The Renal Diet, as Promised

In my research, I found information that amazed me.  Apparently, the majority of the U.S. population over 50 suffers from hypertension which may lead to CKD.  How are all these people paying for their nutritionist if they do develop CKD, I wondered.  Most people think of a nutritionist as a luxury even if they do have a chronic disease.  When I pulled out my checkbook to pay my renal dietitian [RD], I was told the government will pay for her services.  That made sense.  Especially in the current economic atmosphere and for older people, the government needs to help pay our medical bills.

Crystal Barraza, the RD in my nephrologist’s Arizona Kidney Disease & Hypertension Center practice, clarified the reasoning behind the diet with the following:

“One of the most obvious messages [I’ve heard] is that when people are sick, the last thing they want to hear is what they can and cannot eat.  It makes sense.  I feel that this is also true for many who have many chronic illnesses.  I have heard, time and time again from patients like you, ‘I am not going to be able to eat anything!’ My goal for any session is to help destress people about the diet and help with better food choices.  The main goal is to help protect your kidney(s). My favorite word is moderation.  I don’t feel that eliminating favorite food from anyone’s diet is going to help anyone.  It has to be realistic for all.  So, I have learned that the best approach is to meet you where you are.”

In order to fully understand the renal diet, you need to know a little something about electrolytes. There are the sodium, potassium, and phosphate you’ve been told about and also calcium, magnesium, chloride and bicarbonate. They maintain balance in your body.  This is not the kind of balance that helps you stand upright, but the kind that keeps your body healthy.  Too much or too little of a certain electrolyte presents different problems.  Eating a larger portion than suggested in the renal diet of a low sodium, phosphate, protein or potassium food is the equivalent of eating a high sodium, phosphate, protein or potassium food.  This simply did not occur to me until I read it in one of my sources.

Sodium is pretty well known since news articles about its effects have produced an influx of low sodium foods in supermarkets.  Too little sodium can be a problem. Since most adults easily consume the estimated required minimum daily 500 mg. without adding salt to food, it’s not a common problem.  However, excessive sodium intake is.  It can lead to hypertension which can be a cause of CKD.  It also may lead to edema, or swelling, another possible problem with CKD.

What makes it worse is that there is no internal mechanism that tells us if we need more or less salt.  CKD sufferers are in a spot because the kidneys are the only route by which to eliminate excess salt.

Basically, sodium balances fluid levels outside your cells.  You need it because it is responsible for watering your cells. This watering is the prompt for potassium to dump waste [cell process by-products] from your cells.  Sodium does deal with other functions of the body, but this is a pretty important one.

If you have damaged kidneys and cannot excrete most of the sodium you ingest, you’re up against higher blood pressure which may worsen your CKD which may further cut down on your elimination of sodium and so on and so forth in an ever spiraling cycle. In addition, for CKD patients, too much sodium causes fluid retention, thereby causing swelling, further resulting in weight gain, leading to shortness of breath.  That’s why your nephrologist asks if you’ve experienced shortness of breath.

That’s also why the following are not on the renal diet or, if they are, it is suggested they be eaten  in severely limited quantities once in a great while: pizza, frankfurters, canned soup, frozen dinners, luncheon meats, cheese and smoked or cured food. There are low sodium cheeses but you have to search for them.  The most common are Swiss and provolone. I had mistakenly thought nitrates were the problem with frankfurters.  Although there are now no nitrate brands, they are still too high in sodium.

It’s also become possible to buy reduced or no sodium mayonnaise, baking powder, butter, margarine, seasonings and snacks such as crackers, cookies, pretzels and chips. Don’t go too far and use salt substitutes.  Rather than help, they’ll hurt. They contain potassium chloride which could raise your potassium levels.

This information about food seems to interest people with or without CKD the most.  It makes sense.  We are a nation of people who love to eat and can.  We have supermarkets laden with food that is readily available.  There is so much more to learn about how to make appropriate choices as CKD patients.  Especially since our healthy choices are not the same as those without CKD.  There will be at least one more post on this topic.

Until Friday,

Keep loving your life!

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Published in: on November 30, 2010 at 4:56 pm  Leave a Comment  

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