Today I wanted to clear up a few things in regards to what constitutes a healthy renal diet. I receive emails daily from confused and at their “wits end” kidney disease sufferers, wanting to know what they can eat. Especially what they CAN eat, not what they CAN’T eat (fair enough too).
This problem lays not in whether or not the right information is out there, but unfortunately in that all the good information has been diluted by all the garbage out there. Mass article writers, without any medical training, and even worse, (some) large kidney health organisations are to blame. Articles are prepared to supply a demand, but are not based on any proper healthy renal diet knowledge.
A diet can be healthy for one person, and harmful to another, a diet can be deemed healthy in terms of the right proportions of carbohydrates, fats, and protein, but totally miss the mark in taking into account foods that have a directed negative impact to the kidneys. This is the problem, and this why you are reading one article that says “X”, and another that says “Y”.
And so my goal today is to provide reliable, trustworthy renal diet information based on sound naturopathic and nutritional teachings to provide you with the top 7 tips on how to eat a healthy renal diet – so that you may at least have your foundations right; because without healthy dietary foundations, then any renal failure diet guidelines you follow… will fail.
Here Are My Top 7 Healthy Renal Diet Tips:
1. Consume: Everyone is telling you want you can’t eat, so I decided to tell you first what you can eat. Nothing’s better to knock the wind out of your sails while you are trying to come to terms with your current health situation, than to be faced we a wall of “Can’t have’s”, and “Should not’s”.
The list of foods below is deemed “healthy” in kidney disease, but also some of the foods are especially beneficial for kidney disease. These foods are marked with an asterix*.
• Fruits: Apples, without skin; Apricot; Blueberries*; Grapes, red or green; Peach; Pears, asian; Pineapple; Plums; Raspberries*; Strawberries; Watermelon*.
• Vegetables: Asparagus*; Cabbage, red; Cauliflower; Celery; Garlic; Lettuce, iceberg; Mushrooms; Onion; Parsley; Radishes; Mung beans, sprouted.
• Protein: Fish*; Chicken; Tempeh*; Tofu*.
• Miscellaneous: Carob (good alternative to chocolate); Flaxseed Oil*; Hummus; Popcorn, air-popped; Rice, white; Sea Salt; Olive Oil; Olives; Horseradish; Tapioca pearls; Oregano; Curry Powder; Sesame seed kernels; Paprika; Macadamia nuts.
Of course there are more foods than this that you can eat while suffering with renal failure, the difference being is that these foods are “healthy”. It is also important to note that these foods also satisfy the requirements of potassium, phosphorus, and sodium content for renal diet (as explained below), but with most things in life, you can have too much of a good thing – therefore the foods are healthy when eaten at normal servings sizes per day. Don’t overdo anything, moderation is the key.
2. Avoid: Unfortunately this tip cannot be avoided, there are simply foods that are downright bad for your kidneys, and these need to be removed from your renal diet. Here are a list of foods deemed “bad” for kidney disease, and therefore should be avoided in your renal diet:
• Red meat: See my article on negative effects of red meat here
• Dairy: this includes, milk, butter, cream, ice-cream, yoghurt, and all dairy containing pre-made products.
• Alcohol: ALL alcohol, including red wine.
• Gluten: is found in flour based products; and therefore in the following grains: wheat, rye, spelt, kamut, oats, and barley. Safe gluten FREE grains and alternatives include: rice, corn, amaranth, millet, quinoa, sorghum, teff, and buckwheat.
• Highly processed foods
There are many more foods that I could list, but these main categories encompass the best part of them. If you can follow an unprocessed, whole food renal diet, then meal times will be a breeze. If you resist change, and resort to processed, take-away, and pre-packaged foods, then you will struggle, and fail to realise the benefits that a healthy renal diet can have on you and your kidneys.
3. Monitor: Probably the most well known of all renal dietary guidelines, is to make sure your consumption of Potassium, Phosphorus, Protein, and Sodium are within normal healthy limits. Unfortunately “normal” healthy limits between individuals can vary greatly, and that is why you need to see a trained nutritionist or naturopath (or doctor) to customise a diet just for you.
The first thing to note that a lot of people fail to mention, is that not everyone needs to rigidly adhere, monitor, and calculate their daily potassium, phosphorus, protein, and sodium levels. It all depends on your stage of kidney disease, and your blood test results (especially your blood test results). I have some clients that need to increase their sodium and potassium levels… which is completely different to what a lot of people are recommending on the web. Why do I do this? Because I actually look at their blood test results before I recommend anything! You see, not every kidney disease sufferer is going to have high levels of one, or any of these four nutrients.
Therefore rule 1 is: get your blood tested*, and request a copy from your doctor. This way you are familiar with you condition, and better equipped to take more control of your health. And of course you’ll know exactly which nutrients are high (or low) so that you may alter your renal diet accordingly.
*Note: Protein is the only nutrient (out the four) that cannot be measured in the blood. As a result protein intake is based on your estimated Glomerular Filtration Rate (eGFR).
Here is a quick reference guide to help you calculate your intake of potassium, phosphorus, protein, and sodium.
Renal Diet: Potassium Recommendations
- Kidney Disease Stages 1 to 2 (eGFR of 60 to 90+): 2 to 5g a day
- Kidney Disease Stages 3 to 4 (eGFR of 20 to 60): 2 to 4g a day
- Kidney Disease Stages 4 to 5 (eGFR of 5 to 20): No more than 2 to 2.5g a day
Renal Diet: Phosphorus Recommendations
- Kidney Disease Stages 1 to 4 (eGFR of 25 to 90+): Phosphorus: up to 1000mg a day (up to 1200mg a day for those that exceed 90 kilos (200+pounds))
- Kidney Disease Stage 4 (eGFR of 15 to 25): Phosphorus: up to 750mg a day (up to 1000mg a day for those that exceed 90 kilos (200+pounds))
- Kidney Disease Stages 4 to 5 (eGFR of 5 to 15): Phosphorus: up to 7mg per kg of body weight
(e.g. up to 420mg for a 60 kg (130 lb) woman)
Please note: that these figures are a “general rule”, and therefore subject to change depending on your requirements and blood work. This means that may consume more, or need to consume less, depending on your current situation and blood test results.
Renal Diet: Protein Recommendations
- Kidney Disease Stages 1 to 2 (eGFR of 60 to 90+): Protein – 0.8 to 1.2 gram per kilo of body weight
(e.g. 48 to 72 grams for a 60 kg (130 lb) individual)
- Kidney Disease Stages 3 to 4 (eGFR of 20 to 60): Protein – 0.6 to 0.8 gram per kilo of body weight
(e.g. 36 to 48 grams for a 60 kg (130 lb) individual)
- Kidney Disease Stages 4 to 5 (eGFR of 5 to 20): Protein – Ideal 20 grams, Max 30 grams total*
* It is also important to note that these recommendations are for people who are not receiving dialysis treatment, as soon as you commence dialysis, protein intake will need to be increased – speak to your doctor or nutritionist or naturopath when this occurs.
Renal Diet: Sodium Recommendations
- Kidney Disease Stages 1 to 4 (eGFR of 25 to 90+): 1 to 3.5g a day
- Kidney Disease Stage 4 (eGFR of 15 to 25): 1 to 2.5g a day
- Kidney Disease Stage 5 (eGFR of 5 to 15): 1 to 2g a day
4. Alkaline: An important aspect of your renal diet, that is rarely mentioned, is following an alkaline diet. This is because your body requires an alkaline blood supply to survive. Any deviation from the very narrow window of 7.35pH to 7.45pH will cause the body to shut down, and ultimately result in death. But don’t worry, when you eat a healthy whole food renal diet, you can’t help but be following an alkaline diet too.
…The kidneys play a massive role in regulating this balance, and therefore not only will you be giving your kidneys one less task to do (from already over burdened kidneys), but you will also be providing them with life giving alkaline blood to support, nourish, and rejuvenate them.
For more information on an alkaline diet in kidney disease, see my article here: http://www.kidneycoach.com/799/kidney-diet-best-for-kidney-disease-sufferers/
5. Fluid: first of all let’s get clear on what I mean by “fluid” in a renal diet…
Fluid is any of the following drinks (consume): water, herbal teas (e.g. lemon, ginger, berries, rooibos, green tea, Echinacea, plus many more), and vegetable/fruit juices.
Fluid does not mean (avoid): coffee, caffeinated drinks (except green tea), artificially sweetened “sugar-free” drinks, tea, alcohol, cordial, sugary drinks, soda pop, and soft drinks.
The reason I need to stipulate this is because so many people are just drinking the wrong drinks without any “awareness” of what they putting into themselves.
Here are four main reasons why you need to swap what you are drinking:
1. The drinks in the avoid section are directly toxic/unhealthy for the kidneys, especially alcohol, coffee, and artificially sweetened drinks.
2. The drinks in the avoid section actually deplete the body of more fluid than they put in. This is because they act as diuretics, and thus make the body urinate more.
3. The drinks in the avoid section deplete the body of vital nutrients.
4. The drinks in the avoid section cause many more serious health condition if drunk on a regular basis.
Contemplate: The human body is 65-70% water, therefore the fluid you drink, literally becomes you. What are you becoming?
6. Manage pre-existing conditions: Do you have diabetes or high blood pressure (hypertension)? Yes? Well it is important to make sure you are doing everything you can with managing dietary specifics for those conditions too. Overwhelmed yet? Don’t be, because if you follow all the rules of a healthy renal diet then you will automatically be following 90% of a healthy diabetic or high blood pressure diet. You may just need a few tweaks to your diet to appease whatever pre-existing medical condition you have. For example, in high blood pressure you are recommended to increase potassium foods – this of course would not be suitable if you have high potassium blood levels, therefore you would not follow this recommendation.
7. Dedication – The good news… and the bad news: So you want to improve your kidney function, and you want to be able to eat yourself to health, without the need of expensive toxic drugs, and live a vital healthy life, right? GREAT! The good news is that you can have it all if you apply these simple tips, each and every day. It is that simple, and it is possible.
The bad news however is because it is that simple, most of you reading this will not do it, or worse, only just apply some of it. (I say “worse” because you are so close to achieving it, but at the same time so far away).
You see unlike many other health conditions, a healthy renal diet needs to be applied religiously; it needs to become part of your new way of living. It is not enough to pick and choose the days you “feel like” eating healthier, it is not enough to say “oh, just a little bit won’t hurt”, it requires dedication. But hey, I think once you are feeling fantastic, watching your creatinine levels drop, and have the energy to live life again, you’ll be saying to yourself “it was worth it!”.
Now I know all too well about following strict diets… I am a naturopath for heaven’s sake (laugh)! I have been eating what is considered to be a very healthy diet for many years. Sure I had my occasional “treats” and “indulgences”, but I largely ate from a perspective of health, vitality, and prevention.
August last year that all changed when my wife was diagnosed with MS.
After doing much, much, much research, my wife embarked on a new diet to help reverse her condition (my wife is also a naturopath). It is very similar diet to the renal diet I am describing here, no red meat, virtually no saturated fats, no hydrogenated oil, no dairy, no gluten, no, no, no…
The research shows that even just a small “slip” (literally one meal) can completely undo all the good work. This means that my wife must follow this diet for the rest of her life, with not so much as one meals grace…
Needless to say I was shocked at both the benefits of the diet (in a good way), but more so the nature of the diet – not being able to miss a beat. After going through the diet, and wanting to do anything I could to help my wife, I decided to follow and stick to the diet exactly as she needs to.
This wasn’t an easy decision for me, heck, I like a treat as the next person. And there was plenty “gnashing of teeth” when I thought about all the good things I needed to give up. But I would do ANYTHING for her, and so changing my diet to make life easier for her, showing her support, and doing it as a team was a “no-brainier” for me. I want her to be fit and healthy, I want her to live a long and healthy life (note: since changing to this diet, a lot of her symptoms have gone, and some lesions in her MRI scans have disappeared!).
I don’t tell you this story to impress, but to let you know I can understand what you are going through, to illustrate what is possible, that it is possible, and most importantly, when you have a strong desire burning inside (e.g. health), what seems hard now, is actually very easy to do.
Dedication is the key to this renal diet, and although it is not as sensitive to a one meal “slip up” like the MS diet is, dedicating yourself to live a healthy life style and renal diet will pay you back 10 fold on your efforts. Guaranteed.
… Once again, that a wrap folks! I hope you really enjoyed today’s article on how to eat a healthy renal diet, and the seven tips to get you there.
Until next time, take care.
P.S. Please leave your thoughts, wisdom, and comments below!
Disclaimer: Individual diet needs will vary. Always check with your doctor or dietitian before using the meals in this meal planner.
About the Author: Hello, my name is Duncan Capicchiano, I am the owner and creator of KidneyCoach.com. My professional background is Naturopathy, and I am also an International Author and Researcher that specialises in the treatment and management of kidney disease. My most famous work in kidney disease is The Kidney Disease Solution Program. Lastly - but most importantly - I am the loving "father" of my two dogs Ruby and Pebbles, my horse Cossie, and husband to my beautiful wife, Fiona.