Mastering Chronic Kidney Disease Nutrition: Strategies for Renal Health

If you’ve been diagnosed with chronic kidney disease or renal insufficiency, you may feel lost and overwhelmed. How do I manage it? Will I need dialysis? A transplant? The reality of CKD is that everyone is different. For some, GFR may stay the same for a very long time. For others, it may drop quickly, needing more treatments sooner. Because it is different for everyone, CKD nutrition goals can also vary greatly. 

What is Chronic Kidney Disease and GFR?

What is CKD?

Chronic Kidney Disease means that your kidneys are having trouble doing the jobs they are supposed to for the body, like filtering blood to remove waste and maintaining the body’s balance. The damage to the kidneys means that the waste can build up in the body, blood pressure may rise, and vitamin D absorption decreases.

Risk Factors for Chronic Kidney Disease

Risk factors for CKD include:

• Diabetes
• High blood pressure
• Age
• Genetics/Race

What is GFR?

GFR stands for glomerular filtration rate. Basically, this is a way to measure how well your kidney is working. Normal GFR is somewhere around 100, which means your kidneys are working at 100%. If your GFR is 75, then your kidneys are functioning at about 75%. If you find out your GFR is less than 60, you should make an appointment with a nephrologist, a kidney specialist, so they can take a closer look at your kidneys.

What can you do to prevent Chronic Kidney Disease?

You may not be able to prevent CKD. There are so many causes and factors that go into our health and diseases. But if you have diabetes, it is important to manage your blood sugar. If you have hypertension, it is important to manage your blood pressure. Some medications can lead to the decline of kidney function, so talk to your doctor if you are concerned about your kidney health. 

Medications

Some medicines, like NSAIDs (Advil), can be damaging to the kidneys and hinder progress.

Chronic Kidney Disease Nutrition

Because everyone is different, nutrition goals can vary greatly. That means the info you find online might not fit your needs– it could be overly restrictive or just plain inaccurate for you. We do our best to educate through our blogs; however, we highly suggest adding a dietitian to your treatment team because of how individualized CKD nutrition can be.

There are several nutrition-related factors when it comes to managing CKD.

Sodium

In most circumstances with CKD, limiting sodium is an appropriate goal. Sodium is everywhere in processed, convenience, and restaurant foods. That doesn’t mean you have to avoid them, but it is important to recognize how much sodium is in your day to day diet and prioritize low sodium foods for CKD. In general, a good goal for sodium is between 1500-2000 mg per day. When reading nutrition facts labels, if the sodium content of a single food item is less than 230 mg, that’s considered low. If the food is going to be the entire meal (like soup for example), and the sodium is between 500-600 mg, that’s still decent and can work in the daily goal of 1800 mg of sodium. 

Hydration

Drinking adequate water and fluids is typically helpful for kidney function. Water can get a little monotonous though, so add variety into your day with different kidney friendly drinks. Fluid goals are different for everyone, and later stages of CKD and dialysis may require a fluid restriction. It is important to talk to your treatment team to determine your specific fluid needs. 

Protein

It may be appropriate for you to limit your intake of protein, or opting for more plant based protein rather than animal based protein. However, if on dialysis, your protein needs change drastically. The low protein diet is appropriate for stages 1-4. Once on dialysis, a high protein diet is necessary.

Animal sources of protein are rich in protein, which means a higher amount of urea and nitrogenous waste is created (which needs to be processed by the kidneys). You may see BUN (or blood urea nitrogen) becoming elevated.

You can reduce your intake of animal proteins (meat, poultry, fish, egg, cheese, yogurt) and also opt for some plant proteins (tofu, lentils, beans, nuts, nut butter, hummus), as they have less protein and therefore produce less urea and nitrogen. 

Potassium

Potassium and kidney disease is a common discussion point for nutrition counseling. If you have elevated potassium in your blood work, you will need to limit your intake of high potassium foods. A potassium restriction is typically 2000-2500 mg of potassium per day. However, if your potassium is (and has been) normal, then you don’t need to be too restrictive of your potassium intake. 

If your potassium is trending upward, try  limiting high-potassium foods first like potatoes, bananas, tomato products, and orange juice.  

Phosphorus

Phosphorus and kidney disease is another common topic of discussion. Like potassium, if phosphorus is elevated in your blood work, you may need to limit high phosphorus foods. If your phosphorus is normal, you do not need to be restrictive of phosphorus foods. If your phosphorus is trending upward or is high, try reading the nutrition facts label for phosphorus additives. “Phos” in the ingredient list means inorganic phosphorus has been added to the food and you will absorb much more of this phosphorus than you would the naturally occurring phosphorus in things like whole grains, beans, and nuts. 

What to Eat with CKD

“What to eat with CKD” is a complex question because of the different needs, depending on the person and labs. While fast food and restaurant meals are ok occasionally, the sodium content is going to be a problem. Cooking low sodium foods at home is going to be the best option. 

For meals, general idea of “MyPlate” is good for kidney disease. Half of your plate should be fruits and vegetables (low potassium if applicable), a quarter of the plate is grains (whole grains if potassium and phosphorus are normal), and a quarter of the plate can be protein. For the protein, you want to be mindful of the portion. It can be helpful to work with a dietitian to determine how much protein is appropriate for you. 

For renal friendly snacks, try options that are low in sodium and low in protein  to leave your higher protein foods for mealtime. Low sodium snack foods (like crackers, popcorn, graham crackers, cookies, corn chips, rice cakes), fruit or vegetables, and depending on the person, you can pair with something like hummus, a small portion of nuts or nut butter, cream cheese, yogurt, or dairy free yogurt. 

If you are looking for more personalized nutrition information, we suggest meeting one on one with a renal dietitian from our team!