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Ask the Dietitian: Back to Basics for the Kidney Diet

When a new year starts there is a desire to start fresh.  Often, we set new goals and work on accomplishing something new.  While the temptation is there to jump on the newest trend in the new year, what if this year was the year of resetting to just the basics.  I feel that if you have a strong foundation of the basics and have developed habits that support your ability to apply the basics in your life you will naturally progress to whatever is the next level.  When thinking about living with kidney disease, diet and lifestyle basics are a big part of managing this health condition. 

Diet Basics

In all stages, limit sodium. 

Your healthcare provider will let you know the best target for you and guidelines suggest a daily range between 1500 mg – 2300 mg daily.  Limiting the salt at home in cooking or at the table is a good starting point.  Check out food labels too and see if your commonly used foods are high in sodium.

Eat fruit and vegetables with most meals and fill half of your plate full of them. 

Depending on your specific needs some fruit and vegetable choices will be preferred.  They are full of nutrients, fight inflammation, and provide some fiber to help keep you regular.  Ask your provider and dietitian which fruits and vegetables are right for you.

Monitor or Limit How Much Fluid You Drink or Eat

Fluid is important to keep your kidneys and body hydrated.  Kidney disease can change how much fluid you need.  People living with kidney stones need to drink up to almost 1 gallon of water or other fluid per day.  People on dialysis are told to limit fluid to no more than 1 liter per day.  Your fluid needs are specific to your stage of kidney disease.  Check with your provider to make sure you are drinking the right amount.  As a reminder in addition to water or other beverages and foods like ice, soup, popsicles, ice cream, and gravy count as fluid.

Portion Your Protein

How much protein you should eat changes as kidney disease progresses.  In stages 1 and 2, your protein needs are the same as someone who does not have kidney disease.  Those in stages 3 – 5 who are not on dialysis need a little less protein each day and those in stage 5 on dialysis need more protein each day than any stage.  A good rule of thumb to portion your protein is to use your hand as a guide.  Stages 1 -2 can go for the palm of the hand at each meal.  Stages 3 – 5 not on dialysis can do about half of the palm of the hand at each meal.  Stage 5 on dialysis at least the palm of the hand and even just a little more with each meal.


Limit Phosphorus Additives

Did you know that depending on the food we can absorb more or less phosphorus even if the amount of phosphorus listed is the same?  This is because foods that have phosphorus in them from an additive are easier for our bodies to absorb and retain than phosphorus found naturally in foods.  Check the ingredients of the food label for ready-made, convenience foods to see if any of the ingredients contain the word “phos.”  This means that phosphorus has been added to the food.  Try to find an alternative option with zero or less phosphorus additives to limit phosphorus in your diet.

Lifestyle Basics

Move your body for at least 30 minutes each day.

Exercise and movement are important for overall health and wellbeing.  It strengthens your bones, muscles, lowers blood pressure, and helps keep your blood sugar in check.  If you find that you are sitting more than moving try taking some standing or walking breaks in your day.  If you are new to exercise break up your movement into smaller chunks of time like 5 minutes a few times a day and slowly build until you get to 30 – 60 minutes of moving your body each day.

Aim to get 7 – 9 hours of sleep each night.

Sleep is the time for our body to reset, heal, and rest.  A lack of sleep has been linked to many health conditions and problems like obesity, insulin resistance, difficulty thinking, and of course fatigue.  Having good sleep hygiene is a good first step in getting a restful evening.  This includes going to bed at the same time each night and waking up at the same time each day, limiting screens about 30 – 60 minutes before bedtime, limiting eating about 60 minutes before bed, and engaging in stress reducing activities like reading a book, taking a bath or shower, and gently stretching. 

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