When you find out you need dialysis due to kidney failure, options for treatment include transplant, traditional in-center hemodialysis (ICHD), home hemodialysis (HHD), in-center nocturnal dialysis (ICND) and peritoneal dialysis (PD). Each treatment choice has different pros and cons when it comes to diet. Today let’s take a look at the peritoneal dialysis diet.

PD is performed on a daily basis which means waste and fluids are removed more often compared to three times a week traditional in-center hemodialysis. For this reason some parts of the diet are more liberal. Read more…

Thursday March 11 is World Kidney Day, a time to bring attention to kidney disease awareness, treatment and prevention. I will be participating in Building Bridges to Optimum Health World Kidney Day Los Angeles, a conference at the Holman United Methodist Church—please stop by if you happen to be in the LA area.
For those of you who cannot attend, here are a few highlights from my talk on Nutrition and Kidney Disease.
Kidney disease continues to rise with a strong link to epidemic rates of obesity, diabetes and high blood pressure. Early nutrition intervention can make a difference in preventing and treating these diseases that increase risk for kidney failure.

• If you are at risk for kidney disease but do not have it yet, follow a DASH diet (Dietary Approaches to Stop Hypertension) to help lower your blood pressure and eat healthier. For more information on DASH diet: www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
• If you already have early kidney disease (stage 1-3) focus on controlling blood pressure and diabetes. A low sodium diet, carbohydrate counting, glucose monitoring and daily exercise are recommended. Reduce protein to the Dietary Reference Intake (DRI) 0.8 grams/kg body weight/day and limit high phosphorus foods and phosphate additives to help preserve kidney function. Most Americans eat much more protein in their daily diets. Work with your doctor and dietitian to be sure you eat enough high quality protein to prevent malnutrition.
•  If you are in stage 4-5 CKD, not on dialysis, you may need to restrict potassium, phosphorus and fluids in addition to sodium. A reduction in protein to help decrease waste build-up in the blood may be prescribed, but maintaining adequate calorie and protein intake to prevent malnutrition is even more important.
• After starting dialysis there is no need to restrict protein—in fact extra protein is needed to replace losses in the dialysis treatment. Low sodium and low phosphorus are still required. Potassium and fluid restriction depend on the type and frequency of dialysis selected.
• In addition to the above, focus on consuming healthy fats (omega 3’s from fish, monounsaturated fats from olive and canola oil), high quality, low phosphorus proteins (egg white, fish, lean meats).
• Eat the rainbow–for good health include colorful fruits and vegetables high in anti-oxidants with anti-inflammatory properties as well as fiber, vitamin C and vitamin E.
• For successful dietary changes focus on education, family support, variety in meals and commitment to making changes to improve your health.
  Takeaways
• What you eat matters in your health-disease  for chronic disease prevention and treatment
• Diet goals change with stages of chronic kidney disease (CKD) and dialysis
• Start making changes now; it will make a difference tomorrow.

Learn more about kidney disease at www.kidneyawarenesstime.org, www.davita.com, www.yourkidneys.com, and www.kidneytrust.org.

January is a great time to make positive lifestyle changes. If you have chronic kidney disease (CKD) or are a dialysis patient, consider resolutions around eating better to keep your nutrition up and manage potassium, phosphorus, sodium and fluid the best you can.

Among the DaVita resources, several tools are available to help you stay on track. There are Diet and Nutrition articles, kidney-friendly cooking videos and my favorite, DaVita Diet Helper.  All of these resources can help you stick with your 2010 kidney diet resolutions.

Sign up for DaVita Diet Helper an online kidney meal planner. This one-of-a-kind planner uses your diet prescription for protein and potassium to create several weeks of kidney-friendly meals including recipes, what to serve with the recipe and what to snack on in between meals. Read more…

When you were first diagnosed with chronic kidney disease one of your first questions may have been ‘What can I do to save my kidneys so I don’t need dialysis?’ Blood pressure control, managing glucose for diabetics and adjustment in dietary protein intake can make a difference in kidney disease progression according to the research.

High Protein Foods

If you eat lots of protein and have CKD, you may want to make a few changes because a high protein diet is hard on your kidneys. On the other hand, a diet too low in protein is even worse for you. When you don’t eat enough protein, your muscles begin to break down. A blood protein called albumin begins to fall. People starting dialysis with low albumin levels are more likely to be hospitalized or die within the first 3 months compared to those with normal levels (4.0 mg/dL or greater). Following a low protein diet may buy some time before Read more…

Diet Questions ???

What is a renal diet or a kidney diet? For a person with a newly diagnosed chronic kidney disease, figuring out what to eat is quite confusing. The truth is there are different diets for kidney disease and diet focus changes depending on the stage of CKD.
Early stages of CKD usually focus on low sodium intake to help control blood pressure and carbohydrate balance if you have diabetes and CKD. Controlling blood pressure and blood glucose can help slow progression of kidney failure. You may be told to avoid excess dietary protein to reduce the kidney workload and minimize build-up of protein waste products in the blood. As kidney disease progresses, more focus is placed on phosphorus and potassium, since the kidney loses ability to remove excess amounts from the body.
Once you start dialysis, diet changes again. A low protein diet is replaced Read more…

Thursday November 27th is Thanksgiving, a holiday to celebrate America’s beginning and give thanks for all we have. For kidney patients, following a renal diet is even more challenging when so many favorite foods are on the menu but not on the low potassium, low phosphorus, low sodium diet list.

Here are some ways to stick to your kidney diet, Read more…

People with chronic kidney disease (CKD) and those on dialysis need to be aware of how much protein, potassium, sodium, phosphorus and calcium they consume. Since phosphorus and potassium are not required on food labels, food manufacturers may not analyze and provide data on these nutrients. Many online diet analysis tools provide only the available nutrient data. When values are missing, these tools calculate a zero value. Consequently, a person using the tool may assume they are eating less potassium or phosphorus than they actually consume.

DaVita’s online meal planning tool for kidney diets, DaVita Diet Helper, includes a Nutrition Log where users can enter foods eaten and view nutrient values for calories, fat, saturated fat, cholesterol, carbohydrate, fiber, sugars, protein, sodium, potassium, phosphorus and calcium.

Each food in the database includes a complete nutrient profile, including potassium and phosphorus content. Users can be sure all the values are correct and potassium and phosphorus are not falsely low when using DaVita Diet Helper to analyze their daily food intake.

If you use another diet analysis tool be sure to check for accurate potassium and phosphorus values.

Did you know most people with Chronic Kidney Disease (CKD) also have cardiovascular disease? CKD is one of the risk factors for cardiovascular disease. For this reason, CKD non-dialysis patients and those on dialysis are encouraged to take preventative actions to protect against heart disease.

Some of the things to do include:

• exercise
• stress reduction
• avoid smoking
• take prescribed medications
• keep normal levels of phosphorus and calcium
• lower blood fats and cholesterol
• make healthy dietary changes

Many people already know techniques to lower cholesterol and saturated fat intake. Those in early stages of CKD benefit from following a DASH type diet Read more…

Starting and following a renal diet for people with kidney disease is a challenging and often frustrating task. If you are on a kidney diet you can probably relate to lists–foods to eat, limit or avoid, lists of foods high in potassium, high sodium food lists and foods high in phosphorus.

Sometimes the lists contradict each other. The dialysis diet often goes against traditional healthy eating guidelines. Instead of ‘eat more fresh fruits and vegetables’ the new guideline is limit fresh fruits and vegetables, especially those high in potassium. Instead of “eat more whole grains and fiber’ the kidney diet guideline is ‘limit or avoid whole grains because the potassium and phosphorus content is higher than refined grains’.

Even for renal dietitians, planning individualized menus for each patient is an almost impossible job. Menu planning takes lots of time, especially considering each person’s food preferences and the differnet renal diet prescriptions.

Thanks to DaVita.com, people looking for help with renal diets now have another tool. A new online meal planner for kidney diets called DaVita Diet Helper is available at no charge for anyone looking for preplanned kidney friendly menus with recipes. Users can pick and choose 2 weeks of meals and snacks according to their food preferences. DaVita Diet Helper is based on the diet prescription prescribed by the doctor or dietitian. Meal plans from 50 to 100 grams protein are available. Potassium choices are 2000 mg low potassium or 3000-4000 liberal potassium. All meal plans are low in sodium and phosphorus.

In addition to menus and recipes, DaVita Diet Helper has a Nutrition Log where any foods eaten during the day can be recorded to show intake of calories, protein, carbohydrate, fat, cholesterol, fiber, sugars, sodium, potassium, calcium and phosphorus. The large database includes many restaurant foods, and all foods have potassium and phosphorus data included.

To use this fantastic tool, users need to know their kidney diet prescription. Clickhere to find the Diet Prescription sheet that can be printed and taken to the doctor or dietitian to complete before using DaVita Diet Helper.

Grabbing a fast meal on the run or going out for a nice dinner may be more challenging when following a renal diet. Here are some tips to help kidney patients keep sodium, potassium and phosphorus in check.

• Choose grilled, broiled or roasted beef, chicken, pork chops, fish or seafood. Avoid breaded items—these add extra sodium and fat.
• Kabobs or fajitas are usually made from fresh meats and vegetables. Ask for sauces or toppings on the side.
• Buttered noodles, plain pasta with olive oil and garlic or steamed rice are lower in potassium compared to potatoes and tomato sauce pastas.
• Checkout the fresh vegetables available. Make lower potassium choices like green beans, cauliflower, broccoli, summer squash or carrots.
• Go for a grilled or broiled chicken, fish or hamburger on a bun with lettuce, onion, mayonnaise, mustard or tartar sauce. Limit ketchup to 1 packet. Forget the high sodium pickles and processed cheese.
• For sandwiches, choose turkey, roast beef, tuna or egg salad instead of cured and heavily processed meats. Top with onions, lettuce, a thin tomato slice, bell peppers, cucumbers, alfalfa sprouts and a small amount of mayonnaise, mustard or oil and vinegar.
• Choose a side salad with dressing on the side, macaroni salad or coleslaw instead or potato salad, chips or French fries.

For more ideas on eating out read Fast Foods and the Dialysis Diet on www.DaVita.com.