Eating right is not just required to prevent diseases but also to manage various disease conditions.
Diet is considered the most crucial factor in maintaining overall health. A diet chart for kidney patients is a valuable tool that provides essential information about foods to be included and avoided.
However, various kidney diseases require specific treatment, and no general diet chart can fulfil the requirements of every renal condition.
Here are some dietary factors to be considered to keep the diseased kidneys functioning properly.
Overview
A kidney or renal diet is essential for people with impaired kidney function. Kidney dysfunction results in an increased amount of waste in the blood. This is due to the inability of the kidneys to filter or remove wastes.
Waste in the blood can have a negative impact on a patient’s electrolyte levels. A renal diet may also help promote kidney function and slow the progression of kidney failure.
Since the body and its metabolism vary with each individual, it is critical for a patient with kidney disease to consult a renal dietitian to develop a diet that is tailored to the patient’s needs.
Foods for Kidney patients
Cauliflower
Cauliflower is considered a versatile vegetable. Less potassium and sodium levels in cauliflower help maintain the fluid balance in the body.
This vegetable is also helpful in detoxifying the kidney by removing toxins and is a potent antioxidant which helps in the proper kidney functioning.
- Phosphorus - 47.33 mg
- Potassium - 329 mg
- Sodium - 30.72 mg
Cabbage
Cruciferous vegetables, in particular, are kidney-friendly foods. Cabbage is high in vitamin C, K, B6, folic acid and fibre.
It’s an inexpensive option for the kidney diet because of its low potassium content. Raw cabbage is an excellent addition to the dialysis diet.
- Phosphorus - 30.15 mg
- Potassium - 233 mg
- Sodium - 14.98 mg
Blueberries
Blueberries are a low potassium fruit option. They are also relatively low in sodium and phosphorus, making them an excellent choice for a kidney-friendly diet.
This fruit is safe to consume when a patient has any of the following kidney conditions.
- Kidney stones
- Hemodialysis for ESRD/CKD
- Peritoneal Dialysis/Nocturnal Hemodialysis
- Phosphorus - 12 mg
- Potassium - 77 mg
- Sodium - 1 mg
Egg whites
Although egg yolks are nutritious, they are high in phosphorus. This makes egg whites more preferable to egg yolks for kidney patients. Egg whites are a high-quality, kidney-friendly protein source.
Furthermore, they are an excellent choice for dialysis patients with higher protein needs but must limit phosphorus.
- Phosphorus - 5 mg
- Potassium - 163 mg
- Sodium - 166 mg
Garlic
According to an Elsevier article, garlic is an excellent nutritional food ingredient for use in a ‘Food as Medicine’ approach for chronic kidney disease due to its potent anti-inflammatory and antioxidant properties (CKD).
- Phosphorus - 116 mg
- Potassium - 453 mg
- Sodium - 10.56 mg
Fish
Fish is recommended in a renal diet due to their high protein content. Omega-3 fatty acid-rich fish can help lower triglyceride levels in the blood vessels, heart and kidneys.
In addition, omega-3 fatty acids lower blood pressure in people with kidney disease.
- Phosphorus - 211 mg
- Potassium - 345 mg
- Sodium - 20.25 mg
Onions
The high vitamin C, calcium and phosphorous in onions can be beneficial to people who have elevated creatinine levels and poor kidney function.
Onions also contain prostaglandin, which naturally lowers blood viscosity. It also aids in lowering high blood pressure, which slows the progression of kidney disease.
In addition, onions contain the antioxidant quercetin, which protects the kidneys from free radical damage and helps in detoxification. While recovering from a kidney condition, onion is one food to be included in the diet.
- Phosphorus - 39.65 mg
- Potassium - 160 mg
- Sodium - 4.06 mg
Diet chart for kidney patients
The following is just a sample meal plan for a kidney patient. However, consulting a dietitian is necessary to get a personalised diet plan according to a specific disease condition and anthropometric measurements of an individual.
| MEAL TIMING | MENU | QUANTITY |
| Breakfast | Broken wheat upma Egg whiteChutney of choice | 200 g2 Nos2 - 3 Tsp |
| Mid-morning | Fruit of choice (Preferably Apple, Grapes, Pear) | 100 g |
| Lunch | Chapathi + RiceLeached vegetablesRasam (less tomato)Vegetable gravy(Note: No papad/pickle) | 2 Nos + 200 g200 g100 ml50 g |
| Snacks | Millet BiscuitsTea/Coffee | 2 Nos100 ml |
| Dinner | Rava Idly/ DosaOnion Chutney | 3 Nos3 Tsp |
How can I follow a kidney-friendly eating plan?
A kidney-friendly diet plan is possible by monitoring the intake of macronutrients like carbohydrates, protein and fat and micronutrients like phosphorus, sodium and potassium. Sticking to the nutrient recommendation can prevent disease progression.
Protein
Protein is often connected to kidney function. Normally, protein is ingested, and waste products are produced, which are then filtered by the kidney’s nephrons.
The waste is then converted into urine. Damaged kidneys fail to remove protein waste, leading to accumulation in the blood.
Protein consumption is difficult for chronic kidney disease patients because the amount varies depending on the stage of the disease.
Protein is required for tissue maintenance and other bodily functions, so it is vital to consume the amount recommended by the nephrologist or renal dietician for the specific stage of the disease.
According to NKF - DOQI guidelines, protein recommendations for various kidney conditions are as follows:
- Chronic Kidney Disease - 0.6–0.8 g/kg/day
- Chronic renal failure without dialysis - 0.60 g/kg/day, increase to 0.75 g/kg/day if not tolerated
- Hemodialysis - 1.2 g/kg/day
- Chronic peritoneal dialysis - 1.2-1.3 g/kg/day
- Kidney stones - 0.8-1.0 g/kg/day (PubMed)
Fat
It is critical to choose unsaturated, healthy fats over saturated and trans fats to protect both the kidney and the heart.
According to uptodate.com, < 30 % of total calories must come from fat and < 10 % of total fat should come from saturated fat.
Carbohydrates
High carbohydrate intake has been linked to insulin resistance and obesity. Given how Diabetes and obesity are linked to an increased risk of CKD, a low carbohydrate diet may help manage kidney function.
Nonetheless, more research is needed to demonstrate the direct impact of carbohydrates on kidney function.
Potassium
People with chronic kidney disease should limit their potassium intake because their kidneys cannot process potassium properly, causing it to accumulate in the blood. Potassium levels can be raised by medications used to treat kidney disease.
American Kidney Foundation allows for 2000 mg of potassium per day in a potassium-restricted diet.
Phosphorous
High phosphorus levels have been shown to harm the kidneys and cause kidney function loss directly. This loss of function raises the possibility of kidney failure.
People with Chronic Kidney Disease (CKD) have difficulty removing phosphorus. Phosphorus levels that are too high can harm the body. Excess of this mineral causes body changes that pull calcium out of the bones and weaken them.
Daily phosphorus recommendation for a kidney patient is 800 mg per day. There may also be health benefits for people who reduce their phosphorus intake below their current intake.
Sodium
Extra sodium in the urine is excreted by healthy kidneys. When kidney disease occurs, the body is unable to eliminate sodium, and it can accumulate.
Excess sodium can lead to fluid accumulation in the body, resulting in swelling in the legs, feet, ankles, hands, abdomen and face. It also causes increased weight, shortness of breath and elevated blood pressure.
Patients suffering from hypertension and chronic kidney disease (CKD) must limit their salt and sodium intake to keep their blood pressure under control and to keep extra fluid from accumulating in the body and causing swelling.
According to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) guidelines, the sodium recommendation for non-dialysis CKD patients is < 2.3 g/day.
The NKF KDOQI recommends that hemodialysis patients should consume no more than 2 g of sodium per day.
Proper diet plan for kidney patients
Energy
Adults should consume approximately 35 kcal/kg/day in order to save protein for tissue repair and maintenance. A Diet plan should meet the individual’s energy requirement.
Some energy adjustments should be made to normalise requirements in significantly overweight patients.
Reduced risk of infection
A proper diet plan for kidney patients should reduce the risk of infection.
People with kidney disease may be more susceptible to infection due to associated conditions such as Diabetes, insufficient calorie and protein intake, and an infection-prone access site such as dialysis. Consuming enough calories, protein and nutrients strengthen the body’s immune system and wards off infections.
Healthier body weight
Body weight determines the overall health of a person. Maintaining a healthy weight through diet can help people with kidney disease control their symptoms and avoid further health problems.
Blood pressure and blood sugar levels usually improve when excess weight is lost. This may postpone or prevent further kidney damage.
When people add calories to their diet, they can prevent malnourishment and muscle loss and gain energy for daily activities.
Decreased risk of disease progression
A good, kidney-friendly diet plan reduces the risk of disease progression by providing immunity through nutritional foods. A balance of nutrients has a role in kidney function like protein, potassium, sodium and phosphorus.
Foods with less sodium (salt)
Although sodium is necessary for body functions, too much of the mineral can be harmful to people with kidney disease since the kidneys cannot remove excess sodium and fluid from the body. This results in fluid accumulation in the body.
So, choosing foods with minimum sodium/ salt content is advisable. This is possible by
- Using herbs and spices for flavour while cooking
- Choosing fresh fruits or vegetables instead of canned vegetables
- Requesting the restaurant chef not to add salt to the food ordered.
Do’s And Don’ts for kidney patients
DO’S
Limit fluid intake
Fluid restriction is necessary for people with later stages of CKD and those on dialysis as the kidney cannot filter excess fluid. People with kidney stones, however, should consume adequate fluids.
Keep a food diary
A food diary helps monitor the foods and liquids consumed by a patient along with the quantity. This can be used by a healthcare professional to evaluate and make modifications to the diet plan.
Choose low potassium foods.
Low potassium fruits and vegetables like apples, grapes, beans, cruciferous vegetables, onion and radish can be included in the renal diet. Certain vegetables can also be leached before use to reduce potassium levels.
DONT’S
Avoid sodium-rich foods
High sodium foods like salt, seasoning, sauce, chips, pickles, fast foods, processed and canned foods and foods containing preservatives are to be avoided by a kidney patient.
Avoid foods rich in phosphorus
High phosphorus foods to avoid include dairy foods, lentils, nuts, oatmeal, processed meats and beverages.
Avoid high potassium foods that cannot be leached.
Potassium-rich foods are to be restricted in a renal diet. Though certain vegetables can be leached, fruits and a few other ingredients cannot be leached. These foods should be avoided.
High potassium foods to be avoided include banana, avocado, potato and coconut water.
Avoid high sugar foods
According to a PubMed article, sugar consumption raises the risk of CKD. Therefore, avoiding sweets, sugary foods and snacks with sodium and potassium are advisable.
Foods to include in the diet
Cereal & cereal products
- Parboiled rice
- Brown rice
- Unpolished rice
- Cornflakes
Pulses & legumes
- Chickpeas
- Bengal gram dhal
- Toor dhal
Fruits & vegetables
- Apple
- Grapes
- Cabbage
- Cauliflower
- Berries
- Onions
- Carrot
Conclusion
Most common kidney diseases include kidney stones, Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), End-Stage Renal Disease (ESRD) and Kidney cancer.
Health insurance for kidney stones has become prominent recently as it protects you with financial aid and provides comprehensive coverage against treatment and surgery costs.
The nutrient requirement and restriction vary for each kidney disease, so a customised diet plan is best for any patient.
With no proper diet plan, the disease may progress and result in kidney failure. It is crucial for the patient to know about the foods to be included and avoided to choose suitable options while ordering out.
A doctor or dietitian consultation is mandatory to get the right amount of nutrients.
