Chronic Kidney Disease (CKD) or Chronic Renal Failure (CRF) is the inability of the kidneys to fully function in their filtration patterns leaving them unable to rid the body of toxins and metabolic by-products. If an excess of urea, which contains ammonia, and other nitrogenous waste products build up in the blood stream, more complicated and critical consequences ensue. There are five stages of renal failure with stage 5 requiring dialysis, otherwise known End Stage Renal Failure (ESRF). Dialysis is the process by which a machine extracts and “cleans” the toxic build-up in the blood and filters back into the body.
Renal failure can happen quickly or over a long period of time depending on a number of factors, disease state, health condition, or side-effects of prescription or other drug use. Causes most often seen with renal failure are diabetes, lupus, chronic hypertension, prolonged urinary obstruction, and stenosis, among some other serious conditions. Your physician, nephrologist, and registered dietitian can address your current renal function to make the most appropriate nutrition and lifestyle recommendations. Below are five main components that affect kidney health; specifically if renal function has declined or to consider for preventing kidney complications from happening. Please also see our blogs on these specific components for additional information.
5 Components Affecting Kidney Health
Sodium – Since sodium intake affects fluid status and the kidneys are being taxed already, both sodium and fluid intake should be carefully considered. Sodium intake should be 2300mg a day and 1500 mg a day if hypertension, diabetes, or other multiple health conditions exist. Limiting processed foods such as soups and adding salt to your cooking will greatly decrease sodium intake.
Fluid – Fluid intake should be monitored regularly and the recommended amount is usually figured by adding 500-1000 mL to output, or no more than 32 ounces a day. During dialysis, fluid is specifically important to limit in order for it to work most efficiently and reduce stress on the body. Patients are often weighed at sessions to monitor drastic fluctuations often due to fluid retention.
Potassium – Potassium is found in a variety of fruits and vegetables and critical to many functions throughout the body, including contraction of the heart. In stages 1- 2, < 4g/ day is recommended and at stages 3- 4, 2.4 g/day is recommended.
Protein – Protein needs are usually less when not on dialysis in order to prolong kidney function further as are well as reduce metabolic by-products such as ammonia. Recommended levels are 0.8 g to 1.0 g per kg of body weight for stages 1-2 and 0.6 g – 0.8 g of protein per kg of body weight for stages 3-4, while those on dialysis need significantly more. Protein sources include high biological value (HBV), which are most efficiently absorbed by the body. These sources mostly focus on animal protein such as poultry, fish, and eggs. Protein powder and supplements as well as plant-based protein can also be incorporated as deemed necessary and appropriate.
Phosphorus – Too much phosphorus can cause itching or more serious consequences such as brittle bones and hardening of blood vessels. For those on dialysis, phosphate binders are often prescribed in order to pull out excess phosphorus from the body and limiting it in early stages of kidney disease is important. In stages 1-2 it is recommended that 1.7 g/day be taken in and in stages 3-4, 0.8-1.0 g/day is recommended. Foods high in phosphorus are usually those high in protein as well, specifically dairy and meat products as well as processed foods such as store or restaurant bought biscuits. Whole grains, nuts, and soda, especially dark colas, are high phosphorus foods.