Renal Diet

[goofball]

Does following a renal diet help?

If so, how?

[kporter85db]

I follow a low sodium, low sugar diet. But not necessarily renal.

On PD for 2+ years with no problems.

But you need to listen to your labs.

[midges]

I think so, yes. I find that I feel much better and have better labs when I follow my dietitians recommendations. Also, eating too much phosphorous makes me itchy and I get muscle spasm when my potassium is out of range. When I don't pay attention to limiting my fluids my blood pressure gets really high. Of course, I am already on dialysis. I would imagine if one is pre-dialysis it would be beneficial to follow dietary recommendations to reduce the strain on your system and stay as healthy as you can for as long as possible.

[Dman73]

I find that eating the same thing week to week helps balance my labs without much variation. It's boring I know but on D boring is good.

My diet starts out with Spec-K High Protein cereal mixed w/4oz Novasource Renal vanilla that replenishes some of the vitamins/minerals lost by D. My lunch on off day will be a Subway 6" cheese-steak on wheat bread w/southwest chipotle sauce, lettuce & olives or a tuna sandwich. Lunch on D-day will be a large Wendy's chili w/unsweet iced tea & lemon (I will drink 1/2 of this as a special treat before going to D). Dinner after D will be drained chicken noodle soup and a ham & cheese grilled sandwich. Dinner on non-D days will be 2 chicken breasts with rice or macaroni & cheese or possibly an western style egg omelet.   

Snacks will be frozen grapes or sliced nectarines, dried cranberries, 1/2 corn muffin or oats & honey bar.

Fluid can be a real problem easily so I don't really drink per say but rinse my mouth similar to mouthwash that can make you feel like you had a drink. My favorite drinks are unsweet green iced tea, Diet Sierra Mist lemon-lime soda, diluted lemonade or apple cider.

I watch my potassium closely as it runs 5.0-5.5 and schedule a 1K bath on every Saturday to keep it within that range. Occasionally I will have a small piece of 90% supreme dark coca (acquired taste) or a few pieces from a fruit cup.

Eating is not my main goal in life and could just as well take a pill or have some astronaut food out of a tube just enough to maintain nutrition. I would like to eat more fruit and vegetables, tomato sauce & potato's and they need to make a low potassium version of these.

[MooseMom]

goofball, are you asking about a renal (dialysis) diet or a PRE-renal diet?  They are two different things.

[goofball]

Pre-dialysis... for now!

[MooseMom]

Pre-dialysis... for now!

Back to your original question, help what?  Help keeping you alive?  YES!  I was on the pre-renal diet for 8 years and adhered to it fairly strictly.  Do you have any particular questions about the pre-renal diet?

[goofball]

Is it supposed to help with certain symptoms? 

[Jean]

Following the pre-D renal diet is designed to help your kidneys last a little longer. It has helped me, so far, to not be as itchy. Altho, my skin is dryer than it ever has been, so I add a little baby oil to my lotion and that helps. I was so worried about eating too much meat and after a review of my 3 day diet, the nurse told me I needed to eat more protein. Go figure!!!

[SooMK]

I am pre-D and follow a diet that is meatless, minimal dairy, minimal processed foods and I exercise. After I watched the movie "Forks Over Knives" I was really impressed. This is the same diet I would like to think I'd be on if I didn't have kidney disease. At 17% eGFR I feel fine. I don't know if it's slowing down my kidney disease but my labs--for a kidney patient--are good. It works for me and I wish I had stumbled upon this way of eating long, long ago.

[MooseMom]

Is it supposed to help with certain symptoms?

Can you be more specific about which symptoms you experience?  Even when my egfr got as low as 14, I wasn't experiencing specific symptoms, so before I try to answer you, I'd like to hear more about your symptoms.

Do you exercise?  Do you sleep well?  I've read that you have frequent UTIs; are these infections currently under control?  Are you taking antibiotics right now?  How are your labs?  Are you anemic?  If so, are you being properly treated for anemia?

[kristina]

...If you really want to help yourself with a vegetarian diet, there are many vegetarian options to be found on the Internet...
you can also bake your own salt-free fresh bread and you can get all your fresh vegetables and fruit from the market...
 
You can also refine your vegetarian diet according to your own preferences...
another important point is to figure out how much potassium, how much water etc.
your body can tolerate according to your weight and your kidney function  etc.
(with the help of the Internet you can learn how to work it out quite easily).

This vegetarian diet is a bit hard in the very beginning but you might soon find your way
and if by any chance you find your diet boring or even very boring,
don’t forget: dialysis is much more boring and surely much more frightening...

I have been a vegetarian for over 42 years (since my kidneys first failed and recovered a little again...)
 and my vegetarian diet has kept me from dialysis ever since and that is all I need.
I have been in complete ESRF again for the past 7 years with a kidneys function of only 10-12 %...
but with lots of exercises and my vegetarian diet I am doing as well as I possibly could do... and certainly without dialysis...

Good luck from Kristina.

[Jean]

Very nice to see a post from you Kristina. Was wondering if you were still okay. Glad to hear it. You are a model for those of us trying to stay off dialysis.

[kristina]

Thanks for your kind thoughts, Jean... mind you, I do know how hard it can be sometimes
to stick to such a boring diet...  day after day... every day of the year...year after year...

...but every time I feel myself weaken, I remind myself of all those lovely people who became my friends after we met
in waiting rooms of nephrologists ...  many lost their battle whilst they were still on dialysis...
... and others lost their battle after they had their kidney transplant...
 
... and whenever I think of all those dear friends, my vegetarian diet does not seem so boring any-more
and seems to be a very small price to pay for my survival without dialysis in ESRF ...

Mind you, I don’t think I am a model for those who try to stay off dialysis...
... I believe that I only do my very best to survive for  as long as possible
with my vegetarian diet and my drinking water ...
... and so far I have been very lucky...

I don’t even know (and nephrologists don’t know that either...yet... )
if it is “my” particular chronic proliferative glomerulonephritis
which makes my body react so favourably to my particular strict vegetarian diet
and assists me to keep off dialysis for so long ...?
 
... Or perhaps I was just very lucky to find this particular vegetarian diet...
... and refine it eventually to a very fine art...
... and stick to my strict vegetarian diet ... day after day, year after year... ?

I send you my best wishes and good luck and thanks again for your kind thoughts from Kristina.

[Grumpy-1]

I'm an example of a bad example.  I'm on hemo dialysis (going on 4 years) and I really don't follow any diet.  I eat what I want (and/or tastes good) Dark sodas are out at they don't taste good.  I do watch the labs and try to adjust what I eat based on the labs.  I too find that phosphorous makes me itchy and muscle spasm or twitch when my potassium is out of range and drinking too much fluids will raise my blood pressure.    And each lab report I get the same comments from the dietitians.   Grumpy

[kristina]

P.S.   I do not know if my vegetarian diet is the answer to my ESRF with 10-12% kidney function without dialysis...

... there may very well be genetic components... and it may also be my particular kidney disease...
(chronic proliferative glomerulonephritis) ... and/or other health-related components...

It seems very, very complicated... and Nephrologists/doctors cannot help me as their knowledge seems very, very limited,

relative to the complicated health issues I have...

... All I can do is try to help myself, using the best logic and the best (Internet) information at my disposal...

... many years of studying my own vegetarian diet has proved to me and doctors
that through my own particular vegetarian diet I have been able to control my protein, sodium, potassium
and also –  though very difficult –  my Creatinine and Urea (bun)...

How long I will be able to keep these matters under control in the future ... I don’t know...

I just do the very best I can..  for as long as I can...

Best wishes from Kristina.

[Deanne]

I think genetics plays a large role. I was diagnosed with kidney disease in 1972. Back then, my doctor urged eating a lot of protein to replace what I was losing through my kidneys. Later, of course, this guidance was reversed. I tried not to pig out on protein, but I never watched it very closely, either. I still didn't need to start dialysis until a few weeks ago.

Now that I'm on dialysis my plan is similar to Grumpy-1. I'll eat whatever my labs say I can eat, but I'm also honest with my dietician and will make changes as needed if my labs start to come back showing problems.

[kclapham]

I have been on dialysis for 18 years and I tend to eat minimal red meat but lots of eggs. Luckily I don't have much issue with phosphate. I thinks its all about the person and still enjoying food, not seeing it as a chore

[galvo]

You are my hero, Grumpy!

[Grumpy-1]

Galvo - not sure I should be your role model.  BUT go for it if you want.   BUT also, if you are going to follow my example, just make sure you eat less and watch the labs (adjusting as needed) Grumpy

[galvo]

Absolutely, Grumpy! I get labs done once a month, and carefully monitor my behaviour where necessery. Had a session with a nutritionist/dietician on Tuesday and she and I agreed that, although my lifestyle doesn't fit into the official parameters, I am doing pretty well. She also agreed that further behaviour modification could not guarantee me one extra happy day. Four years of incenter HD now, one heart attack, a few other health problems and as happly as Larry! Best wishes to you, Grumpy!

[kristina]

I think genetics plays a large role. I was diagnosed with kidney disease in 1972. Back then, my doctor urged eating a lot of protein to replace what I was losing through my kidneys. Later, of course, this guidance was reversed. I tried not to pig out on protein, but I never watched it very closely, either. I still didn't need to start dialysis until a few weeks ago.

Now that I'm on dialysis my plan is similar to Grumpy-1. I'll eat whatever my labs say I can eat, but I'm also honest with my dietician and will make changes as needed if my labs start to come back showing problems.

It is very interesting what you say, Deanne, because back in 1972 - after my kidney biopsy -
and after my diagnosis of chronic proliferative glomerulonephritis,
... and after I was put on an urgent kidney transplant waiting list ...
(by the way... in 1972  being on the waiting-list for a kidney transplant was ~ 10 years...
... and survival on dialysis was ~ maximum 3 - 5 years... )

... and after I was also told by nephrologists (in 1972)  that I would be on dialysis very soon anyway ...
I was also urged by these nephrologists to eat as much protein as possible  ...

... Fortunately I had already consulted with a Professor of Medicine
(who happened to be one of the best heart specialist in Europe)
whose “hobby” was preventative medicine...

... and I was sent to this Professor for consultation because of his “hobby” of preventative medicine ...
because nephrologists were unable to give me any answers in 1971/72
how I could possibly save or improve my little kidney function ...  and/or avoid dialysis ...

...This Professor had already told me at the first consultation that he would “go vegetarian”
and he would avoid as much protein as possible if he were in my desperate ESRF situation ...

... I believed what the Professor told me because I thought that a Professor of Medicine
would surely have much more medical knowledge and much more medical experience
and perhaps be much more clever than any “ordinary” nephrologist...

... and so it came that I preferred to believe the knife-sharp logic of this Professor who explained to me
that my compromised kidney function really needed all the help I could possibly give
by eating only very easy digestible vegetarian food which could assist my "injured" kidneys ...
... and he was right ... because my strictly vegetarian diet assisted
my compromised and "injured" kidney function from  1971  ... until August 2006...

... But with the help of the Internet I was given another chance to improve & refine my vegetarian diet
with the very latest medical findings in diet - courtesy of the Internet - in August 2006 -
after I was told by nephrologists ... again ... that I am in ESRF ... again... and nothing could be done ... again...
with only 6 months to go 'till dialysis in August 2006 ... again...

...  so far my improved & refined vegetarian diet has assisted me ... again... to stay off dialysis... 
... and as I have said before... I have no idea for how long I might be lucky...

but I surely treasure every day/every moment I can stay off this dialysis-business ...

[Alex C.]

My GFR is at about 10%, and I'm still pre-dialysis. My nephrologist has given me some recent findings in the field, and it seems that certain amino acids found only in meats actually HELP delay the formation of kidney cysts. So, even though I can only tolerate 40-45g/day of protein, I make it a point to have at least some meat protein each day.

Recently, my potassium levels have been increasing, so I have given up most potatoes, orange juice, ant tomatoes. Still, the potassium remains high, and I'm wondering what my nephrologist's next idea is going to be.

[MooseMom]

My GFR is at about 10%, and I'm still pre-dialysis. My nephrologist has given me some recent findings in the field, and it seems that certain amino acids found only in meats actually HELP delay the formation of kidney cysts. So, even though I can only tolerate 40-45g/day of protein, I make it a point to have at least some meat protein each day.

Recently, my potassium levels have been increasing, so I have given up most potatoes, orange juice, ant tomatoes. Still, the potassium remains high, and I'm wondering what my nephrologist's next idea is going to be.

One of the challenges of the pre-renal diet is remaining properly nourished.  One can get protein from sources other than meat, but those sources can be high in phosphorus, so it gets complicated.  Having a 3oz portion of lean meat a day is fine for a pre-dialysis patient.

I strictly followed my pre-renal diet for 8 years, but once my egfr dropped below, say 22, I started having problems with potassium, so my neph started me on sodium bicarb tablets, and those really helped.  However, as my renal function declined, I had to take more sodium bicarb.  By the time my egfr declined to 14, I was taking 12 tablets a day.  So in your case, I am wondering if this is the course your neph may take next.

[Deanne]

Alex, are you on lisinopril or another ACE Inhibitor? It can increase your potassium level. I was on lisinopril for many years, then suddenly my potassium went high. My neph took me off lisinopril and my potassium level dropped back to normal.