Renal insufficiency (or disease) is the term used to describe a condition in which some of the kidney function has been lost, leading to less efficient filtering of fluids, protein and electrolytes (i.e., sodium, potassium, calcium). After being diagnosed with renal disease, patients are often encouraged to begin a renal diet. This diet includes decreased intake of protein, sodium, potassium and sometimes even fluid prior to dialysis.
The main aspect of a renal diet is a decreased protein intake This is especially true prior to starting dialysisbut may not be so after dialysis is started. Protein is a macronutrient that comes from the food you ingest. When protein is digested in the body, a waste product called urea is produced. If the kidneys are not functioning properly, urea builds up in the blood- stream and causes fatigue, nausea and loss of appetite. It is important to consume a renal diet to decrease these symptoms and to reduce the workload on the kidneys.
Sources of Protein include animal products such as poultry, beef, fish and dairy, as well as vegetable products such as bread, cereals, rice, pasta and beans. When consuming a low- protein diet, it is important to find and maintain balance because although you need to limit protein, you still need enough to keep your body strong and healthy. For this reason, consumption of high-quality proteins, such as chicken, fish, lean meats, and eggs are important because the body is able to use them more efficiently.
Sodium, Potassium, Phosphorus and Fluids
The decreased filtering that occurs with renal insufficiency reduces the kidneys ability to eliminate excess sodium and fluid. As they buildup, the amount of blood in your body increases along with blood pressure. Therefore, it is important to restrict sodium from the diet to improve blood pressure. When limiting sodium, processed foods should be avoided. Also, salt should not be used to flavor foods; try spices, herbs, and lemon instead.
It is also important that potassium is limited because increased potassium in the blood can lead to abnormal heart rhythms.
Phosphorus is often restricted with renal insufficiency because extra phosphorus in the blood can pull calcium out of your bones, making them weak, and possibly cause calcium deposits in your blood vessels, lungs, or eyes. The best ways to keep your phosphorus lev- els healthy is to limit your intake of phosphorus-rich foods. Foods high in phosphorus include dairy products, nuts, seeds, beans, and drinks like soda and beer.
Fluid should only be restricted if you accumulate excessive amounts in your body. This varies on a case by case basis.
Some patients find that they have a lower calorie intake while on a low-protein diet but it is important to obtain adequate calories and maintain a healthy weight. Most of your calories should be from complex carbohydrates which can be found in whole grain breads, legumes, rice, pasta and starchy vegetables. Extra calories can be added to the diet by consuming heart-healthy fats that are found in most vegetable oils, olive oil and nuts. Candy and sugar can also increase calorie intake, but it is important to avoid this option if you are diabetic.
Information from: National Kidney Foundation, www.kidney.org/atoz; Medline Plus, www.nlm.nih.gov/medlineplus/; Go Ask Alice, www.goaskalice-cms.org/ scripts; Quest Diagnostics, www.questdiagnostics.com/kbase. Nutrition Education for JUNE 2007. Produced by Meals On Wheels, Inc., of Tarrant County by Haley Hall, Nutrition Intern and Janna Nelinson, Nutrition Intern for Sherry Simon, R.D./L.D. For questions regarding nutrition education contact: Sherry Simon, R.D./L.D., Director of Nutrition Services for Meals On Wheels, Inc. of Tarrant County at 817-336-0912 or email: email@example.com. Website: www.mealsonwheels.org