian will monitor your blood work. If any changes are required to your diet, a renal dietitian will work with you to develop a meal plan that will fit within your cultural and lifestyle needs. It is important to remember that dietary changes may vary among people with kidney disease.

Energy (Calories)

The foods that you eat give you energy. Energy gives you strength to do your day-to-day activities and to remain active.

The amount of energy foods you need depends on the following:

• Height
• Body frame
• Weight
• Activity level
• Age

Fats

You need to include some fats in your meal plan; however some types of fats are healthier than others.

To improve heart health:

• Use vegetable oils, such as canola, olive and soybean.
• Choose non-hydrogenated margarines, since these are low in saturated and trans fats.
• Limit butter, hard margarines, lard and shortening.

Protein

Protein builds, repairs and maintains your body tissues. It also helps your body fight infections and heals wounds. However, eating too much protein may cause waste to build up in your blood and worsen kidney function.

Good sources of protein are:

• Red meats
• Poultry
• Fish and other seafood
• Eggs
• Tofu
• Legumes and beans

Most people need to eat about two to three portions of meat or meat alternates each day. Each portion should be about the size of a deck of cards. Your dietitian will advise you if you need to eat smaller portions of protein.

Sodium

Sodium (salt) affects your body fluids and blood pressure. In kidney disease, the kidneys are no longer able to get rid of excess sodium in the body. When sodium builds up in your body, you retain water. This can cause high blood pressure, shortness of breath and swelling of your feet, ankles and hands.

Here are some ways to reduce sodium in your diet:

1. Do not add salt in cooking and at the table
2. Choose fresh unprocessed foods. Processing adds sodium to foods.

This chart shows that processed foods are higher in salt than unprocessed foods.

Examples of processed foods are:

• Processed cheeses and meats such as ham, sausage and luncheon meats
• Convenience foods, such as TV dinners, canned foods, and bakery products
• Canned soups and dehydrated soups (e.g. packaged noodle soups)
• Salty snacks, such as salted crackers, pretzels, potato chips and salted nuts/seeds
• Packaged pastas and rice with sauces
• Pickles, sauerkraut and olives
• Condiments such as ketchup, soy sauce, and mustard
• Restaurant foods, take-out foods and fast foods

3. Check food labels and ingredient lists for the word “salt” or “sodium” (e.g. monosodium glutamate). If a word including “sodium” is close to the top of the ingredient list, then that food is high in sodium (salt).
4. Instead of using salt to improve the taste of your foods, try:
   • Unsalted spices and herbs (e.g. Mrs. Dash® or McCormick’s ®No added Salt Blends)
   • Lemon juice
   • Vinegar
   • Salt-free flavourings (avoid salted seasonings, such as celery salt, garlic salt, onion salt and poultry seasonings)

*Caution: Do not use salt substitutes such as Half Salt®. Salt substitutes may contain added potassium. Read labels carefully.

Phosphorus

Phosphorus is a mineral that works with calcium to keep your bones healthy. Kidneys normally control the amount of phosphorus in the blood. When your kidneys are not working well, the level of phosphorus in the blood can become too high. This causes calcium to be drawn out of your bones, making bones brittle, weak and painful over time. This calcium can deposit in your body, causing damage to your heart, blood vessels, eyes and skin. Your dietitian will advise you how to limit high-phosphorus foods when the level of phosphorus in your blood becomes high.

Potassium

Potassium is a mineral that keeps your nerves and muscles, including your heart, working normally. If potassium becomes too high or low your heart may beat irregularly. Kidneys normally control the amount of potassium in the blood. When your kidneys are not working well, you may need to adjust the amount of potassium in your meal plan. Your dietitian will let you know if you need to change your diet.