Did your doctor just tell you that you have stage 3 kidney disease and you have no idea where to start?  I want to tell you that is unusual, but it’s not.  I know it’s not what you want to hear, either.

Listen, though.  I know that you are ready to start making some changes and that is all it takes to turn it around in the right direction.  I hear lots of people saying, “When will my kidney disease progress?  Or How Long Until I Start Dialysis?”  Don’t think about it that way!  You can slow the progression down with some simple changes.

What Are The Basics To Follow?

First of all, you should see a nephrologist.  It’s no longer a good idea to stick your head in the sand and figure it out later.  Now is the later you have been waiting for.  A nephrologist helps you to get your medications and disease process under control so you don’t continue on the downward spiral to dialysis.  If you are willing and able to make some changes, the time is now.  Nephrologist’s have studied kidneys and kidney disease extensively, and can guide you down the right path that your general practitioner cannot.

Next, nutrition is key to improving your kidney function.  Yes, there may be some medications that are affecting your kidneys and you should change them (that’s what the nephrologist does).  You may even need to take more medications but they will improve your kidneys as well.  But because the kidneys are key to removing the waste in your blood and make urine, you need to provide less of the food that contributes to damage to the kidney.  Did that make sense?  It will…

1.  Calories are important to understand.  You might have diabetes or heart disease, so you worry about other parts of your diet.  But as your kidney stage advances you will find it more difficult to eat right and keep your weight up.  You will consume fewer calories just because you don’t feel very well.  It’s exhausting for your body to be going through this, and you feel the fatigue.

2.  Protein is the 2nd most important component in a healthy kidney diet.  Protein maintains your muscle tissues, helps heal wounds, and create your bones, skin and blood.  Whew!  That’s a lot for them to do.  When you eat more protein than you need, it breaks down into waste products in your blood stream that are difficult for your body to process.  So you are putting an extra burden on your kidneys.  You should eat a moderate amount of protein – probably in the range of 6-7 ounces of meat or poultry or fish daily.  You might eat that much at one meal, but now you need to spread it out between your entire day.  It’s a portion size issue.

3.  Speaking of portion size, a three ounce portion of meat is about the size of a deck of cards – that is height and length and width.  So, it’s not huge.  Sources of protein are everywhere.  Mainly in your meats, fish, and poultry.  Some better choices for meat to get less protein are egg substitutes, shrimp, tofu, roasted chicken and stews.  Make your sandwiches with thinner slices of meats and add lots of vegetables to the sandwich to make it more filling.  (By the way – in dialysis you eat more protein because the process of dialysis loses protein)

4.  Fat can add calories but you want to make sure it’s the right kind of fat.  Not saturated fat.  You are at higher risk for heart disease as someone with kidney disease, so you need to eat the unsaturated fats – like olive and canola oils.  You don’t want to eat trans-fats either.  Saturated fats are in red meats, whole milk, butter and lard.  Better choices are corn oil, safflower oil, olive oil, peanut oil and canola oil.  So, if you are in need of additional calories to keep from losing too much weight, you should find ways to add healthy fats to your meals to increase the calories but not stop your heart!

5.  Sodium adds to your issues, so watch it carefully.  Sodium is found in some of the strangest foods.  It causes your body to retain fluid and puts extra strain on your heart and kidneys.  Reading the food labels is great – look for items with less than 10% of your daily value listed.  You should try to limit your intake to 1,500 mg or less per day.  In addition to regular table salt, sodium is found in regular canned vegetables, hot dogs, packaged starches, frozen vegetables with sauces, frozen meals, canned soup, tomato sauce and many snack foods.  Use alternative seasonings – like a lemon juice (always my favorite with oil for salad) or herb seasoning.  Just steer clear of the “salt substitutes” that contain potassium chloride.

6.  Potassium – it works in mysterious ways but mainly it’s used by your muscles to work.  When your blood level is too high (serum level over 5.0) you should limit your intake of high potassium foods so you can keep from adding to the problem.  Some high potassium foods are oranges, melons, bananas, potatoes and tomatoes.  Low potassium foods are apples, cranberries, pears, strawberries, pineapple, and boiled cauliflower.  Don’t bother limiting potassium unless your labs indicate it’s too high, though.  You need to focus on protein and sodium first!

7.  Make sure you know your labs – phosphorus levels especially – so you can limit it as well if you need to.  Phosphorus is very hard to limit because it’s in almost everything.  So try to manage what you can with it and if your doctor tells you to limit phosphorus, ask about phosphorus binders to help.  High phosphorus foods include: milk, cheese, yogurt, beans, nuts, dark colas, and processed meats.  Foods that are low phosphorus that you can eat instead are: non-dairy creamer, rice, sherbet, popcorn, rice cereal, clear sodas and rootbeer.

I know it’s a hard transition.  I have created a meal planning system that helps – and each month you get a new guide that goes in depth to provide the needed information to help you get through that stage and make better decisions.  If you are interested, read more about a predialysis meal plan here.

cookbook shelf 1 (Photo credit: chotda)

We have just released the latest in our book series – The Kidney Friendly Diet Cookbook for Predialysis kidney disease.  You may have seen a lot of kidney diet cookbooks on Amazon, but this is one of the best ones on the internet.  I have provided a great deal of information about kidney disease for a predialysis patient.  You don’t need the standard “dialysis” information – you need lower protein and sodium than dialysis.

You need some specialized knowledge to parse out the right recipes for you.  I have done this and created several different groupings for the book.  You will get breakfast, vegetarian, dessert, beef, pork, seafood, poultry and more for you to make a complete meal.  This book has full color pictures of some recipes – I made some very special samples and tried these recipes out on my family!  They loved this food and so will you.

I hope you will look at it – on Amazon you can look inside!  So don’t wait – go there now.

recipe: kochtopf.twoday.net/stories/4282860/ (Photo credit: Wikipedia)

Make A Renal Diet Casserole Recipe

Learning about a renal diet is one thing, trying to create your own meals is another.  I know you want to make meals at home and be healthier for your kidneys, but it’s very hard to find the right recipes and ways to prepare foods that are good and healthy for you.  I want you to be able to grab a few things and create a good casserole.

How To Make A Renal Diet Recipe

First of all, think about what stage of kidney disease you are in.  You are able to eat more protein in dialysis than pre-dialysis, so change the recipe accordingly.  You need to be aware of the types of foods to avoid and include – like whether or not you can have higher potassium foods as part of the recipes.  You might not need to restrict potassium or phosphorus.  (Keep in mind that almost all food contains phosphorus so you can’t get away from it completely).  When you are adding foods together, consider if you need low potassium vegetables, low phosphorus foods and low sodium foods.

Adding The Right Items Together

Here is your starter recipe:

1 – 1.5 pounds of lean protein (beans, poultry, tuna, shrimp, pork or beef)

3-4 cups chopped vegetables (here is where you need to consider low and high potassium foods)

2 cups starchy vegetables or grains (rice, whole grain pasta, biscuits, noodles)

1/2 to 1 cup liquid – low sodium chicken stock works well (so does low sodium pasta sauce and light gravy)

1/2 cup of yummy toppings (chopped nuts, bread crumbs, crushed crackers or cheese)

Mix those together in a 2 quart baking dish and bake at 350′F for 30-45 minutes.  Viola!  You have dinner.

Keeping It Low Sodium and Delicious

First of all, this is a perfect way to add together the foods you like and have a meal.  You may have become very picky in your eating, or you just want a change.  Make up a casserole, and freeze it in smaller amounts or eat on it for a couple of days.  I think this makes a great meal for you to serve to your family as well, and they won’t think there is anything special about it except it’s delicious.  And you will know it’s the right thing for you to eat.

If you are looking for renal diet recipes, check out our meal plans that are made for predialysis, renal diabetic, and dialysis patients  You get a weekly set of 7 evening meals that meet your nutritional needs and taste great too!

The Doctor, by Sir Luke Fildes (1891) (Photo credit: Wikipedia)

How Much Phosphorus Should I Eat?

If you have kidney disease, you certainly know it’s a difficult diet to manage.  That is one of the reasons we offer a meal planning solution – so you can control your kidney diet much easier and without the struggle – which reduces your stress and makes you healthier.  Either way, you have to wonder about all the nutrients you have to control.

Phosphorus is found in most foods you eat.  It’s part of the process of creating energy, so it’s a good thing that it is so plentiful – that is until you need to control it for your kidneys.  As your kidney disease progresses, you will find that you need to lower the amount you consume – most people with kidney disease should limit their diet to 800 – 1000 mg per day.

How Do I Lower My Phosphorus Intake?

Foods that are high in protein are usually also high in phosphorus, so as you progress in kidney diets from stage 1 - – - > stage 5, you will naturally eat less phosphorus.  Your decrease in protein will also give your kidneys a much needed break.

Phosphorus binders are another way you can lower your phosphorus intake.  A phosphorus binder works to keep the phosphorus in foods from being absorbed into your bloodstream.  So it passes through your digestive system without entering your blood stream and keeps your levels down.  Tums is one of the most common phosphorus binders available.  Usually, phosphorus binders are taken in conjunction with a meal – immediately before or when you start eating – as that is when they are most effective.

I Don’t Know If I Need To Limit My Phosphorus Intake

If your doctor has not mentioned it, you should ask.  But you can relax a little if you are not on dialysis since your body is still processing the phosphorus – and you will be on a lower protein diet anyway.  That will naturally decrease the amount of phosphorus in your food and intake.  Sticking to less than 1,000 mg of phosphorus can be hard, but you can certainly lower the amount that you eat by reading labels.

Cheese and milk products, as well as meats, are highest in phosphorus.  You can decrease your intake of those foods if you feel it necessary, but you should also know your labs first and see if you even need to limit the amount of phosphorus.

The single most important thing you can do to reduce the rate of progression of your kidney disease is to lower the amount of protein that you eat which will naturally lower your phosphorus consumption.

Learn more about all of the latest news and tips about renal diets and kidney disease from stage 1 – dialysis by joining our newsletter and get weekly updates.  Click here to go to the sign up page.

Whole Wheat Bread (Photo credit: pierrotsomepeople)

Should I Eat Whole Wheat Bread On A Kidney Diet?

You may have heard not to eat whole wheat bread on a kidney diet, especially on dialysis or as you get closer to stage 5 kidney disease. Many parts of the kidney diet are confusing, and you have heard how much better it is to get a high fiber diet from all the other sources of nutrition information you have that are not related to kidney diets. You may have started to realize how much “unlearning” you now have to do in your meal planning since you have to avoid certain foods or eat more of others. In addition, these may be foods you once loved. Do you have to give up on wheat bread or not?

Whole Wheat Bread On A Kidney Diet Is About Potassium and Phosphorus

The issues with bread are related to potassium and phosphorus. As your kidney’s begin to decrease in function, their ability to process those two items can wreak havoc if not well controlled. You can usually eat potassium and phosphorus without a problem until your doctor tells you to decrease or limit your intake – if you are not on dialysis. If you are on dialysis, you will be told to limit them to a certain amount related to how your blood work looks.

Foods that are less processed retain much of their potassium and phosphorus naturally. So, the whole grain/ whole wheat bread product has more potassium and phosphorus. It depends on how much you eat and how much potassium and phosphorus your doctor said you should eat in a day. You can eat whole wheat bread without a lot of worry if you manage the rest of your diet without much potassium and phosphorus.

Does It Matter How Much I Eat?

The other thing you should consider is knowing how much of the whole wheat bread on a kidney diet that you will be eating. If you eat ½ of a sandwich (1 slice), you won’t get as much potassium and phosphorus as you would with 2 slices of bread. So you can eat a smaller portion of bread to allow yourself to eat whole wheat. Otherwise, you should realize you will have to change to eating white bread most of the time – if not all.

The wheat bread that is not whole wheat bread is very similar nutritionally to white bread, so if you want to eat bread that is labeled “wheat” and not “whole wheat” you would count it the same as white bread. To be sure it’s not whole wheat, make sure it has less than 1 gm of fiber per slice. Whole wheat bread has 1-2 gm of fiber per slice.

What Are The Specifics For Nutritional Information?

Nutritionally, the breakdown of the slices is as follows –
White Bread (.88 oz/slice)
66 calories, 12.7 gm carbohydrate, 0.6 gm fiber, 1.9 gm protein, 170 mg sodium, 25 mg potassium, 25 mg phosphorus
Whole Wheat Bread (1 ounce/slice)
69 calories, 11.6 gm carbohydrate, 1.9 gm fiber, 3.6 gm protein, 132 mg sodium, 69 mg potassium, 57 mg phosphorus

You can see right away that whole wheat bread has more protein, potassium and phosphorus per slice, but less sodium and carbohydrate. It’s a tradeoff, and if you are on dialysis, then it’s probably very important to consider. But prior to dialysis if your doctor has not recommended a low potassium or low phosphorus diet, you can continue to eat the whole grain wheat breads and get more fiber until you are told differently by your doctor.

If you need more information on following a kidney diet, check out our very informative newsletter that guides you with new information about renal diets and how they affect all areas of your life – sign up in on this page: Kidney Diet Newsletter

Are You Looking For A Simple Way To Make Low Sodium Chicken Broth For Your Loved Ones?

You need low sodium foods for your renal diet!

I know you love to make soups, and they are just loaded with sodium.  So much more than anyone needs.  Even the low sodium versions still contain a great deal of salt.  So you need a way to make a low sodium version (very low sodium foods) of chicken broth to make gravy or other foods that call for it.  In my new recipe book, I am releasing this chicken broth recipe, but I am also going to share it with you today. 

First, you start with a fresh chicken carcass and scraps.  You might have purchased and baked a chicken – used the breasts for one meal and the legs and thighs for another.  Don’t throw away the bones!  You need them.  Using a 5 quart dutch oven or stock pot, put your bones and the scraps from the chicken in the pot.  Even leave the skin in the pan, you will strain it later and it can add to the flavor.

Add 12 cups of water, and vegetable scraps and seasonings to make it flavorful.  (No salt or potassium chloride)

Using celery, carrots, onions, garlic and bay leaves makes it a low potassium food as well as one of your low sodium foods.  Rosemary and parsley add a fragrant note to your low sodium chicken broth.

Now, just simmer it on low for 4 hours to let all the flavors blend together.  You can have a wonderful scent flowing through your house for the day.

When you are done, strain out the bay leaves, seasonings, vegetables and chicken using a screen strainer or cheese cloth.  Allow the chicken broth to cool some more, and then divide it up into individual bags of chicken broth and freeze.  I would recommend 1 – 2 cup servings frozen (laying flat for the most room and easiest to thaw later) and then you can use them later in meals and recipes.  Make up a large pot every couple of weeks and you will have the right ingredient for your recipes on hand.