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.