Dietary management of Chronic Kidney Disease

Eating the right foods in childhood is important for normal growth and development. However, due to some of the symptoms of CKD such as feeling sick and having a poor appetite, normal growth can be difficult in children with CKD.

As kidney function decreases, following dietary advice can help control levels of minerals in the blood and improve some symptoms. It is important to talk to your dietitian as everyone's dietary needs will be different. Please click on the next few sections to learn more about this.

Energy

Everyone needs energy from food to grow and be active. We get energy from calories in food. When an individual is feeling unwell they may not be able to eat all the calories they need, this can lead to feeling tired and weight loss may occur. To keep strong, those with CKD may need to include high calorie foods, drinks and additional snacks to get enough energy. The dietitian will help you further with this.

Protein

Protein is found in foods such as meat, fish, eggs, cheese, milk, yoghurt, nuts and beans. It is essential to include enough protein in the diet to grow, but not too much as this can put extra pressure on the kidneys filtering process. The dietitian will help guide you on how much protein you need to eat.

Potassium

Potassium is a mineral needed 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 and this is not healthy for the heart. A specialist dietitian will advise on how to follow a low potassium diet. For example, avoiding bananas, mushrooms and chocolate and replacing them with low potassium foods such as apples, peppers or plain biscuits may be advised.

Phosphate

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 intake of high sources of dietary phosphate is limited, some is still consumed from other foods and drinks. To help keep blood phosphate levels under control, the doctor may prescribe a medication called a phosphate binder that acts as a magnet and binds to the phosphate that you eat to reduce how much is absorbed into the blood. This is a very important medication that should be taken as prescribed by the medical team.

Salt

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 oedema. The dietitian will advise on how to limit foods containing a lot of salt, for example, bacon, sausages, takeaways and processed foods. Eating more homemade foods can help reduce salt intake. Click here to see some examples of how to choose low salt options in the eating out resource.

Filtering Fact:

Salt is also known as sodium on food labels.

Fluid

If the kidneys can not remove excess fluid from the body this can lead to oedema and high blood pressure. A daily fluid allowance may be advised to limit fluid intake and manage oedema / 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 is also provided from the diet. One job of the kidneys is to activate Vitamin D, so if they are not working well the Vitamin D is not activated. This can lead to weak bones. Sometimes a Vitamin D supplement may be recommended by your doctor to help keep your bones strong and healthy.

Summary

There are a lot of different parts to the diet for CKD, and it may seem a lot to take in and learn. A specialist dietitian will help you to understand what changes can be made to the diet. Our video provides a short summary of what the kidneys do and what happens when they are not working very well.

There is also a fun game which you can play!