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For Kidney Failure Patients with End Stage Kidney Disease

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Kidney Disease /
/ Fat / Carbohydrate / Phosphorus / Sodium / Water / Potassium

As the body uses nutrients from the foods we eat, wastes are made.   Many of these wastes are carried by the blood to the kidneys so they can be removed by the blood.  When the kidneys stop working, they no longer remove these wastes. Wastes and fluids will then build up in the blood.

The buildup of wastes and fluids will make the person with kidney failure feel ill.  This is why people with kidney failure need to change their eating habits.   By eating controlled amounts of foods and fluids, you can have better health.   You will need to limit the amounts of protein, sodium, potassium, phosphorus and fluids in your diet.  A dietitian will help you to make the necessary changes in your eating habits.


Kidney Disease and Protein, Fat and Carbohydrate

Foods have different amounts of protein, fats, and carbohydrates.   Your body uses all three of these nutrients for energy.  Protein, however, is used for more than energy.  Protein is used by your body for growth, maintenance and repair.  It is important that you eat enough protein.  However, large amounts of protein will cause high levels of the protein waste product, blood urea nitrogen, or "BUN."

Some proteins are called high quality proteins.  Milk, eggs, cheese and meats are examples of foods containing high quality proteins.  Beans, peas, lentils, nut, grains and vegetables contain some protein.  The proteins in these foods are considered low quality proteins.  The amount of protein you should eat will be determined by your type of kidney disease, your treatment plan and your body weight.   A dietitian will give you guidelines for high and low quality protein foods.   Carbohydrates and fats give calories.  Calories from carbohydrates and fats are important to keep body tissues from being broken down for energy.  Carbohydrates and fats do not cause the build up of wastes.  If you do not eat enough calories, your body will get calories from muscle protein.  This makes protein wastes that will build up in your blood.

Breads, cereals, fruits, sugars, jam, jelly and honey are examples of carbohydrates.  fats are in milk, meats, cream, butter, margarine, salad dressings and oils.  The amount of calories you need will be determined by your sex, height, weight, age and activity level.  Your dietitian will help you choose food sources for carbohydrates and fats.


Kidney Disease and Phosphorus (P)

Phosphorus is a mineral that helps to maintain strong bones.  The level of phosphorus is controlled by your kidneys in your body.  High levels of phosphorus cause calcium to be taken from bones.  When calcium is lost, bones become weak and joints become painful.  Keeping a normal blood phosphorus level is important to prevent bone damage.  High phosphorus levels can also cause calcium deposits.   Calcium deposits in the skin can cause severe itching.

Phosphorus is found in many foods.  Most foods that are high in calcium contain phosphorus.  Dairy foods are high in phosphorus.  Meats, eggs, legumes and bran cereals are also have high amounts.  Medicines called phosphorus binders help to control phosphorus levels in your blood.  It is important that you take your medication and work with the dietitian to keep your phosphorus level in control.


Kidney Disease and Sodium (NA) and Water

Sodium helps with nerve activity, muscle contraction and fluid balance.   Everyone needs some sodium, but since sodium is found naturally in foods, most people consume more sodium than they need.  When kidneys fail, the extra sodium is not removed.  With extra sodium in your body you will feel thirsty and may drink more fluids.  Drinking a lot of fluids is dangerous for people with kidney disease.   Too much fluid can cause high blood pressure, difficulties in breathing and swelling of hands, feet and legs.

The best way to control thirst is to limit sodium.  This means that you need to restrict your use of table salt, avoid salted foods and softened water.   Read food labels carefully.  Watch for the words "sodium," "salt," and "soda."  A dietitian will give you guidelines for sodium and fluids.


Kidney Disease and Potassium (K)

Potassium, like sodium, helps with nerve activity, muscle contractions and fluid balance.  When kidneys are not working, potassium levels will build up in the blood.  This can be dangerous.  Too much potassium can cause muscle weakness.   Since your heart is a muscle, high potassium levels could cause it to beat abnormally or to stop.  There are no warning signs of having high potassium levels in the blood.

Potassium can be controlled by the foods you eat.  Potassium is found in almost all foods.  Fats and sugars are the only potassium free foods.  Milk, bananas, oranges, potatoes, tomatoes and dried beans are high in potassium.  Salt substitutes and sodium-free baking powder are also very high in potassium.

The amount of potassium your body can handle depends on your level of kidney function.  Your doctor will prescribe the amount that is right for you, and a dietitian will help you to plan changes in the foods you eat.


Following a diet that limits protein, sodium, potassium, phosphorus and fluids may be difficult.  It is, however, under your control, and it is something that you can do for yourself.  Be sure to talk with your doctor and dietitian when you have questions about your new diet.


Information from "Living With Kidney Disease - A Patient Manual", by The Tri-State Renal Network




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