protein intake in kidney disease

Food and the patient with Kidney disease or Kidney failure


Kidney function is essential for removing the waste material and some toxins from food that you eat. The kidneys excrete a dietary protein called urea, as well as excess amounts of sodium, potassium, and phosphate. These substances can build up in the body if kidney function is impaired and cause harm.

Following a strict diet can lessen the excessive accumulation of these substances and their bad effects on the body.

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A kidney diet has to be balanced and take into account the stage of the patients disease. Taking too much fluid, salt or potassium may be very harmful. Read below for more details.

 

Controlling your phosphorus (Phosphate)

Excess phosphorus is a mineral that healthy kidneys get rid of in the urine. In kidneys that are failing, phosphorus builds up in the blood and may cause many problems including muscle aches and pains, brittle, easily broken bones, calcification of the heart, skin, joints, and blood vessels. To keep your phosphorus levels in check, consider the following tips:

    1. Intake of foods low in phosphorus

  •      Grape
  •      Vegetables: cabbage, green beans, spinach, lettuce, carrot, cucumber, pear, plum, Pineapple, apple, mango, white bread, pasta, watermelon, potatoes
  1. Moderate intake of high phosphorus foods such as:
  • Meats, poultry, dairy and fish
  • Milk and other dairy products like cheese
  1. Avoid high phosphorus foods such as:
  • Black Beans, Red Beans, Black-eyed Peas, White Beans, and Garbanzo Beans, nuts
  • Dark, whole or unrefined grains, whole wheat, Rice, corn
  • Cheese (low fat cheese), Wara (yoruba)
  • Low fat yoghurt
  • Dried vegetables and fruits, Garlic
  • Chocolate, peanut butter,
  1. Don’t forget to take your phosphate binders with meals and snacks.
  • Your doctor may or may not prescribe a medication called a phosphate binder. You need to take your phosphate binder as prescribed by your doctor. Often you will take a phosphate binder with every meal and snack you take. This reduces the amount of phosphate you absorb from food while allowing you to absorb other important nutrients. Phosphate binders do not prevent absorption of all phosphate.

Controlling your Potassium

Potassium is an element that is necessary for the body to keep a normal electrical activity and water balance between the cells and body fluids. All foods contain some potassium, but some contain larger amounts.

Normal kidney function will remove potassium through urination. Kidneys that are not functioning properly cannot remove the potassium in the urine, so it builds up in the blood. This can be very dangerous to your heart. High potassium can cause irregular heart beats and can even cause the heart to stop if the potassium levels get to high.

Typically, there are no symptoms for someone with a high potassium level. If you are concerned about your potassium level, check with your doctor, and follow the tips below.

  • The following foods are high in potassium and intake of these foods should be limited:

Bananas, Avocado, Oranges, Orange Juice, Prunes, Prune Juice, Tomatoes, Tomato Juice, Tomato Sauce, Tomato Puree, Melon, Nuts, Pawpaw, Chocolate, Red Beans, Milk White Beans, cabbage, onions, groundnut, walnut, mushrooms, corn, potatoes

  • Dark leafy vegetables e.g tete, soko,ugu, green, okro,

Potatoes and vegetables can also contain a lot of potassium but can be specially prepared to reduce the amount of potassium contained in them. For potatoes, 

1. Peel and slice into 1/8 inch pieces.

2. Soak 1 cup potatoes in 5 cups of water for 2 hours.

3. Drain and rinse and drain.

4. Cook in a large amount of water.

5. Drain and mash, fry or serve plain.

For vegetables,

1. Slice and wash in plenty water,

2. Drain the water

3. Cook in plenty water

4. Drain the water

5. Use vegetables to cook food or cook vegetables with other ingredients

Foods Low in Potassium

White bread

White rice

Eggs

Apples ( limited amount)

 

Controlling your sodium (salt)

Sodium, or sodium chloride is an element that is used by all living creatures to regulate the water content in the body. Usually a sodium restriction comes in the form of “No Added Salt.” This is necessary because a greater intake of sodium will result in poorly controlled blood pressure and excessive thirst which can lead to difficulty adhering to the fluid restrictions in your diet. However, your doctor can allow you a limited amount of sodium which can vary between 2-6gms per day

To limit your sodium, you should:

  • Avoid table salt and any seasonings that end with the word “salt”

 

  • Avoid salt substitutes (they contain potassium)
  • Avoid salty meats such as bacon, ham, sausage, hot dogs, lunch meats, canned meats
  • Avoid salty snacks such as cheese curls, salted crackers, nuts, and chips
  • Avoid canned soups, frozen dinners, and instant noodles
  • Avoid bottled sauces, pickles, olives, and MSG

. Salted Butter, milk, carrot, spinach, legumes

 

Foods Low in Sodium

Sugar

Onion, ginger garlic, mushrooms

Pasta, Rice, Macaroni

Tomatoes, plum,

Fresh fruits and vegetables except those listed above

 

Cooking Instructions for low sodium.

1. Cook meat / poultry / fish with recommended allowance of sodium

2. Then use the stock to cook soup / food

 

Controlling your protein

Protein is important to aid in growth and maintenance of body tissue. Protein also plays a

role in fighting infection, healing of wounds, and provides a source of energy to the body.

  • For patients with advanced kidney disease not yet on dialysis, it is important that you take some protein but do not take too much. Remember, you need protein for all of the functions above. The reason for asking patients to reduce their protein intake when they have significant disease but are not yet on dialysis is that an excessive protein load can accelerate the path to kidney failure. However note that many other aspects of care are likely more important than protein intake to reduce the progression of kidney disease such as control of blood sugar, control of blood pressure and relief of any obstruction.                                                                                   
  • For patients with kidney failure, there is absolutely no need to restrict protein as the kidneys have failed and protein restriction will not restore kidney function that has been lost. 
  • You should make sure to eat one tenth of a kilogram of protein every day.
  • Foods that are high in protein include beef, pork, veal, chicken, turkey, fish, seafood, and eggs.
  • 1 average sized egg for example is equal to one-twentieth of a kilogram of protein.

     

    How to be successful on a renal diet

    Moderation

    Dietary Guidelines emphasizes the importance of eating a variety of foods. This applies to dialysis patients, too. You can enjoy all foods in moderation while following a renal diet. One of the guidelines states:

    “Be sensible: Enjoy all foods, just don’t overdo it.”

    We Encourage You To:

    • Slow down while eating. Avoid anxiety and worry at meal times. It takes 20 minutes to send the signal that you’ve had enough to eat.

    . Put down fork between bites

    . Do not put bowls of food on the table

    • Stop eating when full. Patients should walk away from the table feeling that they can eat a little more.

    . Leave the table as soon as eating is done

    • Have one small helping of that chocolate cake once in a while and enjoy every bite.
    • Enjoy that piece of sphagetti twice as much. Eat half in the restaurant and take the rest home to enjoy the next day.

    The Goal

    The goal for our patients should be to achieve optimal nutritional status, a healthy lifestyle, that can be maintained rather than a short-term diet that will most likely be abandoned and produce psychological discomfort and metabolic imbalance.