Kidney-Friendly Diet & Foods for Chronic Kidney Disease

Chronic Kidney Disease (CKD) requires careful dietary considerations to manage effectively. Collaborating with a registered dietitian ensures a personalized meal plan that aligns with your preferences while prioritizing kidney health.

Step 1: Controlling Sodium Intake

Sodium plays a pivotal role in regulating blood pressure. A key measure for maintaining good health is restricting sodium intake to 2,300 milligrams. To achieve this, consider the following dietary adjustments:

  • Refrain from adding salt to your food during preparation or consumption. Experiment with fresh herbs, lemon juice, or alternative sodium-free seasonings.
  • Opt for fresh or frozen vegetables over canned varieties. If using canned vegetables, ensure to rinse them thoroughly before incorporating into meals to eliminate excess salt.
  • Choose food items labeled “reduced-sodium” or “low-sodium” during grocery shopping.
  • Steer clear of processed foods such as frozen dinners and lunch meats, as they often contain elevated sodium levels.
    Related reading: https://crusadekidneydisease.com/eating-right-for-chronic-kidney-disease-series-controlling-sodium-salt-intake/

Step 2: Balancing Protein Consumption

Protect your kidneys by consuming appropriate portions of protein. To summarise

  • Follow a low-protein diet with a low PRAL score. Plant protein over animal protein sources.
  • Consider bicarbonates with careful potassium monitoring.
  • Consult nephrologists for raw amino acid supplements.
  • Integrate ketoanalogues into reduced protein diets under healthcare guidance.

Related reading: https://crusadekidneydisease.com/eating-right-for-chronic-kidney-disease-series-balancing-protein-consumption/

Step 3: Choosing Heart-Healthy Options

Promote cardiovascular health by adopting heart-friendly cooking methods such as grilling or baking. Trim fat from meat, remove poultry skin, and limit saturated and trans fats. Embrace a diet rich in lean meats, poultry without skin, fish, beans, vegetables, fruits, and low-fat dairy products.

Step 4: Managing Phosphorus Levels

Phosphorus, a mineral present in a variety of foods, collaborates with calcium and vitamin D to promote optimal bone health. In individuals with well-functioning kidneys, there is a natural balance in phosphorus levels within the body. However, when kidney function is compromised, there is a risk of phosphorus accumulation in the bloodstream, potentially resulting in weakened bones susceptible to fractures.

Depending on your stage of kidney disease, your doctor may also prescribe a medicine called a phosphate binder. This helps to keep phosphorus from building up in your blood. A phosphate binder can be helpful, but you will still need to watch how much phosphorus you eat. Ask your doctor if a phosphate binder is right for you.

As CKD progresses, continue to monitor phosphorus intake to protect bones and blood vessels. Check ingredient labels for added phosphorus, especially in deli meats. Embrace fresh fruits, vegetables, bread, pasta, rice, and light-colored sodas while limiting intake of phosphorus-rich foods.

Step 5: Balancing Potassium Intake

Maintain optimal nerve and muscle function by regulating potassium levels. Avoid salt substitutes high in potassium and drain canned fruits and vegetables. Choose apples, peaches, carrots, green beans, white bread, rice milk, and cooked rice or wheat cereals while limiting potassium-rich options.
For more detailshttps://crusadekidneydisease.com/the-relationship-between-kidney-disease-and-potassium-implications-for-health/ 

Step 6: Adding Fiber & Precision Pre/Pro-biotic 

Latest research reveals that having an optimal gut health strongly influences kidney function and progression of kidney disease. Food containing a broad-spectrum fiber (such as tubers) and taking precision probiotic supplements or eating probiotic natural foods, can help in fixing any underlying gut dysfunction

Probiotics, Synbiotics and Modbiotics

Every human being is born with a distinctive ecosystem of microbiome, especially gut microbiome. As we’ve transitioned to industrial societies, overall diversity of our gut microbiome has diminished. Nutritionists now recommend rotating across several “broad spectrum” probiotic supplements. However one specific species or family of microbiome plays a very important therapeutic role in our “industrialised guts”, especially around CKD – Bifidobacterium

Let’s get some definitions sorted out first –

  • Probiotics: Live bacterial stains taken as supplement. Sauerkraut, Yogurt are natural alternatives.
  • Synbiotics: Probiotics + Prebiotic Fiber (RS/glucans/FOS/Inulin/GOS), combined. Taken as a supplement.
  • Modbiotics: Synbiotics + polyphenols
A significant decrease in urea nitrogen circulating levels and a favourable CKD prognostic rate were reported in a multinational trial on CKD stage 3 and 4 undertaking proprietary formulation of S. thermophilus, L. acidophilus, and B. longum, over a period of six months.
In a recent study on mice, scientists found that a Synbiotic diet consisting primarily of Bifidobacterium (GFOB – Glutamine / Fiber / FOS / Bifido), reduced serum creatinine, blood urea nitrogen (BUN), indoxyl sulfate (IS; a toxin derived from protein metabolism which often needs dialysis to be cleared from circulation), inorganic phosphorus and parathyroid hormone (PTH). 

Step 7: Choosing Healthy Fats

Incorporate the right types of fats into your diet, such as those found in olive oil. Balancing fat intake is crucial for overall health and aligns with heart-healthy eating principles, including the DASH diet. Increased consumption of oily fish  (Omega-3) as part of plant-based diets with low content of Saturated Fatty Acid (SFA) is likely to benefit patients who have chronic kidney disease.

Step 8: Opting for Whole Grain Carbs

Prioritize whole grains and healthy carbohydrates like fruits and vegetables, steering clear of unhealthy options such as sugary drinks. If diabetic, work closely with your dietitian to monitor and manage carbohydrate intake. Also exercise good portion control to manage nutrient intake effectively. Pay attention to serving sizes, especially for packaged foods, and eat slowly to allow your body to signal fullness.
 

Frequently Asked Questions

Q1: Can alcohol be part of a kidney-friendly diet? A: Moderation is key. Limit alcohol consumption to one drink per day for women and two for men to prevent potential kidney damage. Ideally, to have any chance to halt progression of  or reverse kidney disease, say no to alcohol.  

Q2: How can I monitor my phosphorus levels? A: Regular lab tests can assess phosphorus levels in your blood. Consult your dietitian to adjust your meal plan accordingly.

Q3: What are heart-healthy foods for CKD? A: Lean meats, poultry without skin, fish, beans, vegetables, fruits, and low-fat dairy are excellent choices for maintaining heart health.

Q4: Will My Kidney-Friendly Eating Plan Change Based on My CKD Stage?
Yes, the strictness of your eating plan varies with your CKD stage. Early stages permit more dietary freedom, while advanced stages necessitate limitations on potassium, phosphorus, and fluid intake.

Q5: How Can I Ensure I Get Enough Vitamins on a Kidney-Friendly Eating Plan?
Work closely with your holistic nephrologist or dietitian or clinical nutritionist doctor (ND) to identify suitable supplements tailored to your kidney health. Specialized supplements may be recommended to address specific needs, such as vitamin D, folic acid, or iron.


By following these comprehensive guidelines, you can actively manage your CKD through a kidney-friendly diet. Consult with your healthcare provider and dietitian regularly to tailor your approach to your specific needs and ensure ongoing kidney health.

References

  • Borrelli, S., Provenzano, M., Gagliardi, I., Michael, A., Liberti, M. E., De Nicola, L., Conte, G., Garofalo, C., & Andreucci, M. (2020). Sodium Intake and Chronic Kidney Disease. International journal of molecular sciences, 21(13), 4744. https://doi.org/10.3390/ijms21134744
  • Smith HW (1953) From Fish to Philosopher: the story of our internal environmentLittle, Brown and Company.
  • Fournier, D., Luft, F. C., Bader, M., Ganten, D., & Andrade-Navarro, M. A. (2012). Emergence and evolution of the renin-angiotensin-aldosterone system. Journal of molecular medicine (Berlin, Germany), 90(5), 495–508. https://doi.org/10.1007/s00109-012-0894-z
  • Brown, J. A., Cobb, C. S., Frankling, S. C., & Rankin, J. C. (2005). Activation of the newly discovered cyclostome renin-angiotensin system in the river lamprey Lampetra fluviatilis. The Journal of experimental biology, 208(Pt 2), 223–232. https://doi.org/10.1242/jeb.01362 
  • Li, Y. C., Kong, J., Wei, M., Chen, Z. F., Liu, S. Q., & Cao, L. P. (2002). 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. The Journal of clinical investigation, 110(2), 229–238. https://doi.org/10.1172/JCI15219
  • Skiba K, Szotowska M, Kolonko A, Adamczak M, Więcek A: Prevalence of metabolic acidosis in kidney transplant patients. Transpl Int 2013; 26:S243
  • Lyon DM, Dunlop DM, Steward CP: The alkaline treatment of chronic nephritis. Lancet 1931; 2: 1009-1013.
  • Huang, X., Lindholm, B., Stenvinkel, P., & Carrero, J. J. (2013). Dietary fat modification in patients with chronic kidney disease: n-3 fatty acids and beyond. Journal of nephrology, 26(6), 960–974. https://doi.org/10.5301/jn.5000284
  • N. Ranganathan, P. Ranganathan, E. A. Friedman et al., “Pilot study of probiotic dietary supplementation for promoting healthy kidney function in patients with chronic kidney disease,” Advances in Therapy, vol. 27, no. 9, pp. 634–647, 2010.

  • Iwashita Y, Ohya M, Yashiro M, Sonou T, Kawakami K, Nakashima Y, Yano T, Iwashita Y, Mima T, Negi S, Kubo K, Tomoda K, Odamaki T, Shigematsu T. Dietary Changes Involving Bifidobacterium longum and Other Nutrients Delays Chronic Kidney Disease Progression. Am J Nephrol. 2018;47(5):325-332. doi: 10.1159/000488947. Epub 2018 May 18. PMID: 29779028.


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