Pre-Dialysis Diet suggestions?

[kristina]

I have already mentioned a few things I do with my diet,
in this pre-dialysis-stage, I am about 10%GFR.
But I thought it might be interesting to start a thread
specifically about pre-dialysis-diet.
If anyone has ideas, I would be very grateful
if we could compare.
I am a vegetarian which means I do not eat meat or fish
but I eat eggs and lentils and soft cheese which seems
to provide among other things the protein I need.
The only milk I have is in my two cups of coffee each day.
My liquid intake, which I carefully control
consists of two coffees, one mug of chamomile tea,
one mug of peppermint, one mug of black tea with lemon
and one glass of lime-juice (half a freshly squeezed lime)
with filtered water each day. I have sugar in my teas and coffees.
For fruit I have a minimum of one peeled apple and half a pear,
sometimes more each day. I also bake my own salt-free bread.
I do not have salt in anything and I don't eat any tinned food
or any ready-to-go-meals. (Like pierce, ding, eat).
I have a lettuce and cucumber- salad every day.
I would appreciate if I could compare my pre-dialysis-diet
with others, because, with my husbands help I have struggled
to put together a reasonable diet to be kind to my kidneys
and delay the onset of dialysis. If anyone can give some
advice they have received from dietitians, etc., this would be helpful.
Thank you, Kristina.

[peleroja]

The only thing I remember about pre-dialysis is less protein.  Once you start dialysis the protein levels go up as protein is a very tiny molecule and easily removed through dialysis.

[Jean]

Here is what my renal dietician gave me.
Breakfast, within 1.5 hours after you wake up. 1Starch, 1 frui, 1/2 milk and 1 fat
Snack approx 2 hours later, 1 starch 1/2 milk
Lunch, 4 or 5 hours after you get up, 1 starch, 1 fruit, 1 vegetable 2 ounces of meat, and 1 fat
Snack, approx 2 hours later 1 starch, 1 vegetable.
Dinner, 4-5 hours after lunch 2 starch, 1 fruit, 1 vegetable, 2 ounces meat, 2 fats
Snack, 1/2 hour before bedtime 1 starch, 1 milk
I dont like it, and it confuses me, but, you gotta do what you gotta do.

[Chris]

Kristina, the one thing you may need to change later for protein is  the lentils or any beans. When I was on dialysis we were told to avoid those because of either potassium or phosphorus content. I do not have my chart or list in front of me right now, but that is something you need to think about plan ahead to maintain a vegetarian diet like yours. Of course it will also depend on your lab results too. If you do not have the pie chart or listing of foods to avoid, I will get them off my book case and scan them in.

[kristina]

Thank you very much, Jean and Chris, for your valuable comments.
Is there any chance, Jean, that you could elaborate, like the types of vegetables and starch and perhaps what to avoid? That would be very kind. Thank you.
Thank you, Chris, for the kind offer to scan in some details, I would very much appreciate this. Thank you once again, Kristina.

[Zach]

You might find this AAKP article interesting:
http://www.aakp.org/aakp-library/Diet-and-the-Predialysis-Patient/

[Chris]

I should get the information scanned in tomorrow. I just didn't fel like getting up today and when I did, just didn't feel like doing much until 4 pm when I had to clean up the house before parents got home.

[Restorer]

I should get the information scanned in tomorrow. I just didn't fel like getting up today and when I did, just didn't feel like doing much until 4 pm when I had to clean up the house before parents got home.

Only here on IHD does that excuse elicit understanding and caring forgiveness, rather than a reaction like, "Oh, that lazy ass." 

[Des]

Ditto.....

[kristina]

Thanks,  Zach, for the interesting Diet sheet.
I shall think about the details of it and see what I can absorb into my own diet.
It strikes me again and again that the effort has gone into the medical side, which is of course helpful,
but in comparison very little has gone into diet-plans.
Is this because we are all individuals and there are many medical problems where diet is a factor?
I find it very difficult to get any help from dietitians, and I am grateful to find support here.
Thanks again, Kristina.

[Chris]

I didn't find all the information I have in my room, which means it is in the basement with my other medical stuff. The pie chart I am scanning in is not the one I want to post, but it's basic information is useful.. I will scan my information into a .pdf file so if you do not have Adobe Acrobat Reader, you'll need to download it at http://get.adobe.com/reader/

However, most pc's have it. I should have it all posted in about an hour or by the time you read this tomorrow.

[Chris]

Well first couple attempts the file was to big to post, so I am breaking them up by type. First up is Potassium scanned at a lower resolution.

[Chris]

Next file is Phosphorus and Sodium foods. The chart I posted iss bigger than the scanner glass, so it will not post the whole image, but most of the information will show.

[Jean]

Chris, that one you sent is better than any of the ones I got from my Neph. Thanks a lot!!!!

[Chris]

Your Welcome Jean, glad I can help. I have more, but they are in the basement in a storeage box along with other medical stuff I have.

[kristina]

Dear Chris,
I have just printed out all the diet information and everything came out perfect.
Posting all that on the site was really great of you to do.
I shall now sit down and "digest" all the new diet information and check
against my own diet and make adjustments accordingly.
Many thanks indeed for going to so much trouble,
it is very much appreciated.
Kind regards from Kristina. 

[Chris]

I'll start looking in the basement Monday to see what else I can scan. I do have the NKF Renal Book that I can scan too that I have up here. That will take several post due to the amount of pages and space size allowed to post each time.

[kristina]

Thanks Chris, that is very kind of you
and very much appreciated.
Kind regards from Kristina.

[okarol]

There's a brochure on the NKF site available for download entitled:
Nutrition and Early Kidney Disease
Are You Getting What You Need? (Stages 1–4)
go to http://www.kidney.org/atoz/atozItem.cfm?id=195

[kristina]

Thanks Karol,
Very much appreciated.
Kind regards from Kristina.

[kristina]

I was recently contacted by someone who was reading/studying the diet I was following,
which I put  here on IHD and I realized that as time has gone by I have made many modifications and total changes
and I now have a different diet altogether.

The reason why I mention this is because my kidneys were not responding favourably to that diet, so therefore
I went back to the drawing-board and I searched for a different diet that might be more effective.

I now realize working out a diet is extremely complicated because it has to be tailored to the individual.
Because we are all different it may be that what suits one does not suit another.

Also, I have learned, that – I can only speak for myself – modification of the diet is a continual process.
I have come across many people who recommend a particular diet and they were all different and probably one would not suit another,
and none of them suited me with my 10% kidney function due to chronic proliferative glomerulonephritis with SLE/MCTD.
So, in conclusion, I think it best that everyone finds the diet to suit themselves.

Kind regards from Kristina.

[MooseMom]

kristina, you are exactly right in creating a diet for you and you alone.  We all have different experiences with diet and renal disease.  For instance, most people will tell you to avoid sodium, but my neph has me on 8 sodium bicarbonate tablets A DAY to control potassium.  He has told me to ADD SALT to my diet, but then again, my BP is well controlled (it sure ought to be with all the bp meds I take!).

I think you know the general rules about avoiding high potassium and high phosphorus foods (I ADORE beans and could happily be vegetarian, but that phosphorus problem looms large), so my advice would be to keep careful tabs on your lab results and perhaps even keep a food diary.  Keep all of your results so that you can get an idea which foods give you which kind of problem.  It will always be a balancing act, as you have already discovered.  I am also on a pre-renal diet, so I do understand the difficulties you face.  Good luck, and let us know if we can help.