6 TIPS ABOUT DIET IN CKD- RENAL DIET

Chronic kidney disease (CKD) is a severe disease. In this disease, the kidney can’t filter blood properly and stop removing waste materials or toxins from the body.

Kidney damage does not happen overnight, It may take a year or more to declare that you are suffering from CKD, but it may become difficult to provide treatment for Chronic Kidney Disease to a patient if it is delayed. When Chronic Kidney Disease progresses to a higher stage, dangerous levels of fluid, electrolytes and waste products can build up in the body and causes many health issues such as swelling in the body, fever, Fatigue, Loss of appetite, sleep problems, and weakness, etc.

6 STEPS IN MANAGING CKD

1 Control high blood pressure

• First, take your regular medicines to control high blood pressure.

• Patients can do daily healthy activities to keep their bodies active as high blood pressure increases with stress.

• If any patient with CKD has a habit of smoking, then they need to quit it right now.

• Patients are advised to take a low sodium diet as it increases the level of blood pressure.

2. Control cholesterol levels.

When the kidney gets damaged, it causes inflammation in the arteries. This inflammation can produce harmful cholesterol deposits in the arteries (atherosclerosis) which can lead to heart attack or stroke. Patients are advised to take a fat-free diet and use slim/ toned milk instead of whole-milk products.

3. Prevent Anemia.

Sometimes insufficiency of blood may appear in patients with CKD that’s also known as Anemia. The treatment usually differs from iron- deficiency anemia.

4. Reduce water intake

A damaged kidney can’t remove excess fluid from the body, and waste fluid starts accumulating in the body that causes swelling in the body.

In this case, patients are advised to limit their water intake according to their urine output ( around 1.5 -2 liters/day) and they are also asked to substitute their salt with Sendha Namak (Rock Salt) in every meal.

5. Healthy diet in CKD

A healthy diet plays a vital role in every treatment. Especially, in CKD we need to reduce the intake of sodium, potassium, and phosphorus in our diet. In addition, a low protein diet is necessary to reduce waste products in your blood.

A. Phosphorus is a mineral that keeps your bones strong and other parts of your body healthy. Your kidneys can’t remove extra phosphorus from your blood very well. Too much weakens bones and can damage your blood vessels, eyes, and heart. Meat, dairy, beans, nuts, whole-grain bread, and dark-colored sodas are high in phosphorus. Phosphorus is also added to lots of packaged foods.

High Phosphorus Foods to Avoid or Limit:

· Meat & Dairy foods

· Beans & Lentils

· Nuts

· Bran cereals

· Colas & cold drinks

· Some bottled ice tea

B. Potassium keeps your nerves and muscles working well. With CKD, too much potassium can build up in your blood and cause serious heart problems and arrhythmias.

Oranges, potatoes, tomatoes, whole-grain bread, and many other foods are high in potassium, avoid these.

Apples, grapes, carrots, and white bread are lower in potassium.

Dr. Anirban Biswas - MD may also prescribe a potassium binder, a medicine that helps your body get rid of extra potassium if it is high.

C. Sodium affects your blood pressure. It also helps to maintain the water balance in your body. Healthy kidneys keep sodium levels in check. But if you have CKD, extra sodium and fluids build up in your body. This can cause several problems, like swollen ankles, high blood pressure, shortness of breath, and fluid buildup around your heart and lungs. You should aim for less than 2 grams of sodium in your daily diet.

Take these simple steps to cut the sodium in your diet:

• Cook at home -- most fast foods are high in sodium.

• Stay away from packaged foods, if possible like pickle, bread, biscuit, papad, ketchup, sauce, etc. They tend to be high in sodium.

• Read the labels when shopping, and choose low-sodium foods.

• Avoid canned foods (veggies, beans, meats, and fish) or rinse with water before reheating/serving.

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D. A low protein diet is a diet in which the daily protein allowance is restricted below the general nutrition guidelines.

The general recommendation for adequate protein is 0.8 grams of protein per kilogram of body weight.

A low protein diet is anywhere from 0.6 to 0.8 grams of protein per kilogram of body weight. The specific amount determined in this range will include factors such as age, activity level, stage, and cause of kidney disease.

What are the health benefits?

• Research has shown that a low protein diet can reduce protein in the urine, improved cholesterol and lipid levels, and even better glucose control for those with diabetes and early-stage CKD.

• For many people with kidney disease, urea is a big issue. With a low protein diet, the amount of urea produced from protein metabolism is reduced. This can then lower blood urea nitrogen (BUN) levels to help keep kidneys safe.

• Additionally, a low protein diet when paired with a low sodium diet has been shown to improve blood pressure.

Other benefits include;

• Lower risk of metabolic acidosis

• Less oxidative stress

• Less insulin resistance

• Better control of phosphorus

What are there risks of a low protein diet?

If a low protein diet is not monitored by healthcare professionals, there can be potential side effects.

• When reducing the amount of protein, there is a risk of not getting enough calories. This can lead to unintentional weight loss. When weight loss happens too quickly or in an unsafe manner, it can lead to muscle breakdown.

• Another risk is increased inflammation. This can be caused by not eating enough calories or if the muscle breaks down. This inflammation can also cause poor blood sugar control.

• A low protein diet generally requires avoidance or severe restriction of animal meats (more on that below). Because of this, a low protein diet may lead to anemia, one of the first signs and symptoms of kidney disease.

Who Should Follow A Low Protein Diet?

While this type of diet may be helpful for chronic kidney disease, it doesn’t mean this is something everyone should try.

Studies have found a low (or even very-low) protein diet to be beneficial for those in later stages of kidney disease like CKD stages 4 and 5.

If you have both diabetes and kidney disease, it is important to work with a dietitian to have individualized guidance on the best amount of protein for your body.

Who Should Not Follow A Low Protein Diet?

Those with kidney failure on dialysis should not follow a low protein diet. The dialysis process includes filtration of the blood, which removes some protein. That protein needs to be replenished.

A dialysis diet requires approximately 1.2-1.4 grams per kilogram per day.

For those with cancer, a low protein diet is not recommended. However, this may be altered if there is also chronic kidney disease.

Foods To Include On A Low Protein Diet

A low protein diet will include a variety of foods. Food groups considered low in protein include;

• Fruits

• Vegetables

• Whole grains

• Healthy fats

Heart-healthy fats are a must when it comes to a low protein diet. eg.

• Olive oil

• Sesame oil

• Flaxseed oil

• Walnuts

Foods To Avoid On A Low Protein Diet

Foods highest in protein tend to come from animal meats. So when we talk about a plant-based diet for kidney disease, this really fits the bill!

By cutting out animal proteins, you are going to eliminate some of the highest protein sources in your diet.

This includes;

• Chicken/poultry

• Fish/shellfish

• Beef

• Lamb

• Milk/dairy

• Eggs

Additionally, high-protein plant foods such as tofu, legumes, and beans may need to be limited as well. It’s not just about the source of protein in your diet; it’s the quantity.

By cutting out these significantly high protein sources in the diet, you are giving your kidneys a break from dealing with a huge incoming protein load!

6. Regular yoga

Patients with CKD need to perform yoga and breathing exercises instead of muscular or Vigorous activities. It helps to control high blood pressure and keep your body active and calm.

Yoga is known as an excellent physical therapy for patients with kidney disease. Yoga improves the function of the kidney and improves the quality of life. In addition, yoga is very effective in keeping the kidney and liver healthy.

On the whole, here are the three Physical Activities that a kidney patient can perform.

1) Yoga asana

2) Breathing exercises (Anulom, Vilom)

3) Meditation

SUMMARY: Diabetes & CKD Foods

Your dietitian can give you lots of tasty ideas for healthy meals.

Below are just a few examples of foods a person with both diabetes and CKD can eat. Your dietitian can give you lots more suggestions and help you find recipes for tasty meals:

• Cereals: wheat, rice, oatmeal.

• Fruits: berries, grapes, cherries, apples, pears, plums, papaya

• Veggies: cauliflower, onions, eggplant ( baingan ), turnips, Parwal, tinda, tori, bottle gourd ( lauki ), pumpkin, radish, carrot, cabbage, bell pepper ( Shimla Mirch), ginger, peas ( boil before use)

• Pulses: moong dal, masoor dal

• Dairy: avoid dairy products except for small quantities of low-fat milk.

• Spices: methi, coriander, bay leaves, mint, black pepper, cardamom

• Proteins: lean meats (poultry, fish), eggs, unsalted seafood

• Carbs ( occasionally): white bread, bagels, sandwich buns, unsalted crackers, pasta

• Drinks: water, clear diet sodas, unsweetened tea

• Dry fruits: dried cranberries, walnut, flaxseeds, chia seeds

• Oils: olive oil

Avoid Eating:-

• · High potassium fruits and vegetables like oranges, lemons, potato, tomato

• · Fruit juices

• · Sea salt

• · Caffeinated drinks, iced tea

• · whole-grain bread

• · Dried fruit