National Kidney Foundation's Kidney Disease Outcomes Quality Initiative Did you know that the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-KDOQI™)has guidelines that help your doctor and healthcare team make important decisions about your medical treatment? The information in this booklet is based on the NKF-KDOQI recommended guidelines for nutrition. Stages of Chronic Kidney Disease There are five stages of chronic kidney disease. They are shown in the table below. Your doctor determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your level of kidney function. Your treatment is based on your stage of kidney disease. Speak to your doctor if you have any questions about your stage of kidney disease or your treatment. Stages of Kidney Diseas e Stage Description Glomerular Filtration Rate (GFR) 1 Kidney damage (e.g., protein in the urine) with normal GFR 90 or above 2 Kidney damage with mild decrease in GFR 60 to 89 3a Moderate decrease in GFR 45 to 59 3b Moderate decrease in GFR 30 to 44 4 Severe reduction in GFR 15 to 29 5 Kidney failure Less than 15 www.kidney.org 3 Why is good nutrition important for people with kidney disease? Making healthy food choices is important to us all, but it is even more important if you have chronic kidney disease (CKD). Why? Good nutrition gives you energy to: •do your daily tasks •prevent infection •build muscle •help maintain a healthy weight •— and it may keep your kidney disease from getting worse. 4 National Kidney Foundation Will I need to change my diet if I have kidney disease? There is no single eating plan that is right for everyone with kidney disease. What you can or cannot eat will change over time, depending on how much kidney function you have and other things, like having diabetes. Your doctor can refer you to a dietitian who can teach you how to choose foods that are right for you. What are the basics of good nutrition? A healthy eating plan gives you the right amount of: •protein •calories •vitamins •minerals You will need to choose foods that give you the right amounts of protein, calories, vitamins, and minerals each day. This will help to keep you healthy. It may also help to keep your kidney disease from getting worse. www.kidney.org 5 Why do I need protein? Protein is an important nutrient. Your body needs protein to help build muscle, repair tissue, and fight infection. But if you have kidney disease, you may need to closely watch the protein you eat to prevent protein wastes from building up in your blood. This can help your kidneys work longer. Your doctor will tell you if you need to limit how much protein you eat each day. Decisions are based on your stage of kidney disease, level of nutrition, muscle mass, and other things. It is also important for your protein intake not to be too low. Let your kidney doctor and dietitian help you. TIP If you need help finding a dietitian who specializes in kidney disease, you can ask your doctor for a referral or contact the Academy of Nutrition and Dietetics at 800.877.1600 (www.eatright.org) 6 National Kidney Foundation You get protein from:* •red meats (beef, veal, lamb) •pork •poultry (chicken and turkey) •fish and other seafood •eggs •vegetables and grains Your dietitian can help you learn how to maintain good nutrition and eat the right amount of protein to help your kidneys. How many calories do I need? Every person is different. Calories are like fuel—they provide your body with the energy you need to live. They are important because they: •help you stay at a healthy body weight TIP There are two kinds of proteins. “Higher quality” proteins are found in animal products like meat, poultry, fish, and eggs. They are the easiest proteins for your body to use. “Lower quality” proteins are found in vegetables and grains. A well-balanced diet for kidney patients should include both kinds of proteins every day. *This food list is not complete. www.kidney.org 7 •give you energy to do your daily tasks and remain active •help your body use the protein in food to build muscles and tissues (Without enough calories, your body will "waste" protein to provide you with energy instead of using protein to build your muscles and tissues.) It is important to plan meals that give you enough calories each day. Otherwise, your body may not have energy to stay healthy. Your dietitian can help you do this. Some people may be told to eat more calories. They may need to eat extra sweets like sugar, jam, jelly, hard candy, honey, and syrup. Other good sources of calories come from fats such as soft (tub) margarine and oils like canola or olive oil. How do I get enough vitamins and minerals? Most people get enough vitamins and minerals to stay healthy by eating a wide variety of foods each day. However, if you have kidney disease, you may need to limit some foods that would normally give you these important vitamins and minerals. 8 National Kidney Foundation If so, you may need to take special vitamins or minerals instead. Other tips: •Take only the vitamins and minerals your doctor recommends,