Should I follow a low-phosphorus diet if I have kidney disease?

This is a question you should discuss with your doctor or a renal dietitian, and the answer is often affirmative. Phosphorus is a mineral primarily abundant in dairy products and meats. It plays a crucial role in building strong bones and teeth. However, as chronic kidney disease (CKD) progresses, typically even in the early stages, the kidneys gradually lose their ability to eliminate excess phosphorus from the body. Since excessive phosphorus can harm your bones, it is prudent to reduce your phosphorus intake.

Many experts recommend aiming for a daily phosphorus intake of approximately 800 to 1,200 mg. Unfortunately, food labels do not always disclose phosphorus content, so consulting a renal dietitian or referring to a nutrition reference guide becomes necessary. Over time, you’ll become more familiar with the phosphorus values of the foods you frequently consume.

If you are also on a lower protein diet, adhering to a low-phosphorus diet becomes more manageable because foods high in protein often contain elevated phosphorus levels. Your doctor may recommend restricting daily dairy servings and taking a calcium supplement. When taken with meals, calcium supplements function as phosphate binders, attaching to excess phosphorus and preventing its absorption by the body.

Should I follow a low-potassium diet if I have kidney disease?

Maintaining the appropriate level of potassium in your body is essential for the smooth functioning of all your muscles, including your heart. Healthy kidneys are responsible for regulating potassium levels in your blood. However, as kidney function declines, they lose this ability.

Regular monitoring of your potassium levels through blood tests is crucial. If your levels are consistently high, your doctor may advise you to adopt a low-potassium diet.

Numerous foods contain potassium, with some, like avocados, dried fruits (such as raisins, apricots, and prunes), potatoes, oranges, bananas, and salt substitutes, being particularly high in potassium. If potassium restriction is necessary, a dietitian can guide you on identifying foods with higher and lower potassium content.

Should I follow a low-protein diet?

Protein, present in foods like meats, fish, poultry, dairy products, nuts, and certain grains, is vital for muscle and tissue formation. However, when your kidneys are not functioning optimally, the byproducts generated during protein breakdown can accumulate in your bloodstream, placing additional strain on your kidneys.

Many individuals with kidney disease discover that their appetite for protein-rich foods diminishes over time due to changes in taste perception. In some cases, you might need to make a concerted effort to consume adequate protein and calories because kidney disease can lead to reduced appetite.

In all stages of chronic kidney disease (CKD), it is essential to avoid malnutrition. A blood test measuring albumin, a type of protein, serves as a reliable indicator of your nutritional status. Your albumin level should ideally be at or above 4.0 g/dL. If you experience weight loss, appetite loss, or other signs of inadequate nutrition, consult your doctor or a renal dietitian.

If your diet provides very little protein, your doctor might recommend supplements that supply the nutrients typically obtained from protein, such as ketoacids and/or amino acids.

To determine the protein content of your diet, read food labels and consult nutritional reference resources. Renal dietitians possess specialized expertise in assisting individuals with kidney disease in creating healthy meal plans. Always consult with your doctor or dietitian before making any adjustments to your dietary protein intake.

Loss of appetite and kidney disease

A decreased appetite is a common symptom in advanced kidney disease. Even if you don’t feel hungry, it remains essential to maintain good nutrition. Here are some strategies to ensure adequate nutrition:

• Opt for bland or starchy foods.
• If cooking smells bother you, consider cooking in advance and freezing microwaveable meals or exploring low-sodium convenience foods.
• Try a liquid nutritional drink like Boost or Ensure once a day, but avoid relying solely on these drinks due to their high protein, phosphorus, and potassium content. Consult a dietitian before incorporating them into your diet.
• Consume several small meals throughout the day instead of one large meal.
• Watch cooking shows on television to stimulate your appetite.
• Enhance the protein content of your meals by adding egg whites, egg white powder, or protein powder. Alternatively, opt for small portions of cold protein-rich foods like egg salad or a cold chicken sandwich.
• If your lack of appetite persists, seek guidance from a renal dietitian. If you’re in stage 5 CKD and your appetite or nutritional status does not improve, it may signal the need to initiate dialysis. Many individuals find that their appetite improves after some time on dialysis.