You recently learned you have chronic kidney disease (CKD). This means your kidneys are not able to do the job they were created to do which is to remove waste and liquid from your body among many other important jobs. Following your healthcare team’s advice can help you slow the progression of the disease.

A very important member of that healthcare team is your renal dietitian. A renal dietitian is trained and experienced to help you discover what you can eat and the proper amounts. A registered dietitian (RD) like Amy McCallister, is trained to help you make good food choices at home, and also offer ideas for dining out, parties and potlucks. “Plan, plan, plan ahead!” says McCallister. “Become familiar with the restaurants you frequent; ask how a food is prepared, or ask that it be prepared without salt. Your knowledge of potassium and phosphorus also comes in handy here. Restaurant food can be loaded with salt, causing thirst and excess fluid intake.”

Here are some nutritional tips to help you get started.

Protein

In the March/April 2005 issue of Kidney Beginnings: The Magazine , Keith Norris, MD, board-certified specialist in Internal Medicine and Nephrology, explained that protein is an extremely important nutrient for all people. “Mainly found in muscles, protein is essential for life and is a major part of the body. We need protein for the growth and repair of tissues. During digestion, proteins are broken down into smaller units called amino acids. There are about 20 different amino acids in protein. However, the body cannot make nine of them, called essential amino acids. The others are called non-essential amino acids. Only animal sources contain all the essential amino acids, but by combining different plant proteins, you can also make complete protein foods.” Dr. Norris’ article mentioned the dangers of too much protein for people with kidney disease. Dr. Norris wrote, “After the protein is eaten, it is absorbed into the body, which metabolizes the proteins. Proteins in the blood (albumin) and protein waste products (blood urea nitrogen or BUN) are eventually filtered by the kidney. If there are high levels of protein filtered by the kidney, this can cause damage to the small filtering cells in the kidney. Over time, this can lead to decreased kidney function.” In addition, if your kidneys are not working well, they cannot filter protein waste products. This will show up as a high BUN level on your blood test, which will make you feel bad. It is for these reasons your doctor or dietitian will work with you to make sure your protein intake is not too high. At the same time, it is important to make sure that you eat enough protein. Too little protein intake can lead to poor nutrition that can lead to muscle loss and increase the chance of infections. It can also increase the risk of hospitalization and even dying. It is important to find the right types of protein in the right amounts.

Phosphorous

Phosphorous is a mineral found in the body, 85 percent of which is found in the bones. Phosphorous is also found in foods. Excessive amounts of phosphorous can cause calcium to be leached out of the bones, leading to weak and brittle bones. When your kidneys are not working properly, phosphorus will begin to build up in your blood. Your doctor may prescribe a medication called phosphorous binders to keep the phosphorous from accumulating in your blood stream. You’ll need to limit the amount of phosphorous-containing foods you eat. Foods that have a lot of phosphorous include some beans, cheese (except cream cheese), chocolate, custard, meats, milk (all kinds) and nuts. Prepared foods, sodas and canned foods contain a high amount of added phosphorous.

Sodium

Sodium is an important mineral that helps to control blood pressure. Too much sodium intake can lead to high blood pressure. High blood pressure is one of the leading causes of kidney disease. High blood pressure makes the heart work harder and eventually can damage blood vessels throughout your body, including the blood vessels in the kidneys. If your kidneys are damaged, they will stop filtering waste products from your blood and will not remove extra fluid from your body. The extra fluid may then raise your blood pressure even more.

The average American consumes well over the USDA and American Heart Association recommended 2,400 milligrams of sodium per day. Work with your RD to lower your sodium intake. You don’t have to give up your favorite foods, but you may have to limit some of them. And remember, salt substitutes may not be the answer for you. Some salt substitute may contain potassium which can be dangerous for a CKD patient.

AAKP’s Nutritional Counter is a great way to get the nutritional values of some of your favorite foods. This pocket size brochure contains the nutritional value for more than 300 foods, as well as menu items from 11 fast food restaurants. It’s available in English and Spanish.

Call the National Office at (800) 749-2257 for your free copy. You can also download a copy by going towww.aakp.org and clicking the “Brochures” button in the left navigation bar. Remember the secret to any successful diet is PORTION CONTROL! Contact a registered dietitian in your area for more personalized information.

Jamie Shish is a Registered Dietician working as a case manager for Fresenius Medical Care. Jamie also has training as an athletic trainer and holds a bachelor’s degree in Kinesiology.

Jerome A. Bailey is the Communications Coordinator for AAKP.