Nutritional interventions for patients with kidney disease

Chronic kidney disease (a serious kidney disorder) and need or special diet.

Chronic kidney disease is a serious kidney disorder condition associated with gradual loss of kidney function over time.

  • “Special” diets are advised for the treatment and prevention of this serious kidney disorder.
  • Diet items differ according to stage of the kidney disease.
  • Proper diet can help lower the rate of kidney failure and reduce the risk of associated complications including heart disease and bone disorders besides ensuring a good nutritional status.

Kidney Friendly Diet

What is the role of protein restriction?

  • Dietary protein restriction forms the mainstay of nutritional therapy for patients with kidney disease
  • Low protein content in diet can slow the progression of kidney disease.
  • Recommended protein intake in patients with kidney disorders is 0.6-0.75 grams/kg bodyweight/day.

How does sodium restriction help?

  • Dietary sodium restriction can help reduce the excretion of protein in urine along with the reduction in blood pressure in patients with kidney disease.
  • A daily salt intake of 60–80 mmol can help decrease the progression of kidney disease.

How many calories are recommended in patients with kidney disease?

  • It is essential to ensure that the full energy requirement is met in patients with kidney disease.
  • One has to take in enough calories if he/she is losing weight
  • The control of quantity of calories depends upon clinical assessment and body weight control.
  • If a low-protein diet is recommended, the calories from protein may be replaced with fruits, breads, grains and vegetables.
  • The recommended dietary energy intake is 25-35 kcal/kg body weight/ day.

What are the effects of high levels of phosphate?

  • Dietary sodium restriction can help reduce the excretion of protein in urine along with the reduction in blood pressure in patients with kidney disease.
  • A daily salt intake of 60–80 mmol can help decrease the progression of kidney disease.

Importance of fluid management

  • Diet of kidney disease patients should include food items like soups, sauces, gravies, yoghurt and custard that contribute to daily fluid intake besides water, coffee, tea or soda.
  • There should be even distribution of fluid intake throughout the day.
  • Sipping of liquids is preferred rather than gulping them down.
  • A daily fluid intake of 1.5-2 liters is recommended.

Effects of processed foods in kidney disease

  • Canned and processed foods can have adverse outcomes in patients with kidney disease as they usually have higher amounts of sodium, phosphate and unwanted chemicals than raw or homemade alternatives.
  • Consumption of cooked foods should be preferred instead of eating prepared food
  • Canned foods like beans or frozen vegetables, if consumed, should be washed thoroughly with water before eating.

Lifestyle modifications in kidney disease

  • Regular exercise may slow the progression of kidney disease and improve overall health outcome
  • Cessation of smoking is associated with minimizing the risk of kidney disease and death due to kidney failure.

Ideal requirements of sodium, potassium and phosphorus in patients with kidney disease

  Sodium Potassium Phosphorus
Chronic kidney disease patients not receiving dialysis 2 – 4 gm/day As per blood K+ levels As per blood P levels
Chronic kidney disease patients receiving dialysis 2 – 4 gm/day 2 – 4 gm/day 800 – 1000 mg/day
Chronic kidney disease patients with high blood pressure <2 gm/day <2 gm/day As per blood P levels
Chronic kidney disease patients with diabetes 2 – 4 gm/day As per blood K+ levels As per blood P levels
  • While using vegetables for food recipes, use the list given below to choose the ones containing appropriate sodium, potassium and phosphorus levels.
  • Use methods like blanching and leaching to reduce the mineral content from vegetables if required.
  • Use salt sachets to check the direct sodium intake
  • For diabetics, use non fleshy fruits high in fibers and avoid packaged foods.

Recommended fluid and calorie Intake In patients with kidney disease

Fluid Intake Calories
As per blood pressure/blood sodium levels 25-35 kcal/kg body weight/day
1000 ml/day + urine output 25-35 kcal/kg body weight/day


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