What is the difference between a regular renal diet and a soft renal diet?

A soft renal diet is a combination of foods that are good for your kidneys, and easy to chew. This is helpful for people who might not have enough energy or enough teeth to chew food thoroughly. Sometimes other medical issues create problems with this as well.  When that happens, it’s difficult to get enough calories, and might even be a hazard if you have difficulty swallowing. If you are having any difficulty swallowing, be sure to let your doctor know, so you can be properly evaluated to make sure you don’t develop complications when eating.

In this discussion, we’ll talk about how you can combine the general guidelines for both renal and soft diets to meet your needs. First, let’s review your renal diet needs.

Pre-dialysis Diet

Your pre-dialysis diet recommendations depend a lot upon which stage of chronic kidney disease you have, and what your lab values are. Depending on the stage of your kidney disease, your doctor might recommend that you limit several things in your diet, including protein , foods high in sodium, foods high in potassium, and foods high in phosphorous.

Each person’s needs are unique. While there are guidelines you should follow for foods you should avoid on a pre-dialysis diet, your doctor and your renal dietitian will be able to provide the most individualized assessment of your needs, and recommendations for your care.

Dialysis Diet

Your renal dietitian may have recommended that you limit protein before you started dialysis, but dialysis patients are encouraged to eat lots of high quality protein to build muscle and tissue and promote health and healing.

However, dialysis patients need to limit potassium and phosphorous more strictly, since potassium build-up between treatments can be especially dangerous and phosphorous isn't removed well during dialysis.

Keep in mind that even with low potassium foods, you need to limit quantities, since your total potassium intake can build up more quickly than you realize – the only foods you can rely on to be completely potassium-free are butter, margarine, and oils – and your cholesterol levels won’t appreciate too much of those!

Patients on peritoneal dialysis (PD) may be allowed a more liberal diet regarding potassium, since this treatment is performed daily, and potassium is usually removed fairly effectively. Your doctor and renal dietician will make recommendations for you.

Another concern for dialysis patients is phosphorous, since only limited amounts are removed with treatments. A combination of low dietary intake and use of medicines called phosphate binders is very important, since it’s difficult to remove it from the blood, both with hemodialysis and peritoneal dialysis.

High phosphorous foods typically come from animals (high-protein meats), as well as dried beans and peas. Most high potassium foods come from plant sources, like fruits and vegetables.

There are some “double jeopardy” foods that are high in both potassium and phosphorous, so you have to be especially careful with these – dairy, nuts, seeds, chocolate and whole grains. The good news is that there are some great alternatives to the double jeopardy hazards, and many of them will fit into your soft renal diet meal plan.

Another caution about phosphorous: it’s added during processing in things like deli meats and colas, as well as in many preservatives in processed foods. Check the label, and if you see any of these names listed, there’s phosphorous hiding somewhere:

• Phosphoric acid
• Dicalcium phosphate
• Monocalcium phosphate
• Pyrophosphates
• Hexametaphosphate
• Polyphosphates
• Sodium phosphate

Whew! Who’d want to eat something with that kind of name in it anyway?

Soft Diet

The soft diet is just that. Soft and easy to chew. Since some of the food types we’re going to cover may be limited in your specific type of renal diet, you’ll need to apply the principles of the soft diet to the foods you are permitted to eat, and ignore the rest!

• Milk products are typically restricted in diets for both pre-dialysis and dialysis patients, but we’ll just mention that if you’re having them, stick to smooth and soft textures.
• Safe meat and protein principles mean that meat should be ground; fish should be baked, poached or broiled, and anything that’s thick or in large chunks should be avoided.
• Vegetables should be cooked soft, minced or diced to less than ¼ inch cubed.
• If you’re allowed fruits, choose things like applesauce and soft fruits without skin. If thin liquids are a problem, don’t use canned fruit unless the liquid is drained.
• Breads, cereals and starches should be soft or creamy. No brown or wild rice or cold cereals with dry fruit or nuts.
• Desserts! As long as they’re soft, and don’t have anything hard, dried, or chewy in them.

Sometimes, nutritional supplements are added to soft diets. Since these supplements often have too much of what’s not good for your kidneys, a supplement specifically created for patients on dialysis such as Nepro®, may be a great option. Ask your renal dietitian to be sure.

So what’s a soft renal diet?

It’s a diet made up of kidney-friendly foods that are easy to chew to get the nutrition you need. If you’re having trouble chewing food, or don’t have the energy to finish meals, a soft renal diet may be just what you need. You can find out more about a renal diet by checking out some of our amazon books that teach more specifics of a renal diet. Go there now