What Diet Should I Follow For Stage 4?

Keep reading to find out more about the recommended stage 4 kidney diet!

The stages of kidney failure designate the level of damage to kidney. Staging can also signify the relative kidney function. Patients with the 4th stage renal failure condition more often than not are still non-dialysis patients. In this article, we will be discussing kidney failure as the chronic type, or the long-standing form. The staging used here will be relative to the chronic renal failure type.

As earlier mentioned, pre-dialysis patients may include stage 4 kidney failure patients. However, that depends on individual presentation and requirements. The diet that comes along with this stage is also important to ensure kidney longevity and avoid further damage.  You can follow a ckd stage 4 diet to slow the progression of kidney failure and improve your health.

In stage 4 kidney failure, the kidneys are already in “preparation” to the next stage, which is stage 5 and would require a different, stage 5 renal failure diet like a dialysis diet. In stage 5 (also end-stage), dialysis and transplant are required. Thus, it is essential to take care of the kidneys in every stage; more importantly when it is already in the higher stages, that includes stage 4.  A sample diet for stage 4 kidney disease can be found below, described in detail regarding the stage 4 renal failure diet plan.

Stage 4 – The Restricting Diet: Diet For Kidney Failure Stage 4

At stage 4, the kidneys function from 15-29 percent of the expected normal function. Further damage thus is imminent and diet should be restricted to its maximum, as much as possible. A renal dietitian or nutritionist should work hand in hand with your physician in order to ensure the most favorable kidney health.  You might be wondering what foods to eat with stage 4 kidney disease, and they can be part of a balanced diet but you need to make sure you don't over do it.  When you are on a stage 4 kidney failure diet, or just a stage 4 kidney diet, you are going to be more restricted on certain foods and probably have to manage your potassium and phosphorus.

You can also get meal plans on this website to help you cope with the difficulty of the diet, and our email list sign up below can get you 7 days of a sample diet for stage 4 kidney disease.

Included in the restrictions are: protein, fluids, electrolytes and minerals (potassium, sodium and phosphorus). A balanced diet with fats and carbohydrates are adjusted according to a patient’s weight and age to go with the required calories per day.

• Protein restriction:Diet For Kidney Failure Stage 4

For the most part a patient in a stage 4 kidney failure, protein is maximally restricted on the stage four kidney failure diet. Take note that the kidneys take part in most of protein metabolism in the body. Nitrogen is the by-product of this process, which has quite a taxing effect on the kidneys. A protein intake of 0.6 g per kilogram of body weight according to the Kidney Disease Outcome Quality Initiatives (K/DOQI) Nutrition Guidelines is actually beneficial for glomerular filtration. This guideline is further computed and assessed by a nutritionist to give you a list of the equivalent daily protein intake.
It should be noted that only protein from quality food sources should be taken and added to the diet list.  When you are thinking of a protein restricted diet menu, you must make sure you are aware of all the protein sources in your end stage kidney disease diet are healthy and provide other valuable nutrients like vitamins and minerals that your body needs.  

• Fluid restriction: Stage 4 Renal Failure Diet

In order to avoid fluid accumulation, edema and of course additional kidney workload, fluids should also be restricted daily. For patients, this will be quite hard to maintain because thirst will always come in the way. However, this should be on strict monitoring because as the kidneys progress into further damage, urine output decreases and fluid retention will ensue. This condition will result in edema, shortness of breath and even high blood pressure.

• Electrolyte and Mineral restriction: Diet For Kidney Failure Stage 4

Potassium is restricted from 2000 to 3000 mg daily. Take note that potassium may accumulate when not restricted in stage 4 kidney failure and may cause fatal results such as heart attack if not strictly monitored. 

Phosphorus restriction is from 800 to 1000 mg daily. When not monitored accordingly, phosphorus may remain in the body and cause a cascading effect of poor calcium absorption. This will, in turn, lead the parathyroid hormone to affect the release of calcium and phosphorus from bones. The overall effect to bones, heart and blood vessels may be devastating.

Sodium should also be restricted in stage 4 kidney failure. Based on certain aspects such as blood pressure and fluid balance, sodium is limited only from 1000 to 4000 mg daily. In restricting sodium from the diet, fluid retention and thirst is controlled.

Calories and Overall Health: Diet For Kidney Failure Stage 4

In order to achieve not only optimal kidney health but overall health as well, calorie intake should be monitored as well. In protein restriction itself, a patient on a ckd stage 4 diet can suffer weight loss due to decrease supply of calories from protein. Adding more protein when this condition occurs may risk kidney health. Thus, consulting your nutritionist on a regular basis will help a lot in controlling calorie intake and ensuring you have the best kidney health possible as you prepare for dialysis.

One of the best ways to avoid weight loss on the renal diet is to adjust carbohydrate and fat intake. In this way, calorie intake will be increased and weight loss is avoided to a certain extent. If protein needs to be adjusted due to muscle loss, always seek professional advice.

A healthy diet may be quite limiting for stage 4 kidney failure patients, but this is the best way one can do in order to evade the more damaging effects of the unnecessary foods to the kidneys. With this, progression to stage 5 is delayed and the kidneys are safeguarded from further injury and damage.

Working to improve your health is important, and you can slow the progression of your kidney failure with a great diet.

For a Great Predialysis Cookbook see my cookbook on Amazon!  It's a great way to have some renal nutrition books to read.

Also published on Medium.