About Kidney Disease

Darlene, can you lend a hand here?  And anyone else with information, please!

There was an inquiry about kidney disease after I posted on the asparagus thread.  I tried to email Katherine B.  but couldn't  so here is my reply:

I am just beginning to research kidney disease, also called kidney failure renal disease, renal failure,, it turns out to be a silent killer.  From what I can gather, we start out our lives with extra kidney capacity but that doesn't always last.  People with two healthy kidneys can even donate one, allowing two bodies to be healthy. 

Age, high blood pressure (hypertension), diabetes, obesity, all reduce the efficiency of the kidneys, which may not ever matter.  However, the kidney disease which "normal" folks don't even notice can cause problems if there are health issues causing the kidneys to work harder.

Heart catheterization requires dye in the bloodstream.  The kidneys must then clean this out, and diseased kidneys can't do a very good job of it.  My father just went through this.  At stage 3b kidney disease (worst is stage 4, requiring dialysis and leading to death)  special measures had to be taken and there was still a threat of dialysis.

I started researching what steps could be taken, and found that there are a few foods that are particularly hard on the kidneys, one being asparagus.  Some medications are tougher than others for kidneys to deal with as well. 

When I started researching this, I looked back at my numbers and found that I am at stage two.  I am told that if I treat my kidneys well, that should not ever be a health factor. Just one more reason to eat right, and be an informed medical consumer.  www.nlm.nih.gov/medlineplus/kidneyfailure.html  and  www.healthandage.com/html/min/eama/eama4/publi/0101010087/sl d001.htm#top  are two sites I visited.

I'm not trying to scare anyone, but this is not something I was informed about before.  I cannot find any indication that it can be reversed, just that  treating the above-listed conditions will slow its progression. 

Diet - chronic kidney disease

MedlinePlus Topics

Kidney Diseases

When you have chronic kidney disease, you need to make changes in your diet, including:

• Limiting fluids
• Eating a low-protein diet (this may be recommended)
• Restricting salt, potassium, phosphorous, and other electrolytes
• Getting enough calories if you are losing weight

Your recommended diet may change over time if your kidney disease gets worse, or if you need dialysis.

Function

The purpose of this diet is to maintain a balance of electrolytes, minerals, and fluid in patients who are on dialysis. The special diet is important because dialysis alone does not effectively remove ALL waste products. These waste products can also build up between dialysis treatments.

Most dialysis patients urinate very little or not at all. Therefore, fluid restriction between treatments is very important. Without urination, fluid will build up in the body and lead to excess fluid in the heart, lungs, and ankles.

Recommendations

Ask for a referral to a registered dietitian for diet information about kidney disease. Some dietitians specialize in kidney diets. Your dietitian can help you create a diet to fit your specific needs.

The Kidney Foundation has chapters in most states. It is an excellent resource for programs and educational materials to help people with kidney disease and their families.

Your daily calorie intake needs to be high enough to keep you healthy and prevent the breakdown of body tissue. Ask your doctor and dietitian what your ideal weight should be, and weigh yourself every morning.

CARBOHYDRATES

If you are overweight or have diabetes, you may need to limit the amount of carbohydrates you eat. Talk with your doctor, nurse, or dietitian.

Otherwise, carbohydrates are a good source of energy for your body. If your health care provider has recommended a low-protein diet, you may replace the calories from protein with:

• Fruits, breads, grains, and vegetables. These foods provide energy, as well as fiber, minerals, and vitamins.
• Hard candies, sugar, honey, and jelly. If needed, you can even eat high-calorie desserts such as pies, cakes, or cookies, as long as you limit desserts made with dairy, chocolate, nuts, or bananas.

FATS

Fats can be a good source of calories. Make sure to use monounsaturated and polyunsaturated fats (olive oil, canola oil, safflower oil) to help protect your arteries. Talk to your doctor, nurse, or dietitian about fats and cholesterol that may increase your risk for heart problems.

PROTEIN

Low-protein diets may be helpful before dialysis. Your doctor or dietitian may recommend a moderate-protein diet (1 gram of protein per kilogram of body weight per day).

Once you start dialysis, you will need more protein. In fact, a high-protein diet with fish, poultry, pork, or eggs at every meal may be recommended. This will help you replace muscles and other tissues that you lose.

People on dialysis should eat 8 - 10 ounces of high-protein foods each day. Your doctor, dietitian, or nurse may suggest adding egg whites, egg white powder, or protein powder.

CALCIUM AND PHOSPHOROUS

Calcium and phosphorous, two other important minerals in the body, are also monitored closely. Even in the early stages of chronic kidney disease, phosphorous levels in the blood can become too high. This can cause:

• Low calcium (this causes the body to pull calcium from your bones, which can make your bones weaker and more likely to break)
• Itching

You will need to limit the amount of dairy foods that you eat. This includes milk, yogurt, and cheese. Some dairy foods are lower in phosphorous, including tub margarine, butter, cream cheese, heavy cream, ricotta cheese, brie cheese, sherbet, and nondairy whipped toppings.

Fruits and vegetables contain only small amounts of phosphorous.

You may need to take calcium supplements to prevent bone disease, and vitamin D to control the balance of calcium and phosphorous in your body. Ask your doctor, nurse, or dietititan.

If dietary measures to lower phosphorous are not enough, your doctor may recommend "phosphorous binders."

FLUIDS

In the early stages of chronic kidney disease, you do not need to limit how much fluid you drink. As your kidney disease becomes worse or when you are on dialysis, you will need to watch how much you drink. In between dialysis sessions, fluid can build up in the body.

Your doctor and dialysis nurse will let you know how much you should drink every day. Do not eat too much of foods that contain a lot of water, such as soups, Jell-O, popsicles, ice cream, grapes, melons, lettuce, tomatoes, and celery.

Use smaller cups or glasses and turn over your cup after you have finished it.

Tips to keep from becoming thirsty include:

• Avoid salty foods
• Freeze some juice in an ice cube tray and eat it like a popsicle (you must count these ice cubes in your daily amount of fluids)
• Stay cool on hot days

SALT OR SODIUM

Reducing sodium in your diet helps you control high blood pressure, keeps you from being thirsty, and prevents your body from holding onto extra fluid. A low-salt diet is usually needed.

Look for these words on food labels:

• Low-sodium
• No salt added
• Sodium-free
• Sodium reduced
• Unsalted

Check all labels to see how much salt or sodium foods contain per serving. Also, avoid foods that list salt near the beginning of the ingredients. Look for products with less than 100 mg of salt per serving.

Do not use salt when cooking and take the salt shaker away from the table. Most other herbs are safe, and you can use them to flavor your food instead of salt.

DO NOT use salt substitutes because they contain potassium. People with chronic kidney disease also need to limit their potassium.

POTASSIUM

Normal blood levels of potassium help keep your heart beating steadily. However, too much potassium can build up when the kidneys no longer function well. Dangerous heart rhythms may result.

Potassium is found in many food groups, including fruits and vegetables. Choosing the right item from each food group can help control your potassium levels.

When eating fruits:

• Choose peaches, grapes, pears, cherries, apples, berries, pineapple, plums, tangerines, and watermelon
• Limit or avoid oranges and orange juice, nectarines, Kiwis, raisins or other dried fruit, bananas, cantaloupe, honeydew, prunes, and nectarines

When eating vegetables:

• Choose broccoli, cabbage, carrots, cauliflower, celery, cucumber, eggplant, green and wax beans, lettuce, onion, peppers, watercress, zucchini, and yellow squash
• Limit or avoid asparagus, avocado, potatoes, tomatoes or tomato sauce, winter squash, pumpkin, avocado, and cooked spinach

IRON

Patients with advanced kidney failure usually need extra iron.

Many foods contain extra iron (liver, beef, pork, chicken, lima and kidney beans, iron-fortified cereals). Because of your kidney disease, talk this over with your doctor, nurse, or dietitian.

Alternative Names

Renal disease - diet; Kidney disease - diet

References

National Kidney Foundation. Dietary Guidelines for Adults Starting on Hemodialysis. 2009. Accessed September 22, 2009.

Eat right to feel right on hemodialysis. NIH Publication No. 08-4274. August 2008. Accessed September 23, 2009.

Mitch WE. Chronic kidney disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 131.

Update Date: 10/5/2009

Updated by: Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

See area I marked in Red

I should know more about it than I do.  My husband's mother was on dialysis for 17 years before she died.  His sister has had a transplant.  His aunt (mother's sister) has had a transplant.  His uncle (mother's brother) was on dialysis.  His other sisters (3 of them) are all in the beginning stages of renal failure.  Quite a family history!

He has been tested and has a nephrologist (who has had everyone as his patient) that he sees once a year, but so far his kidneys are fine....just a slight decline in function and that is more due to his age than anything.  The doctor told him he would die at the age of 92 from a jealous husband. LOL

Our kids are very much aware of the family history and always remind their doctor when they have annual physicals to check this when they do blood work.  So far, so good for them. 

I do know that there are foods that they couldn't have and low sodium was a must.  Seems as if there was a Vitamin K issue, but I don't remember if they were supposed to avoid that or consume more.  None of these family members lived very close to us, so I wasn't as aware as I could have been about all of it. 

Take care of yourself!

Wanda

Thanks, folks, I knew Darlene could come through!  Anyone else have experience with this?

Hi, Jane - Thank you for all this info - and thanks, Darlene, too.

I am stage one - and this start just before my lapband - I checked my past 5 bloodwork reports.
The chart says you should be more than 59 on the level I was checking - gmbh?  Something like that.  My last test was 52.  So I dont think I can blame this on my lapband diet - which is very high in protein (60-70) and lots of liquids - which Darlene's article said is ok at the beginning. Low
salt, healthy foods of course.

I'm going to go to a kidney dr after my next bloodtest end May.

I'll check out your links and thanks again for all your info.

Katherine B