The importance of diet for chronic kidney disease patients
Diet control is crucial for CKD patients because it helps:
- delay kidney deterioration
- postpone the stage that dialysis is necessary
- alleviate the burden of kidneys in getting rid of waste products
- mitigate the workload of kidneys
- reduce the buildup of waste products from food
- prevent malnutrition
- improve patient's health and quality of life
Nutrients that have an impact on kidney disease
When renal patients are at the stages in which kidneys do not function efficiently, or when blood test results come out abnormal, patients should be advised about foods that they need to avoid or restrict. Certain nutrients cause health problems when consumed excessively because they leave too much waste products in the body. Important nutrients in food that normally have negative impacts on kidney disease are:
- Sodium Our body needs sodium in small amounts to control blood pressure. In renal patients, kidneys cannot remove excessive sodium, resulting in fluid retention and swelling. This condition leads to hypertension, pleural effusion and may cause heart failure.
Food to avoid or limit: sodium-rich food; for example, salted fish, ham, bacon, sausages, pickled food, salted snacks and cheese. In addition, foods that are not salty but contain sodium should also be avoided, such as bread that contains sodium bicarbonate.
- Potassium is a mineral that makes muscles and nerves work properly. When kidney function reduces, the ability to remove potassium through urine is decreased, leading to potassium accumulation. When the potassium level is too high, muscles get weak or cramp, and patients may experience irregular heartbeat. Patients in early stages of kidney disease (eGFR >90 mL/min/1.73m2) and middle stages (eGFR 30-59 mL/min/1.73m2), whose kidneys still remove waste and whose potassium level in the blood is considered moderate or at 3.5-5.0 milligrams/deciliter, may continue to consume fruits and vegetables. However, renal patients whose level of potassium in the blood is nearly or over 5.0 milligrams/deciliter need to control fruits and vegetables consumption. Patients in this group can eat fruits and vegetables that are low in potassium once or twice per day. Vegetables and fruits low in potassium include cabbage, cauliflower, cucumber, lettuce, sprouts, grape and pineapple.
Food to avoid or limit: potassium-rich food; for example, all kind of dried fruits, durian, tamarind, cantaloupe, Tahitian noni juice, tomato, green leafy vegetables, turnip, bananas, oranges, papaya and jackfruit.
- Phosphorus When the kidneys fail, our body is unable to absorb calcium and remove phosphorus. Therefore, the body receive only small amount of calcium but retain too much phosphorus in the blood.
Food to avoid or limit: bran, cheese, milk and dairy products, sweetened condensed milk, fish roe, egg yolk, shrimp, crab, products that contain sodium bicarbonate, nuts, dried beans and dark-color soda.
- Protein is a nutrient that our body needs. Even renal patients must consume foods that provide protein, but in limited amount. When the body breaks down and absorbs protein from food, waste products are produced in the process and excreted through kidneys. Eating too much protein makes the kidneys work hard, which is why renal patients should limit amount of foods protein-rich foods, both from plant and animal.
Food to avoid or limit: meat and protein with fat and cholesterol such as yolk, entrails and giblets, pork skin, chicken and duck skin, pork and beef with fat, fatty spareribs, barbecued suckling pig, Peking duck, streaky pork, crackling pork, roasted duck, geese stewed in pa-lo gravy, fish roe and prawn roe. In addition, meat that lacks essential amino acids should also be avoided because it makes kidney work hard in getting rid of waste products. Meat in this group includes sinew of pig, cow and chicken, shark fins, feet of duck and chicken, skin, cartilage, nuts, dried beans and food stuffed with nuts.
Dietary Recommendations
- Eat a variety of food in each meal. Be certain to include rice, meat, vegetables and fruits.
- Chronic kidney disease patients must refrain from artificial seasoning sauce, artificial salt, artificial soy sauce, and artificial fish sauce. Use spices to enhance the flavor instead.