kidneys are working. What is right for others may not be right for you. What about protein and kidney disease? Protein foods are essential to help keep your body healthy, repair body muscle and tissues and heal wounds. Beef, lamb, chicken, fish, eggs, milk and dairy foods are all examples of protein foods. When you have kidney disease, eating too much or too little protein can make you feel unwell. Eating moderate portions of protein can help to reduce the work load of the kidneys and reduce high levels of waste products in your blood. Choose palm sized portions of meats at meals. Chronic Kidney Disease and Nutrition Your doctor can refer you to a dietitian for advice on how much protein to eat. 0800 KIDNEY / 0800 543 639 www.kidneys.co.nz Chronic Kidney Disease and Nutrition 2 What about salt? Too much salt (sodium) affects the amount of fluid the body holds on to and this can cause problems such as: • High blood pressure • Puffy or swollen feet and ankles You may be asked to have less salt in cooking and cut down on salty foods. To help keep your salt intake down: • Use no more than a pinch of salt (iodised) in cooking • Avoid adding salt to food at the table • Avoid foods high in salt such as: - Ham, bacon, sausages, corned beef, smoked fish - Salted chips, crisps, salted nuts - Instant noodles and soups, stock cubes, salty crackers - Salty sauces and pickles - Most takeaway foods To help keep your salt intake down buy fresh foods and make home prepared meals. Use fresh herbs, spices, flavoured vinegars and lemon juice for extra flavour. Your doctor can refer you to a dietitian for help with reducing your salt intake. Do not use salt substitutes like ‘Losalt’ as these have potassium in them and are not suitable for people with kidney disease. Should I change how much I drink? You should continue to drink your usual amounts of fluids i.e. at least 6 – 8 cups/glasses per day. Examples of fluids include water, tea, coffee, soft drinks and cordials. If you are passing more urine you will need to drink more. Your doctor will tell you if you need to start cutting down how much you drink each day. 0800 KIDNEY / 0800 543 639 www.kidneys.co.nz Chronic Kidney Disease and Nutrition 3 What about fruit and vegetables? Fruits and vegetables are important in your daily meals. They contain a mineral called potassium. As kidney disease progresses, potassium in the blood may start to rise. This is because the kidneys are not able to remove extra potassium. This can be dangerous. You may be advised to limit or avoid certain types of fruits and vegetables that are high in potassium. Fruit and vegetables high in potassium include: • bananas • pure fruit juices • dried fruit • potatoes • silverbeet, tomatoes Your doctor regularly checks your blood potassium levels and will tell you if you need to cut down on high potassium fruits and vegetables in your diet. Your doctor can refer you to a dietitian for help to choose suitable fruits and vegetables. What is phosphate? Phosphate is a mineral, which together with another mineral called calcium, helps to keep your bones strong. When your kidneys are not working properly phosphate builds up in the blood instead of being removed by the kidneys. High phosphate levels can cause problems such as: • Itchy and dry skin • Hardening of your blood vessels • Painful joints • Weak bones Phosphate is found in many foods: • Milk, cheese, yoghurt, and ice cream • Calcium enriched milk • Peanut butter • Sardines • Coco Cola, Pepsi Your doctor may also want to give you tablets to help keep phosphate levels in your blood normal. Your doctor can refer you to a dietitian if you need to reduce your phosphate intake. 0800 KIDNEY / 0800 543 639 www.kidneys.co.nz Chronic Kidney Disease and Nutrition 4 Increasing Your Energy Intake Maintaining a healthy weight is important for everyone. Your energy requirements may need to be met by increasing the amount of carbohydrates (starchy) foods and healthy fats (oils and margarines) you eat. • Starchy foods include: - breakfast cereals, breads, crackers and biscuits - rice, pasta,. • Healthy oils and margarines include: - sunflower, canola, rice bran and olive oils. Eating well can help you feel your best and to stay at your well weight when you have chronic kidney disease. If your appetite is not so good and you are not eating your usual quantities of food then try eating smaller meals and snacks more often over the day. You can ask your doctor to refer you to a dietitian if you need further assistance with your meals and making suitable food choices. What if I have diabetes? In some cases you may be asked to make a few changes to your diabetic diet to fit around managing your reduced renal function. If you are advised to have smaller portions of protein you must be sure to get enough calories from other foods. You can ask to be referred to a dietitian for review of your diabetic diet and how to fit in any changes you may need to make to manage your kidney disease. What if I am vegetarian? If you are vegetarian you may need good advice from a dietitian. Vegetarian diets can be high in potassium and phosphate because of all the vegetables, fruits and whole grains that make up your diet. The goal is to eat the right combinations of plant proteins while keeping potassium and phosphate under control. Will I have to take vitamins and minerals? Vitamins and minerals come from a