What business does someone trained as a physician-scientist have, talking about “Tools necessary for a Kidney-friendly kitchen”, you may ask?
Well, it’s my own decade-long Experience navigating life as a Kidney Warrior (currently post-kidney transplant) and the frustrating lack of organized information on this matter in the medical literature or public domain, that has motivated me to help fellow members in the Kidney Community in this regard.
The treatment approach towards Chronic Kidney Disease includes dietary restrictions to help delay kidney damage. The technical name for such diet modifications is “Medical Nutrition Therapy (MNT)”, or more commonly, a Renal Diet Plan or a Kidney-friendly Diet plan.
WHAT ENTAILS A KIDNEY-FRIENDLY DIET PLAN?
Organs in our body are naturally wired to function in environments that are tightly regulated with extreme precision. When we talk about the body environment, we primarily refer to our blood composition. In good health, our Kidneys & Lungs are in charge of regulating this blood biochemistry. However, Kidneys are unable to play their part in “blood -balancing” functions during Chronic Kidney Disease (CKD).
In CKD, filtration zones in nephrons within our kidneys get severely damaged following constant local injury. This could be either by our immune system (non-diabetic CKD) or high blood sugar (CKD with Diabetes) or the sheer force with which blood gushes to these filters when kidney disease follows uncontrolled high blood pressure. Other causes such as Polycystic Kidney Disease (stems out from kidney tissue itself) and conditions that block the urine “outflow pipe” could damage nephrons via other internal mechanisms.
As organ damage progresses, kidneys gradually lose their capacity to segregate “blood wastes” from “useful blood proteins and nutrients”. As a result, blood levels of all these parameters go haywire! Such upset blood composition “instigates angry reactions” (CKD symptoms) from all body organs.
What we “feed into our systems” directly affects our blood composition. So in CKD, when kidneys are unable to balance out our blood composition, making some smart modifications in our diet goes a very long way in maintaining our blood composition to near-normal levels and keep our organs “a lot less angry for a lot many years than otherwise”. Such Diet Modifications in the context of kidney disease comprise a “Medical Nutrition Therapy” (MNT) or Renal Diet.
When started early on in course of your CKD journey, a kidney-friendly diet has been clinically proven to effectively delay disease progression & add many symptom-free years before our kidneys finally start to give up.
Of all things that make up our blood, there are 5 major components that impact our CKD journey the most. These are:
Focusing on managing these very components in our diet would suffice when following a Renal Diet Plan.
Find the general outline about these blood components and links to comprehensive guides about these, below.
Sodium is a major mineral mainly present in our bloodstream (outside the cells). It is a major component of table salt. Among other functions, Sodium helps maintain our Blood Pressure. CKD causes an increase in blood Sodium levels beyond permissible levels which in turn undesirably increases our BP and promotes further kidney damage. This calls for a reduction in our daily Sodium intake once kidney disease or any of it’s risk factors (such as high blood pressure) sets in.
Learn more about this crucial topic by clicking on the image link below:-
Potassium is also a major mineral in our human body chiefly present inside each cell. Normally, it helps keep our heart rhythm. It also keeps our Blood Pressure in check by “balancing out” the BP-raising effects of Sodium in our body.
Chronic Kidney Disease causes an increase in our blood potassium levels as well. So by logic, it should balance out the increase in BP by Sodium again, as it normally does, right? Only, unfortunately, it doesn’t. Potassium does help reduce blood pressure in normal health, but if the levels propel beyond permissible limits (fancy word: Hyper-kalemia), our heart rhythm goes literally crazy! And it’s extremely dangerous both in itself, as well as in terms of kidney disease progression. So Potassium intake needs scrutiny in CKD.
Find all that you must know about Potassium, your kidneys & a Kidney-safe diet, in the image-linkbelow!
Phosphorus is another mineral prevalent in our body, chiefly constituting our bones and teeth. Simply put, it is special.
Phosphorus is naturally present in structural proteins within our body. But when we talk of the phosphorus that our kidney handles, we are primarily concerned with the phosphorus that our intestine absorbs from what we eat.
In CKD, the blood levels initially reduce in early stages due to its rampant urinary loss & lack of “re-absorption” back to our bloodstream. However, intriguingly, “free” phosphorus levels shoot-up once kidneys enter End-Stage Renal Disease (failure).
So why is that bad? Well, you see, Mother Nature taught our body organs to be content with what’s necessary and shun “greed”. So if blood phosphorus levels shoot-up beyond necessary levels, it won’t go and continue to strengthen our bones & teeth. Such “free” phosphorus desperately tends to deposit on other tissues and “eat-away” those tissues gradually.
To avert such catastrophic consequences, our bones volunteer to help. As a result, Calcium leaches-out from bones to “bind” to some of this excess “free” phosphorus and prevent undesirable phosphorus deposition over other tissues. However, in the process, the bones turn really fragile and prone to fractures.
So the”altruism” by bones to curb high blood phosphorus in CKD ultimately does something more concerning (bone damage). That couldn’t be something you could compensate with, right? Thus, controlling dietary phosphorus intake is an absolute necessity once your blood reports prove that your CKD has advanced sufficiently and blood phosphorus levels start rising.
Click on the image link below to learn how best to curb the metabolic menace of high blood phosphorus in Chronic Kidney Disease!
CHOLESTEROL & FATS
Chronic Kidney Disease (and kidney failure) disturbs Liver function, weakens Muscles and all other apparatus where dietary Cholesterol and Fat could be normally diverted for more constructive use. In such a scenario, these “excess” nutrients (fats & cholesterol) end-up clogging our blood vessels, increase blood pressure and promote heart disease by the time our kidneys fail.
Normally, your medical consultant would put you on medication to control the above consequences. However, there is only so much that drugs can help us with. If we continue to “abuse” our body with high cholesterol & fatty diets, that would only make it difficult for the meds to help us and the heart disease will set-in much faster. All this would only add to further kidney damage.
Besides, reducing overall fat content in our diet would also help with weight management that is crucial in CKD. That’s because, greater the “fat content” in our body, more the number of blood vessels. That translates as a blood overload that our already weak CKD-scarred kidneys would need to try and filter. In a nutshell, unwell Kidneys only end-up failing faster!
Hence, reducing CHOLESTEROL & FAT intake in a renal diet is a must.
Now, up until now, as per our discussion, the intake of specific minerals (Sodium, Potassium, Phosphorus ) & Fats needs to be reduced due to the kidney’s ability to flush them out and their damaging consequences.
BUT PROTEIN IS DIFFERENT!
Instead of retention in the blood, there is severe protein loss in urine during CKD & kidney failure. Why is it advised to reduce protein consumption then? Sounds counter-productive right?
It is here that you’ve got to remember an important bit. The protein that we lose in Urine is NOT dietary protein. These are Plasma proteins that float in our bloodstream and carry out a number of crucial functions in the body essential for our survival.
On the other hand, Dietary Protein (from our food) breaks into small amino acids upon digestion. Once these amino acids serve tissue-repair & strengthening roles in our body, they transfer to the Liver to turn into a toxic waste product called UREA. It is true, that some amino acids from digesting proteins in food also get used in the liver to form various plasma proteins such as Albumin. But this process is a lot slower than food proteins forming the toxic waste — Urea.
In normal health, Urea is constantly removed by our kidneys to keep our bodies spic-n-span. But in CKD, unwell kidneys are unable to remove Urea as effectively as they otherwise should. This in-turn reflects as high blood urea levels in our blood reports, especially in advanced stages of Chronic Kidney Disease.
If a CKD patient has a high protein diet, any minute improvement in plasma protein levels measures poorly against the quantity of Urea that forms in the process.
CLICK ON THE IMAGES BELOW FOR MORE
All this undesirably burdens your “unwell” kidneys with more waste to remove. This means a greater workload & damage for a minuscule benefit. So remember to stick to a low-protein diet when following a Renal Diet Plan.
Find your go-to, comprehensive, easy to understand, guide on Dietary Protein in the context of Chronic Kidney Disease in the image link below:
If you are on Dialysis, your medical team will advise you to start clinically approved protein powders in your diet. A lot of care teams worldwide attribute this as “compensation for greater protein loss during dialysis”. But as we have explained above, increasing protein in food is NOT the best way to pump up plasma protein levels diminishing during Dialysis. Advising Protein Powders during Dialysis has more to do with improving overall tissue repair capabilities & the general nutritional status of a CKD patient; it is not a compensation for plasma protein loss in urine.
Nutrient Allowances in a Non-Diabetic Renal Diet
Scroll along to learn more about a hassle-free implementation of the Kidney-friendly Diet plan in your daily lives.
FOR FURTHER DETAIL ON:
1. Individual nutrients;
2. How chronic kidney disease impacts their role in your body;
3. The list of safe foods v/s the ones that must be avoided
4. How sticking to a renal diet plan helps keep you relatively comfortable during your CKD journey