Author: admin

Diet for Chronic Kidney Disease

Diagnosed with Chronic Kidney Disease (CKD), need not worry about your diet!

Let not the thought of a restrictive diet haunt you!!

Yes, it does need changes but slowly and gradually, you can adapt to it.

We can walk you through some tips that can help you select your food items wisely and then we shall look into some kidney friendly recipes too!

Few tips for diet in CKD:

1. Salt restriction: It is of prime importance in CKD. Salt and fluid restriction are needed to avoid complications of CKD like raised blood pressure, swelling on feet/ face, breathlessness, etc. To get answers to some frequently asked questions about kidney diet, click here

Myth: Kidney patients should prefer low sodium salt.

Fact: Kidney patients should not prefer low sodium salt, they should rather prefer normal sodium and iodised salt but in less quantity. Also, they should not prefer a NO SALT diet, but a LOW SALT diet.

Practical tips: Avoid adding salt to chapatti, rice, salads, curd. Add salt only to vegetables/ dals and breakfast/ snacks. Avoid foods with extra salt like baking soda/ baking powder; namely breads, biscuits, khari, butter, toasts, etc.

2. Fluid restriction: As kidneys are responsible for flushing out extra fluid from body, so when kidneys cannot perform this function; fluid can begin to accumulate in the body. This can give rise to symptoms like raised blood pressure, swelling on feet/face, breathlessness, etc. Hence, always talk to your Nephrologist about your fluid intake.

Myth: Drinking more water can help in flushing out toxins like creatinine from body.

Fact: When kidneys are not able to do their work efficiently, it leads to accumulation of fluids and hence, fluid intake should be restricted.

Practical tips: Use a bottle with measurement marks on it, to track your fluid intake. Remember to count all liquids (at room temperature) like tea/ milk/ dal/ kadi/ kadha/ buttermilk/ ice cream, etc as fluids.

3. Potassium restriction: Potassium restriction is required in case your potassium level rises in blood. It is a dangerous element as it can lead to harmful consequences like cardiac arrest (stops the functioning of heart).

Myth: Potassium is not as dangerous as creatinine for kidney patients.

Facts: Potassium is much more dangerous than creatinine as it can lead to cardiac arrest (sudden stoppage of heart) while creatinine does not do so.

Practical tips: For lowering the potassium intake, avoid coconut water and coconut based items like chutneys, etc, fruit juices, soups, sherbats, alcoholic beverages and neera.

4. Protein restriction: CKD diet requires restriction of proteins; however, they should not be completely eliminated from diet. Protein intake for normal individuals should be 1 gram per kg body weight. In CKD, this needs to be lowered down to 0.6-0.8 gram per kg body weight.

Myth: Proteins should be completely stopped from diet if you have CKD.

Fact: This does not serve the purpose, on the other hand; it can cause reverse outcome which is malnutrition. Protein intake should be reduced only if the intake is high and this should be done under the supervision of a Renal Dietician. Talk to your Dietician to know whether you need protein restriction. On a practical note, a Jain patient may already be eating low protein as compared to a Christian patient. So, a Renal Dietician can help you with this.

Practical tips: Avoid eating too many proteins in a single meal. Spread out proteins in every meal in limited quantity, for example – one can prefer milk or curd in breakfast, dal or pulse or egg white in lunch and dinner.

At times kidney patients have to struggle with their meals as they may not be tasty due to low salt intake, so if you are looking forward for some LOW SALT but highly tasty kidney friendly side dishes, click here

By-

Dr Rachana Jasani,

Renal Nutritionist,

PhD, RD

Diet for hemodialysis

Initiated on dialysis and worried about what to eat and what not?

Relax, we can help you stay healthy and eat healthy while on dialysis.

We can walk you through some tips that can help you select your food items wisely and then we shall look into some dialysis friendly recipes too! To get access to low salt, low potassium, high protein dips for dialysis patients, click here

Few tips for diet in dialysis:

• Salt restriction: Eating excessive salt can make you feel thirsty. Drinking excessive water can lead to fluid burden in your body which can result into accumulation of fluids in body. Hence, salt restriction is essential while on hemodialysis.

Myth: Salt substitutes are healthy for dialysis patients.

Fact: Salt substitutes like low sodium salts contain potassium which is a dangerous element as excessive potassium can cause changes in normal rhythm of the heart and can be fatal.

Practical tips: Avoid salted nuts, snacks, biscuits, dry fruits, etc. Avoid adding salt to chapatti, rice, salads, curd. Add salt only to vegetables/ dals and breakfast/ snacks. Instead of salt, you may use other flavouring agents like lime, vinegar, amchur powder.

• Fluid restriction: Yes, fluid restriction is carried further from CKD to dialysis as well. This is because kidneys are no longer able to flush out extra fluids from the body. Dialysis begins at the last stage of kidney disease and it helps in flushing off extra fluids; along with toxins, hence fluid restriction is essential. Talk to your Nephrologist about the amount of fluid that you can drink.

Myth: Water drunk during dialysis session can get flushed from the machine at the same time.

Fact: Water drunk cannot get flushed out from the body at the same time.

Practical tips: You may opt to drink luke warm water instead of cold water as warm water is difficult to be had in a large quantity while cold water can be had easily. To reduce the fluids intake, warm water can prove to be beneficial.

• Potassium restriction: Potassium restriction is required in case your potassium level rises in blood. It is a dangerous element as it can lead to harmful consequences like cardiac arrest (stops the functioning of heart).

Myth: Potassium is not a dangerous parameter.

Facts: Potassium is a SILENT KILLER! Especially for patients with heart problems, it can lead to sudden cardiac arrest (sudden stoppage of heart) without warning sings.

Practical tips: For lowering the potassium intake, prefer rice chapatis or bhakhris over wheat chapatis. Prefer kadi over curd. Prefer leaching vegetables and dals/ pulses. Avoid coconut water and coconut based items like chutneys, etc, fruit juices, soups, sherbats, alcoholic beverages and neera. To view low potassium vegetable recipe, click here

NOTE: Leaching is process which involves chopping and either soaking vegetables (or dals/ pulses) in large quantity of water or boiling vegetables in large quantity of water and then discarding water. This helps in reducing the potassium content from vegetables or dals/ pulses.

• Protein supplementation: Once on dialysis, you need to eat extra proteins to compensate for the loss of proteins during dialysis procedure. If you are on hemodialysis, you need to eat 1.2 grams proteins per kg body weight per day (i.e. 20% more than the protein intake for normal individuals). To incorporate this extra proteins intake, you may need artificial supplements like high protein powders or high protein biscuits. You may talk to your Nephrologist/ Renal Dietician for same. To gain access to high protein dialysis friendly recipes, click here

Myth: Over the counter protein supplement can be preferred by dialysis patients.

Fact: Dialysis patients need special supplements which are low in electrolytes, phosphorus and high in calories as well as proteins. They are specially designed keeping the needs of dialysis patients in mind. Hence, any over the counter protein supplement should not be preferred.

Practical tips: To increase your protein intake, you may opt:

• 4-6 egg whites a day or
• 80-100 grams paneer (chenna/cottage cheese) a day or
• 25 grams of defatted soya chunks

In addition, it is advisable to have cereal – pulse combination based items as they are good sources of protein too, for example – khichdi/ idli/ dosa/ uttapam/ etc.

By-

Dr Rachana Jasani,

Renal Nutritionist,

PhD, RD