Ipswich & District Kidney Association

There is no single diet for people with kidney failure. Everyone will have a different set of blood results, individual tastes in food and different medical problems which will formulate advice, to keep you well. Healthy kidneys control the level of chemicals and water in the body. Some chemicals are waste products; others are minerals such as potassium, sodium and phosphate which are important for your health whatever the medical condition. When the kidneys are not working well, the waste products build up causing weight loss, nausea, taste changes and a reduced appetite. At this stage, the balance of minerals may become upset causing them to rise or drop below the levels needed for good health. These minerals come from the food you eat so the diet may need to be changed to control the levels within your body. Despite this time, it is important to continue to eat a well-balanced diet. It is still possible to eat well with a renal diet despite having other conditions such as coeliac disease, diabetes and heart disease. So it is important to discuss honestly about any concerns and ask the dietician to explain the reasons behind any changes to the diet so that you are fully aware about what is going on. From time to time dietary advice will change in response to your medical condition or treatment. 

 

If you need to eat less potassium, you will be advised to limit certain high potassium foods or avoid them altogether to keep your potassium level around 5.0 mmol/l. The main sources of high potassium foods are coffee, fruit juices, chocolate, dried fruit, rhubarb, bananas and foods made from these too. Some foods, such as milk and certain fruit and vegetables contain a moderate amount of potassium and provide other valuable nutrients. Guidelines on the amounts and types of foods that can be eaten are provided which will be adequate for people with diabetes or heart disease. There are also many foods that are low in potassium which can be eaten in normal amounts such as apples, pears, tinned fruit, tea, bread, rice, pasta and noodles. However, even foods eaten in large amounts that are low in potassium can result in a high potassium level in the blood. 

 

As most food contains potassium it is not possible to omit it from the diet completely so it needs to be included in modest amounts. It is also dangerous for your heart should you restrict potassium unnecessarily. Your dietician will often rank foods as high (contains 5-7 mmol), medium (contains 3.1-4.9 mmol) or low (less than 3 mmol), depending on the level of potassium in a typical portion. 

To keep your potassium levels under control try to choose foods from the low or moderate groups and only have foods high in potassium in small amounts occasionally (once a week or fortnight). Culinary methods such as soaking and boiling are a very useful way of reducing the potassium content of potatoes, yams and other vegetables to be consumed as part of a healthy balanced diet. There is still potassium in protein foods such as meat, fish, eggs, cheese, Quorn and tofu which is important for building and maintaining muscle. It is still necessary to include these foods in moderation or in the portions advised. 

 

Healthy Eating 

A healthy diet will be beneficial for most people with kidney failure. Some health problems will improve such as blood pressure, by eating less salt and aiming for a healthy weight. It will also protect the kidneys from further damage. Healthy eating also helps to prevent and treat medical conditions such as diabetes, obesity, high blood fats and high blood cholesterol. It will also make you fitter for dialysis or a transplant operation when the time for one of these arises.

 

 

 

 

General Tips for Healthy-Eating 

 

 

Eat Regular Meals & Try Not to Skip Meals Especially Breakfast 

 

This advice is useful for everyone. If you are underweight or have a small appetite, eating regularly and including extra snacks between meals is a useful way to make sure you eat enough. Some people find that when they are on dialysis they are unable to manage big meals, so this way of eating would be beneficial. 

 

Eat Less Fat and Fewer Fatty Foods 

 

This will help to reduce weight and control cholesterol particularly eating less saturated (animal) and total amount of fat. 

 

If You Eat Fat, Choose Healthier Fats 

 

Healthier fats are unsaturated fats which are mainly plant based such as olive, rapeseed, sunflower oils and margarines. 

 

Eat Oily Fish Regularly

 

The omega-3 oil found in oily fish (herring, salmon, mackerel, trout and sardines) but not white fish can help to protect against heart disease. It is still possible on a low phosphate diet to include some oily fish in the diet such as salmon, trout, fresh tuna and mackerel, once a week. White fish can be eaten regularly, low in fat and is a good source of protein. 

 

Eat Less Sugar & Fewer Sugary Foods 

 

These tend to be high in calories and low in other valuable nutrients, so are not useful if you are overweight. If you are underweight, feel nauseous or have a poor appetite they can provide extra energy. 

 

Eat Foods Rich in Fibre 

 

Eating fibre rich-foods protect you against heart disease and cancer. It also helps to keep the bowels working normally. With a low potassium diet it is still possible to include some fibre safely in the diet such as granary bread, low potassium fruit and vegetables. 

 

Eat More Fruit & Vegetables 

 

The amount of potassium varies. Therefore, try to choose more of low to moderate content of these. They provide vitamins, minerals and fibre which can protect against heart disease and cancer. 

 

Eat Less Salt 

 

Eating less salt can prevent or treat high blood pressure which will protect against strokes, heart attacks and further damage to the kidneys. When fluid intake is restricted it helps to reduce salt intake to control thirst. It is best to flavour food with herbs, spices, black pepper, lemon juice, vinegar, onions and garlic rather than with salt. 

 

Drink Alcohol in Moderation 

 

Unless your doctor has advised to avoid this, alcohol can be included. It is advised to limit to a maximum of 21 units per week for men, and 14 units per week for women. Certain alcoholic drinks will contain more potassium such as beer, cider, lager and red wine than spirits which are low in potassium. Any alcohol consumed needs to be included as part of the fluid allowance.

 

 

Lisa Chapman

Renal Dietician