Diet Changes by Stage of Chronic Kidney Disease

As with many other chronic illnesses, chronic kidney disease is measured in stages. These stages mark the progression at which the kidneys are losing function.

The stages of kidney disease are determined by a factor known as the glomerular filtration rate, or GFR. Your GFR value is determined by blood tests, specifically your creatinine levels, and other factors. This value is a measurement of your kidney function; therefore it helps to pinpoint which stage of kidney disease you are in.

As soon as you are diagnosed with chronic kidney disease, your doctors are going to recommend dietary changes. Depending on your stage of renal failure, these may be simple changes or very strict restrictions. This is because what you eat has a huge effect on your kidneys. Everything you eat, after all, ultimately gets filtered through your kidneys. As your kidneys lose function, it gets harder and harder for them to filter out waste and other excess material. Dietary restrictions are necessary to make it easier for your kidneys to do their job.

Stage 1: GFR over 90

The first two stages of chronic kidney disease are usually pretty asymptomatic. The first stages of kidney disease are usually only caught by blood work done during routine checkups.

Dietary Changes: At this point, your doctor will likely recommend that you start eating a healthier diet overall and getting regular exercise. He or she will recommend that you cut back on your sodium intake, as sodium has a big impact on your kidneys.

Stage 2: GFR 89-60

Dietary Changes: Significantly lower sodium intake. Eat a healthier diet overall. Focus on whole grains, lean proteins, and lots of fresh produce.

Stage 3: GFR 59-30

Stage three chronic kidney disease can vary in its severity, but typically patients start noticing symptoms such as fatigue, back pain, leg cramps, fluid retention, and changes in urination patterns.

Dietary Changes: At this stage of chronic kidney disease, you will likely be referred to a dietitian or nutrition specialist. You will be given a list of recommended foods and restrictions will become necessary to help stop the progression of damage to your kidneys. Specific items to restrict will be sodium, potassium, and phosphorus. As you near stage four, your doctor may limit your protein intake as well.

Stage 4: GFR 29-15

In stage four, chronic kidney disease starts to become very uncomfortable. In addition to the symptoms of stage three, there can be pain, swelling, nausea, vomiting, and nerve problems. Symptoms in stage four of chronic kidney disease can be pretty uncomfortable.

Dietary Changes: On top of a very restrictive diet, your doctor will likely recommend that you start to limit your fluid intake to take more pressure off of your failing kidneys.

Stage 5: End Stage, GFR less than 15

Stage five kidney disease is also referred to as “end stage renal disease”. At this point, dialysis or transplant is necessary.

Dietary Changes: While many of your restrictions will remain, your doctor may let off on some of them. This may also be determined by the type of dialysis you choose and how often it is necessary.

Your diet is perhaps the most important and effective treatment for chronic kidney disease. As your condition progresses, your dietary changes and restrictions will too, to keep up with the loss of kidney function. Speak to your doctor for more information about what food items you should be monitoring or restricting from your diet to treat your chronic kidney disease. For more information about your diet by stage of CKD, click here.

Also published on Medium.