The kidney diet is all about reducing the amount of protein. Its task is to prevent the production of excessive amounts of protein metabolism products, which can be toxic to the body in the case of kidney diseases. What to eat in chronic renal failure? What are the principles of the kidney diet?
Contents:
- Kidney diet - rules
- Renal diet - supplementation
- Four Periods of Chronic Kidney Failure - Dietary Recommendations
- Kidney diet - recommended and contraindicated products
The kidney dietis a diet that requires a lot of knowledge and is difficult to develop independently. At least at the beginning, it is worth using the help of a nutritionist dealing with kidney diseases, who will develop an individual diet taking into account the patient's test results and diseases accompanying kidney failure.
Kidney diet - rules
A proper diet for kidney problems is of utmost importance to slow the progression of the disease and prevent complete damage to the kidneys. Here are the rules that must be absolutely followed.
- Energy
The energy value of a diet depends on the level of nutrition and activity of the patient. As kidney failure can be a consequence of diabetes mellitus, patients may become overweight and need to be overcome.
Losing weight to an optimal body weight reduces the progression of kidney damage and enables better glycemic control. On the other hand, many sick people are malnourished. It is important to maintain an adequate supply of energy from your diet to protect against the breakdown of body protein.
- Protein
The most important recommendation of a kidney diet is to limit protein. Protein metabolism leads to the production of urea and creatinine, which are removed by the kidneys in he althy people. Failure of this organ leads to the accumulation of toxic compounds in the body.
Diets with excess protein lead to proteinuria and phosphate build-up, which causes bone decalcification. The amount of protein in the diet is adjusted to the GFR, urea and creatinine levels. The lower the GFR and the higher the levels of urea and creatinine, the less protein is given in the diet. The protein administered should be predominantly of animal origin, but its sourcesat the same time, they must contain little phosphorus.
- Fats
Fat is not restricted in the kidney diet. It should provide about 30% of the daily energy requirement. If a patient with renal insufficiency is also diabetic, the proportion of fat should be higher, because in such a situation it is inadvisable to increase the proportion of carbohydrates in the diet, and these are the most common supplementation of protein removed from the diet.
Fat can then account for up to 55% of the energy requirement. Patients may develop hyperlipidaemia as a result of decreased plasma lipoprotein lipase activity, carbohydrate intolerance, and hyperinsulinemia.
Therefore, the classic recommendations indicate to use mainly vegetable fats, and strongly limit animal fats in order to reduce the risk of atherosclerosis. However, new research shows that saturated fat and unsaturated fat have equal effects on the risk of heart disease and cardiovascular disease.
- Carbohydrates
Carbohydrates supplement the body's need for energy. Their amount depends on the amount of protein and fat in the diet. It is important that the carbohydrate foods you eat are low in protein, phosphorus and sodium.
Hence, low-protein and low-sodium bread, white rice, white pasta, small groats is recommended, and all preparations made of whole grains, coarse groats or brown rice are limited. Simple sugars (sugar, sweets, honey, sweetened drinks, juices) should not provide more than 10% of energy.
- Phosphorus
The kidneys are responsible for the excretion of about 70% of phosphorus. In chronic renal failure, kidney retention occurs, which in turn leads to bone decalcification, accumulation of calcium-phosphorus deposits in the heart, muscles and blood vessels.
You should significantly reduce the amount of phosphorus in your daily diet. Foods rich in phosphorus include offal, yellow cheese, processed cheese, feta cheese, egg yolks, herring, small fish eaten with bones, legumes, cocoa, chocolate, cola drinks, brown rice, thick groats, bran.
To reduce the concentration of phosphates, it is recommended to use preparations that bind phosphate in the digestive tract during meals.
- Sodium
As the disease progresses, the ability to excrete sodium decreases, leading to increased thirst, water retention, edema and high blood pressure. Foods with a lot of s alt, such as meat preparations, silage, powdered soups and sauces, ready-made mixes, should be eliminated from the diet.spices, stock cubes, canned food, pickles, smoked products, cheese, feta cheese, snacks such as crackers, crisps, s alted peanuts.
Food s alt should be reduced, or preferably eliminated. Sodium intake should not exceed 1800-2500 mg / day.
- Potassium
Potassium is retained in the period of end-stage failure and oliguria. The amount of this ingredient should then be limited to 2000-2500 mg / day. High levels of potassium in the blood are life threatening as it interferes with the heart function.
Potassium-rich foods to limit include legumes, cocoa, chocolate, walnuts, prunes, raisins, figs, bananas, mushrooms, citrus fruits, avocados, tomatoes, potatoes, leafy vegetables, carrots, buckwheat.
In order to reduce potassium, the peeled and finely chopped vegetables are poured with boiling water, soaked for half an hour, rinsed several times and cooked until tender. However, it causes a significant loss of vitamins.
- Vitamins and minerals
Nutritional restrictions in the kidney diet lead to calcium deficiency. Supplementation with vitamin D and calcium supplements is recommended to maintain optimal calcium and phosphate metabolism.
Due to the impaired absorption of iron and the lack of the erythropoietin hormone necessary for the construction of hemoglobin, it is necessary to supplement both iron and erythropoietin. The kidney diet is often deficient in vitamin B1, vitamin B2, vitamin B6, folic acid, biotin and vitamin C.
Their supplementation is recommended. Patients may develop zinc deficiency, but supplementation is only started when there are obvious symptoms of its deficiency. Due to the decreased renal magnesium excretion, hypermagnesaemia may develop. Then you need to exclude corn, poppy seeds, beets, linseeds, oats, cocoa, nuts, soybeans, beans, peas, chocolate, tomatoes and tomato paste, parsley and parsley root from the diet.
- Liquids
The amount of fluid in the kidney diet depends on the amount of urine excreted, edema and high blood pressure. The allowed amount of fluid per day is calculated by adding 500 ml to the amount of urine excreted during the day. Remember that the fluid balance includes water not only in beverages, but also in soups, sauces, vegetables and fruits.
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Find out moreRenal diet - supplementation
Recommended doses of vitamin supplementation in people with chronic renal failure, regardless of the stage of the disease:
| Vitamin | Recommended daily supplementation dose |
| B1 | 1.1, - 1.2 mg |
| B2 | 1.1 - 1.3 mg |
| B5 | 5 mg |
| B6 | 10 mg |
| B12 | 2.4 µg |
| C | 75 - 90 mg |
| PP | 14 - 16 mg |
| H | 30 µg |
| Folic acid | 1 mg |
| A | Do not supplement |
| E | 400 - 800 IU |
| D in active form | 0.25 - 1 µg |
| K | Do not supplement |
Four Periods of Chronic Kidney Failure - Dietary Recommendations
- Period I (latent failure) - no special dietary recommendations, protein within the physiological standard - from 0.8 to 1.0 g / kg of ideal body weight;
- Period II (compensated insufficiency) - protein reduction to the value of 0.6 - 0.8 g / kg N.m., phosphorus limitation, vitamin D supplementation;
- Period III (decompensated insufficiency) - low-protein diet, containing 0.6 g / kg N.m. proteins per day, limiting phosphorus, potassium, sodium, enriched with energy-rich, low-protein industrial preparations;
- Period IV (end-stage failure) - protein limitation to the amount of 0.3 - 0.6 g / kg n.m., sodium, potassium, phosphorus and fluid limitation, introduction of exogenous keto-amino acid preparations in the amount of 15-20 g per day (keto-amino acids) are compounds with a structure very similar to amino acids, in which one amino group is replaced by a ketone group; in the case of amino acids deficiency from the diet, they are metabolized in the same way as amino acids, but without the formation of harmful nitrogen compounds); Necessary renal replacement therapy
Kidney diet - recommended and contraindicated products
| Recommended | Contraindicated |
| Protein | |
| Lean veal, lean pork, lean beef, skinless chicken, rabbit, fish, milk, cottage cheese, grained cheese, egg white | Offal, yellow cheese, processed cheese, feta type cheese, egg yolks, herring, small fish eaten with bones |
| Carbohydrate products | |
| Low-protein bread, wheat flour type 500 and 750, white rice, semolina, two-egg noodles, light rye bread, Kaiser rolls, wheat bread, B alton bread, plain bread, Masovian bread, country bread, potatoes | Brown rice, graham bread, wholemeal flour, whole cereal grains, oatmeal, rye, rye flour, thick groats, muesli, crispbread, pumpernickel bread, wholemeal rye bread, grain bread, germ, bran |
| Vegetables | |
| onion, fresh cucumber, lettuce, Chinese cabbage, green pepper, Brussels sprouts, cauliflower, white cabbage, spinach, radish, leek, zucchini, red pepper, red cabbage, pumpkin, turnip, carrot, tomato, kohlrabi, cabbage Italian, chicory, beetroot | Corn, sprouts, celery, green peas, broccoli, parsley root, garlic, lentils, peas, beans, soybeans, chickpeas, mushrooms, dried mushrooms |
| Fruit, nuts and seeds, chocolate | |
| Blueberries, pear, mango, lemon, watermelon, strawberries, apple, grapes, cherries, wild strawberries, cherries, orange, mandarin, banana, peach, raspberries, kiwi, plums, nectarines, pineapple, gooseberries, papaya, red currants, white currants, apricots, grapefruit, melon | Black currants, chocolate, cocoa, nuts, almonds, sesame, poppy seeds, pumpkin seeds, sunflower seeds etc. |
| Fats | |
| Vegetable oils, soft margarines, butter, mayonnaise | Hard margarines |
| Dairy products | |
| Sheep's milk, cow's milk, buttermilk, milk drinks, unsweetened condensed milk, kefir, fruit yoghurts, natural yoghurts, powdered milk | Goat's milk |
See the gallery of 5 photosAbout the author
Aleksandra Żyłowska-Mharrab, dietician Food technologist, dietitian, educator. A graduate of Biotechnology at the Gdańsk University of Technology and Nutritional Services at the Maritime University. A supporter of simple, he althy cuisine and conscious choices in everyday nutrition. My main interests include building permanent changes in eating habits and individually composing a diet according to the body's needs. Because the same thing is not he althy for everyone! I believe that nutritional education is very important, both for children and adults. I focus my activities on spreading knowledge about nutrition, analyze new research results, and make my own conclusions. I adhere to the principle that a diet is a lifestyle, not strict adherence to meals on a sheet of paper. There is always room for delicious pleasures in he althy and conscious eating.
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