The kidneys remove wastes and extra water from the blood and make urine. To keep the body working properly, the kidneys balance the salts and minerals such as calcium, phosphorus, sodium and potassium, which circulate in the blood. The kidneys also release hormones that help make red blood cells, regulate blood pressure and keep bones strong.

(Read more: Right time to check blood pressure)

When your kidney is not able to function properly, it is not able to filter or remove waste as well as required. If waste is left in the blood, it can negatively affect a patient’s electrolyte levels and other functions. Following a kidney diet may also help promote kidney function and delay complete kidney failure.

(Read more: Electrolyte Imbalance)

There are five stages of chronic kidney disease. Your doctor determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your level of kidney function. Your treatment, diet and fluid intake are based on your stage of kidney disease.

  1. Chronic kidney disease diet: foods to avoid
  2. Chronic kidney disease diet: foods to eat
  3. Manage other complications
  4. Say no to herbal supplements
  5. Chronic Kidney Disease Diet Chart
  6. Doctors for Chronic Kidney Disease Diet and Diet Plan

There are a few minerals that you should watch the consumption of those in chronic kidney disease. 

Eat less salt or sodium

You should reduce the amount of salt/sodium in your diet. Over time, your kidneys lose the ability to control your sodium-water balance. Less sodium in your diet will help lower blood pressure and decrease fluid buildup in your body, which is common in kidney disease. Opt for fresh, homemade food and avoid restaurant and packaged foods since they usually contain a lot of sodium. Always read the nutrition labels whenever you are buying your food and look for low sodium (5% or less) on food labels. Try to replace salt with herbs, spices such as black pepper, oregano, mustard, etc. Don’t use salt substitutes because many of them are very high in potassium, which you also need to limit. To watch your salt intake:

  • Avoid table salt, salted seasonings
  • Say no to chips, namkeen, biscuits, french fries, pizza, burger and bakery products
  • Avoid ketchup, sauce, jam, jelly, cake, pastry, namkeen and biscuits
  • Limit packaged food items such as juice, breakfast cereals, ready to eat meals

Limit the potassium-rich food

The right level of potassium keeps your nerves and muscles working well. With kidney disease, too much potassium can build up in your blood and cause serious heart problems. Foods that are rich in potassium should be avoided, including the following: 

Manage water intake

Fluid control is important for patients in the later stages of CKD as normal fluid consumption may cause fluid build-up in the body, which could become dangerous. To know about the total water intake, consult your nephrologist or nutritionist with your latest kidney function test, microalbumin test and urine creatinine ratio reports.

When you have kidney disease, following are the foods you can include safely in your diet: 

The right amount and the right types of protein

You can become very sick if urea builds up in your blood, which happens when your kidneys are not healthy. Some sources of protein produce less waste than others. These are called high biological value proteins. High biological value proteins come from meats, fish, poultry, eggs, and milk. Getting most of your protein sources from these can reduce the amount of urea in your blood. Not including enough protein in your diet can be equally harmful so it is essential to have just the right amount of it. The guideline for when not on dialysis (Stage 2-4) is to eat less protein, meaning about 0.8 grams/kg. The recommendation for when on dialysis (Stage 5) is to eat more protein, meaning about 1.2-1.3 grams/kg. You should consult with your doctor and nutritionist about your kidney parameters so they can make a customized diet plan for you. 

(Read more: Protein deficiency

Good fat intake

Eating the wrong kinds of fat or eating too much of it can increase the risk of clogged blood vessels and heart problems. Fat provides energy, helps produce hormone-like substances that regulate blood pressure and other heart functions and carries fat-soluble vitamins. Everyone needs dietary fat but some fats are healthier than others. People with CKD are at higher risk of having a heart attack or stroke. Therefore, people with CKD should be especially careful about how dietary fat affects their heart health. 

Saturated and trans fat can raise blood cholesterol levels and clog blood vessels. Saturated fats are found in animal products such as red meat, poultry, whole milk and butter; it is best to avoid these foods. You can use different types of plant-based oils such as olive oil, sunflower oil and canola oil. They are much healthier sources compared to animal fat. 

Fruits for kidney disease

Most people get enough antioxidants and vitamins to stay healthy by eating a wide variety of fruits each day. However, if you have CKD, you will need to avoid certain kinds of fruits that can make your condition worse. The fruits you can include in your regular diet are grapes, cherries, apples, plums, papaya, cranberries, blueberries, raspberries and pears.

Vegetables for kidney disease

Vegetables are good sources of vitamins, minerals, fiber and antioxidants, all of which help us with our bodily functions. But if you have CKD, there are some restrictions in electrolytes that you need to keep in mind. Vegetables that you can safely add to your daily diet are cauliflower, onions, eggplant, turnips, cabbage, carrots, corn, cucumber, capsicum and water chestnut

If you have diabetes, high blood pressure or heart disease, the best way to protect your kidneys from damage is to keep blood glucose numbers close to your goal. Getting regular blood sugar (glucose) tests is an important way to manage your diabetes. You should also try to keep your blood pressure numbers close to your goal. You can discuss what your personal goals for these health measures should be with your doctor.

Herbal supplements aren’t safe if you have CKD. Some herbal supplements can hurt your kidneys and even make kidney disease worse. Some vitamins can cause kidney problems too and should also be avoided. Always talk to your doctor before introducing any dietary supplements or multivitamins in your routine.

Following is a sample of what your daily diet should look like: 

  • Early morning: Tea (1 cup) + roasted chana (1 handful)
  • Breakfast: Vegetable Poha (1 small plate) + milk (1 cup)
  • Mid meal: Papaya (1 small bowl)
  • Lunch: Chapati (2) + curd (1 bowl) + cooked bottle gourd (1 bowl) 
  • Evening Tea: Tea (1 cup) + grilled paneer (4-5 small pieces) / boiled egg (1)
  • Dinner: Chapati (2) + paneer curry (4-5 pieces) + cooked cabbage (1 bowl) 
  • Bedtime: Low-fat milk (1 cup) 
Dt. Rajni Sharma

Dt. Rajni Sharma

Dietician
6 Years of Experience

Dt. Ayushi Shah

Dt. Ayushi Shah

Dietician
2 Years of Experience

Dr. Yogita Johar

Dr. Yogita Johar

Dietician
1 Years of Experience

Dt. Miksha Arora

Dt. Miksha Arora

Dietician
2 Years of Experience

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References

  1. Akchurin Oleh M. Chronic kidney disease and dietary measures to improve outcomes. Pediatr Clin North Am. 2019 Feb; 66(1): 247–267. PMID: 30454747.
  2. Rysz Jacek, Franczyk Beata, Ciałkowska-Rysz Aleksandra, Gluba-Brzózka Anna. The Effect of Diet on the Survival of Patients with Chronic Kidney Disease. Nutrients. 2017 May; 9(5): 495. PMID: 28505087.
  3. Ko Gang Jee, Obi Yoshitsugu, Tortoricci Amanda R., Kalantar-Zadeh Kamyar. Dietary Protein Intake and Chronic Kidney Disease. Curr Opin Clin Nutr Metab Care. 2017 Jan; 20(1): 77–85. PMID: 27801685.
  4. Clase Catherine M., Smyth Andrew. Chronic kidney disease: diet. BMJ Clin Evid. 2015; 2015: 2004. PMID: 26121377.
  5. Clegg Deborah J., Headley Samuel A., Germain Michael J. Impact of Dietary Potassium Restrictions in CKD on Clinical Outcomes: Benefits of a Plant-Based Diet. Kidney Med. 2020 Jul-Aug; 2(4): 476–487. PMID: 32775988.
  6. Natale Patrizia, Palmer Suetonia C, Ruospo Marinella, Saglimbene Valeria M, Strippoli Giovanni Fm. Potassium binders for chronic hyperkalaemia in people with chronic kidney disease. Cochrane Database Syst Rev. 2020 Jun 26;6(6):CD013165. PMID: 32588430.
  7. Carlo Garofalo et al. Dietary Salt Restriction in Chronic Kidney Disease: A Meta-Analysis of Randomized Clinical Trials. Nutrients. 2018 Jun; 10(6): 732. PMID: 29882800.
  8. National Kidney Foundation. [Internet]. New York, US. 6 Tips To Be “Water Wise” for Healthy Kidneys.
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