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There is no specific single diet which is good for all kidney failure patients. There are however some guidelines which I am giving for all kidney failure, dialysis, high urea creatinine patients. Detailed advice for patients with severe kidney disease (less than 30% function, stages 4 and 5 CKD) is best from a renal dietitian.
Protein Intake in Renal Failure - The sources of protein are Animal protein - meat, fish, cheese, eggs, milk, and Vegetable protein - nuts, pulses (beans, lentils etc), tofu, corn. If on Haemodialysis, sometimes a little high protein diet is recommended. This is also recommended if the albumin protein level in the blood is low.
Protein breakdown leads to formation of urea and creatinine. So excessive protein intake must be avoided in Chronic Kidney Disease i.e. CKD. Protein intake depends upon your urea and creatinine levels as well as blood and urine protein levels. Kindly discuss with your renal dietician or doctor for protein intake per day, as per your test reports and body requirements.
Usually the daily intake should be less than 1 gram per kg of body weight. If you weigh 75 kg, then 50-70 gm proteins are ok per day but again the role of dietician or your doctor cant be ruled out who is doing the dialysis and follow up.
SODIUM AND SALT INTAKE IN KIDNEY FAILURE
Usually we consume about 150 - 200mmol (9-12g of salt, or 3-5g of sodium) everyday. We actually need less than half of this. Only 10 % of sodium comes from fresh food but the rest 90 % is coming from salt or sodium bicarbonate in cooking / food processing or preserved food (Sodium benzoate is used as a preservative in many health foods). Much of the sodium we consume also comes from Table salt sprinkled on the food after cooking.
I recommend less than 2 gram of Sodium per day. i.e. about 3-6 grams of salt intake.This allows small amounts of salt to be used in cooking, but means limiting very salty foods, and not adding salt to food after it has been cooked. Less salt may be better still!
Lo Salt !! - These are not recommended because they may not contain sodium but they contain much potassium.
Potassium - Potassium is found particularly in leafy vegetables and most fruit and fruit juice, and in potatoes, especially if they are fried or baked.
In severe kidney failure, the potassium levels are usually high. So this may lead to cut down intake of leafy vegetables, fruit juices, potatoes and some health food supplements like Aloe vera juice or coconut fruit water.
But if you are in renal failure or high urea, creatinine levels and the potassium levels are ok, then this diet is ok. Coconut water and aloe vera juice are recommended and work well if the potassium levels are fine.
Avoid these if there is High Potassium Level
Chocolate, toffees, liquorice, black treacle. Marzipan, nuts, potato crisps,chips, Avoid salt substitutes like Lo Salt etc. Tomatoes, beetroot, plantain, mushrooms, sweet corn, avocadoes, aubergine, parsnip,spinach, Bananas, mango, grapes, apricots, rhubarb, fresh grapefruit,pineapple, Fruit and Vegetable Juices,Coffee – up to one cup per day, Beer, cider, lager, sherry, wine
Low Potassium Alternatives - These can be taken if the potassium is high - Tea, Fruit tea, Spirits, Apples, Pears, Boiled vegetables - Carrots, Turnip, Onion, Cabbage, cauliflower, lettuce, cucumber, celery. Snacks made from Wheat, Corn or rice (popcorn without salt are ok)
Boiled potatoes, noodles, rice and pasta are ok
FLUID INTAKE IN KIDNEY FAILURE
It is very important to restrict salt intake if you want to restrict your fluid intake. If you are eating salt (sodium), you feel thirsty quiet often and you can not control the desire to drink more water or fluids. Salt leads to water retention in the body. Salt restriction helps a lot in controlling the urge to drink fluids.
There is definite benefit of drinking water in a healthy individual but too much is not recommended in kidney failure.
Water is present in all fluids/ drinks consumed per day. So restrict your fluid intake as per doctor's advice.You can yourself judge if you are retaining the water or not. So you can adjust accordingly.
You need not restrict fluid intake if you are not on dialysis. Again I would suggest you to ask the dietician or the doctor and write it down in your diary how much you actually need to consume.
Phospate and Calcium
This is usually a problem if the patient is in end stage renal disease when the kidney function is less than 25 % . Phosphate is found in milk and cheese. Only a few other foods contain a lot of phosphate like wholegrain cereals, baking powder, shellfish. Some convenience foods also contain phosphate.
High calcium and phophate causes itching problem. Usually there are drugs which help to lower down the levels but again the diet and the problem needs the concern of doctor and the dietician involved.
Diet alone is hardly helpful in bringing down phosphate levels, so the drugs like phosphate binders are usually given. These are taken with food, and work by keeping the phosphate in your food in the gut, preventing it being absorbed into the blood when the food is digested. It is important that these are taken at the right time just before food (or with it) as they won't work otherwise.
Herbs in Kidney Failure
Few Ayurvedic herbs are recommended in Kidney failure. These are
Mutrakrichantak Churna - Take 1 tablespoonful of this, boil in 400 ml of water. Keep it boiling untill the water remains 50 ml. strain it and consume once daily.
The Other Herbs which are used by Ayurveda Practitioners in India are
- Rencure Formula Capsules - 2 capsules twice daily
- Varunadadi Vati - 2 tablets twice daily
- Punarnava Mandur -2 tablets twice daily
