Nutritional therapy : Chronic Kidney Disease

  • Nutritional therapy
    • Protein restrictions
      • Calorie-protein malnutrition is a potential and serious problem that results from altered metabolism, anemia, proteinuria, anorexia, and nausea
      • Additional factors leading to malnutrition include depression and complex diets that restrict protein, phosphorus, potassium, and sodium.
      • Frequent monitoring of laboratory parameters, especially serum albumin, prealbumin (may be a better indicator of recent or current nutritional status than albumin), and ferritin, and anthropometric measurements are necessary to evaluate nutritional status
    • Fluid restrictions
      • Water and any other fluids are not routinely restricted in patients with CKD stages 1 to 5 who are not receiving HD
      • Use of diuretics to reduce fluid retention
      • Patients on HD are on more restriction and depends on daily urine output
    • Sodium and Potassium restrictions
      • Sodium-restricted diets may vary from 2 to 4 g/day.
      • Instruct the patient to avoid high-sodium foods, such as cured meats, pickled foods, canned soups and stews, frankfurters, cold cuts, soy sauce, and salad dressings
      • Potassium restriction depends on the kidneys’ ability to excrete potassium.
      • Salt substitutes should be avoided in potassium-restricted diets because they contain potassium chloride.
      • High-Potassium foods

Fruits

Vegetables

Other Foods

  • Apricot, raw (medium)
  • Avocado ( 1 whole)
  • Banana ( 1 whole)
  • Cantaloupe
  • Dried fruits
  • Grapefruit juice
  • Honeydew
  • Orange (medium)
  • Orange juice
  • Prunes
  • Raisins
  • Baked beans
  • Butternut squash
  • Refried beans
  • Black beans
  • Broccoli, cooked
  • Carrots, raw
  • Greens, except kale
  • Mushrooms, canned
  • Potatoes, white and sweet
  • Spinach, cooked
  • Tomatoes or tomato products
  • Vegetable juices
  • Bran or bran products
  • Chocolate (1.5-2 oz)
  • Granola
  • Milk, all types (1 cup)
  • Nutritional supplements (use only under the direction of physician or dietitian)
  • Nuts and seeds (1 oz)
  • Peanut butter (2 Tbsp)
  • Salt substitutes, Lite Salt
  • Salt-free broth
  • Yogurt
    • Phosphate restrictions
      • As kidney function deteriorates, phosphate elimination by the kidneys is diminished and the patient begins to develop hyperphosphatemia.
      • Foods that are high in phosphate include meat, dairy products (e.g., milk, ice cream, cheese, yogurt), and foods containing dairy products (e.g., pudding).
      • Many foods that are high in phosphate are also high in protein.
      • Patients on dialysis are encouraged to eat a diet containing protein, phosphate binders are essential to control the phosphate level.