Slow chronic kidney disease with careful food choices

Chronic kidney disease (CKD) may not be a disease frequently mentioned in the news, but around 26 million Americans have it and for many it won’t be discovered until it becomes more advanced.  Having CKD means your kidneys are damaged and can’t filter blood like they should.  This can lead to wastes building up in your body leading to other health problems.  CKD is often progressive over time, possible leading to kidney failure with the only treatment options being dialysis or a kidney transplant.

Risk factors for CKD

The most common risk factors for development of CKD are high blood pressure and diabetes.  Other causes include:

·      A family history of kidney failure

·      Over the age of 60

·      Kidney stones

·      Lupus and other autoimmune diseases

·      Frequent urinary infections

·      Tumors or enlarged prostate gland in men

·      Ethnic populations with high rates of high blood pressure and diabetes – African Americans, Hispanic Americans, American Indians, Asians, and Pacific Islanders

Stages, signs and symptoms of CKD

There are 5 stages of CKD with glomerular filtration rate (GFR) being the best measure of kidney function.  The GFR is the number used to figure out a person’s stage of kidney disease. 

Stages 1 and 2 often have no symptoms but a person may discover they have CKD if they are being treated for high blood pressure or have diabetes.  Testing may reveal the following:

·      Higher than normal levels of creatinine or urea in the blood

·      Blood or protein in the urine

·      Evidence of kidney damage in an MRI, CT scan, ultrasound, or contrast x-ray.

·      A family history of polycystic kidney disease.

Stage 3 is more likely to be discovered due to a person developing complications of high blood pressure, anemia and/or early bone disease.  They may also have the following:

·      Fatigue

·      Too much fluid leading to swelling (edema) in the lower legs, hands or around the eyes.

·      Changes in urination – may be foamy, dark orange, brown, tea-colored or red if it contains blood

·      Frequent urination during the night

·      Sleep problems – trouble falling and staying asleep, itching, muscle cramps or restless legs.

Stage 4 has many of the same symptoms as stage 3 but with some additional complications:

·      Nausea

·      Taste changes – may detect a metallic taste in food

·      Uremic breath as urea builds up in the blood causing bad breath

·      Loss of appetite

·      Difficulty in concentrating

·      Nerve problems – numbness or tingling in toes or fingers

Stage 5 include symptoms as stages 1-4 along with:

·      Changes in skin color

·      Increased skin pigmentation

At stage 5, the kidneys can no longer remove waste and fluids from the body so toxins build up in the blood causing an overall ill feeling.   At this point, a nephrologist will decide which treatment is best – hemodialysis, peritoneal dialysis, or a kidney transplant. 

Food choices to help control CKD

When diagnosed with CKD, it is advisable to follow a kidney-friendly meal plan.  This type of meal plan limits certain minerals in the foods you eat helping prevent waste buildup in the blood. Doing so, may help slow down the progression of CKD along with controlling high blood pressure and diabetes and preventing other health issues.  

The main minerals usually needing to be reduced include sodium, potassium and phosphorus along with the macronutrient protein.  Here is how each of these has an effect on CKD:

Sodium – Sodium needs to be reduced to help lower blood pressure which may slow down CKD.  A high sodium intake stays in the body, making blood pressure rise since damaged kidneys cannot filter sodium out of the body as well as healthy kidneys.  Aim for less than 2,300 mg of sodium a day and try to keep blood pressure below 140/90 mmHg.

Foods high in sodium to eat less of include: bacon, corned beef, hot dogs, luncheon meat, sausage, canned and instant soups, boxed mixes like hamburger meals and pancake mixes, canned vegetables, pickles, cottage cheese, frozen meals, snack foods like pretzels, crackers, and chips, soy sauce, baked goods, and bread. 

Potassium – This mineral helps nerves and muscles work the right way.  In CKD, the kidneys may not be able to remove extra potassium from the blood and some medicines can raise your levels of potassium.  This can affect your heart rhythm so a potassium limit may be necessary.

Low potassium foods to choose include:  apples/apple juice, applesauce, blackberries, blueberries, cabbage, carrots, cauliflower, corn, cucumbers, eggplant, grapes, green beans, mushrooms, onions, peaches, pears, pineapple, plums, raspberries, strawberries, tangerines and watermelon.

Phosphorus – Phosphorus is another mineral needed to keep bones healthy, and helps blood vessels and muscles to work properly. In CKD, phosphorus can build up in the blood, making bones thin and weak, along with causing itchy skin and bone and joint pain.  Reducing phosphorus intake is often necessary in CKD.

Avoid foods high in phosphorus which include: 

·      Meat, poultry, and fish – A cooked portion should be about 2 to 3 ounces or the size of a deck of cards.

·      Dairy foods – Keep portion sizes to ½ cup of milk or yogurt, or one slice of cheese.

·      Beans and lentils – Portions should be about ½ cup of cooked beans and lentils.

·      Nuts – Keep portions sizes to about ¼ cup.

·      Bran cereals and oatmeal, colas and some bottle iced teas.

·       Many packaged foods contain phosphorus – look for the word “phosphorus” or for “PHOS”  in words such as “pyrophosphate” on ingredient labels. 

Protein – Many foods contain the macronutrient protein.  It’s found in both animal and plant sources and provides the building blocks helping to maintain and repair muscles, organs and other functions.  However, when the body uses protein, it produces waste needing to be removed by the kidneys.  If you consume too much protein, your kidneys have to work overtime making it difficult for people with CKD to do so. 

Here are ways to eat the right amount of protein without putting undue strain on the kidneys:

·      Keep portions sizes of meat, poultry, and fish to no more than 2 to 3 ounces.

·      Dairy foods – a portion is ½ cup of milk or yogurt, or one slice of cheese.

·      Plant proteins – a serving size is ½ cup cooked beans, ¼ cup nuts, a slice of bread or ½ cup of cooked rice or noodles.

In conclusion

Food choices do make a difference in helping slow down CKD.  The more you know which foods to avoid and which to choose can go a long ways to keeping you and your kidneys healthy. 

To find out additional information on CKD, visit the National Kidney Disease Education Program or the National Kidney Foundation to learn more about CKD and how to prevent or treat it.