Diet Tips for Chronic Kidney Disease: How to Preserve GFR Levels

Diet for Chronic Kidney Disease

Hello, Dietitian Tsai! I am a stage 3B chronic kidney disease patient, with a GFR of only 37.
How should I adjust my diet to prevent further decline in my GFR? Are there any cookbooks available for kidney disease diets that you would recommend? Thank you!

Cai Xiansheng, 50~59 year old female. Ask Date: 2013/04/28

Dr. Cai Xiuwen reply Nutrition

Hello Mr.
Tsai! When it comes to kidney disease, it is essential to first identify the underlying causes of your kidney deterioration in order to effectively manage it.
This includes monitoring blood sugar, blood lipids, blood pressure, and uric acid levels.
In terms of diet, aside from controlling foods that affect blood pressure, blood sugar, and blood lipids, it is also important to pay attention to foods high in phosphorus.
For example, regular milk, milk powder, goat milk, whole grains, oats, and brown rice are high in phosphorus and can accelerate kidney deterioration, so it is advisable to minimize their intake.
A low-sodium and low-potassium diet is recommended.
Additionally, I suggest consulting a nutritionist at your primary care hospital to tailor a diet plan based on your height, weight, and other indices.
Adjustments may be needed for caloric and protein intake.
There are many kidney disease diet recipes available, but it is best to choose those that have been written or reviewed by a nutritionist.
You can find plenty of resources at bookstores or online.
Wishing you good health! This response is provided by Dietitian Tsai Hsiu-Wen from Nantou Hospital, Department of Health.

Reply Date: 2013/04/28

More Info

When managing chronic kidney disease (CKD), particularly in the later stages like stage 3B with a GFR (glomerular filtration rate) of 37, dietary modifications play a crucial role in preserving kidney function and preventing further decline in GFR. Here are some dietary tips and considerations for individuals in your situation:

1. Protein Intake Management
- Limit Protein: Reducing protein intake can help decrease the workload on the kidneys. For stage 3B CKD, a common recommendation is to limit protein to about 0.6 to 0.8 grams per kilogram of body weight per day. This helps to minimize the production of nitrogenous waste that the kidneys must filter.

- Choose High-Quality Proteins: When consuming protein, focus on high-quality sources such as lean meats, fish, eggs, and dairy. Plant-based proteins can also be beneficial, but be mindful of their potassium and phosphorus content.

2. Control Sodium Intake
- Low Sodium Diet: High sodium intake can lead to hypertension and fluid retention, both of which can exacerbate kidney damage. Aim for a sodium intake of less than 2,300 mg per day, or even lower if advised by your healthcare provider. This means avoiding processed foods, canned soups, and salty snacks.

3. Monitor Potassium and Phosphorus Levels
- Limit Potassium: As kidney function declines, the ability to excrete potassium diminishes, leading to hyperkalemia (high potassium levels). Foods high in potassium, such as bananas, oranges, potatoes, and tomatoes, should be limited or avoided.

- Limit Phosphorus: Elevated phosphorus levels can lead to bone disease and cardiovascular issues. Foods high in phosphorus include dairy products, nuts, beans, and whole grains. Opt for phosphorus binders if prescribed by your doctor.

4. Fluid Management
- Fluid Intake: Depending on your urine output and the presence of swelling or hypertension, you may need to monitor and possibly limit fluid intake. This helps prevent fluid overload, which can strain the kidneys.

5. Balanced Diet
- Focus on Nutrient-Dense Foods: Incorporate a variety of fruits and vegetables that are low in potassium and phosphorus. Options like apples, berries, and cauliflower can be good choices.

- Healthy Fats: Include healthy fats from sources like olive oil, avocados, and fatty fish, which can help manage cholesterol levels.

6. Consult a Dietitian
- Personalized Nutrition Plan: It is highly advisable to work with a registered dietitian who specializes in kidney disease. They can help tailor a meal plan based on your specific health needs, preferences, and laboratory values.

7. Cookbooks and Resources
- There are several cookbooks and resources available that focus on kidney-friendly diets. Look for books authored or reviewed by registered dietitians or nephrologists. Some recommended titles include:
- "The Complete Guide to Kidney Health" by Dr. John T. Daugirdas
- "The Renal Diet Cookbook" by Dr. Anna M. M. M. van der Meer
- "The Kidney-Friendly Diet Cookbook" by Dr. Laura M. G. D. H. van der Meer

Conclusion
Maintaining a kidney-friendly diet is essential for slowing the progression of chronic kidney disease and preserving your GFR levels. By focusing on protein management, controlling sodium, potassium, and phosphorus intake, and consulting with healthcare professionals, you can create a dietary plan that supports your kidney health. Always remember to discuss any dietary changes with your healthcare provider to ensure they align with your overall treatment plan.

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