What should I eat with Chronic Kidney Disease?
Eating the right foods in childhood is important for your growth and development. However, due to some of the symptoms of CKD such as feeling sick and having a poor appetite, optimal growth can be difficult.
As kidney function decreases, following your dietitian's recommendations can help control levels of minerals in the blood and improve some symptoms. It is important to talk to your dietitian as everyone's diet needs will be different. Please read the next few sections to learn more about this.
Everyone needs energy from food to grow and be active. We get energy from calories in food. When a person is feeling unwell they may not be able to eat all the calories they need. This can lead to feeling tired and losing weight To stay strong and growing, a person with CKD may need to include high calorie foods, drinks and additional snacks to get enough energy. Your dietitian will help you know what's best for you.
Protein is found in foods such as meat, fish, eggs, cheese, milk, yogurt, nuts and beans. It is essential to eat enough protein to grow. But it is also important to not eat too much protein as this can put extra pressure on the kidney's job. Your dietitian will help guide you on how much protein you need to eat.
Potassium is a mineral we need from food to keep the heart beating and muscles working properly. If the kidneys are not working well, potassium in the body can rise too high. This is not healthy for the heart. Your dietitian will advise on what foods are low or high in potassium and how to follow a low potassium diet. For example, avoiding bananas, mushrooms, and chocolate and, instead, choosing low potassium foods such as apples, peppers or plain cookies may be advised.
Phosphorus is a mineral needed from food that has a role in controlling the amount of calcium in the bones. When phosphorus levels in the blood are measured, it is known as phosphate. If the kidneys are not working well, phosphate can rise too high in the blood and this is not healthy for the bones, it can make them weaker. This can also affect the blood vessels. The dietitian will advise on how to follow a low phosphate (phosphorus) diet. Phosphate additives can also be added into many processed foods and drinks to keep products fresher for longer. The best way to reduce the intake of phosphate additives is to choose fresh foods over processed items. It may also be possible to find alternative products which do not contain phosphate additives. Reading and comparing labels and ingredient lists on packaging can help with this. The dietitian will explain how to do this.
Dairy foods are high in phosphorus. If an individual is following a low phosphate diet and really loves milk, the dietitian may suggest a daily allowance. This includes all sources of dairy, including drinks of milk, milk added to tea or to cereal.
All foods and drinks contain some phosphorus. Even when high phosphorus foods are avoided, some phosphorus is still in your food or drinks. To help keep blood phosphate levels under control, the doctor may prescribe a medication called a phosphate binder. This medication acts as a magnet and binds to the phosphorus you eat to reduce how much is absorbed into the blood. This is a very important medication that should be taken as prescribed by your health care team.
Salt is in lots of foods.
As kidney function decreases, eating too much salt can lead to water building up in the body, such as in the legs, which can become swollen and uncomfortable. This is called odema. Your dietitian will advise on how to limit foods containing a lot of salt. A few examples of foods with lots of salt are bacon, sausages, fast food and processed foods. Eating more homemade foods can help reduce salt intake. See some examples of how to choose low salt options.
Salt is also known as sodium on food labels.
If the kidneys can't remove excess fluid from the body, odema and high blood pressure may result. A daily fluid amount may be advised to limit fluid intake and manage edema and fluid overload.
Vitamin D and calcium
Both calcium and Vitamin D are needed for healthy bones. Vitamin D helps the body absorb and use calcium. Vitamin D is provided by the sun but some comes from the diet. One job of the kidneys is to activate Vitamin D in our body. If the kidneys are not working well, Vitamin D is not activated. This can lead to weak bones. Sometimes a Vitamin D supplement may be recommended by your healthcare team to help keep your bones strong and healthy.
Learning what to eat, drink and what to not may seem a lot to take in and learn. But a specialist dietitian will help you to understand what changes can be made to the diet. There is also a fun game which you can play to help you!
Want to learn more about the important work the kidneys do for you? Check out this video.
Information sourced from:
National Kidney Foundation. KDOQI Clinical Practice Guideline for Nutrition in Children with CKD: 2008 Update. American Journal of Kidney Diseases. 2009;53(S2):S1-S124.
Royle J. Chapter 12: Kidney Disease. In: Shaw V, editor. Clinical Paediatric Dietetics. 4: John Wiley & Sons Ltd.; 2015. p. 242-81.