Kidneys play a vital role in maintaining the overall well-being of the body by regulating fluid levels and performing other key functions. Since our bodies rely on kidneys for regulating blood pressure, balancing electrolytes, supporting bone health, and maintaining pH balance, any malfunctions or damage to these organs can take a big toll on the entire body. This leads to various kidney problems and diseases that make it tougher for patients to perform various basic functions. In this blog let us discuss how kidney disease progresses over time and what dietary modifications you should consider to maintain the optimal health of your kidneys.
Kidney disease progresses through five stages, also known as chronic kidney disease stages. They are:
- First stage kidney damage – GFR 90 or higher
- Mild loss of kidney function – GFR 60-89
- Moderate loss of kidney function – GFR 30-59
- Severe loss of kidney function – GFR 15-29
- Kidney failure (end-stage renal disease) – GFR<15
When does a patient need dialysis?
Typically, doctors mandate dialysis when the patient reaches stage 5 of chronic kidney disease, also known as end-stage renal disease. At this stage, the kidneys almost lose 90% of their functionality, giving the patient no other way than dialysis. However, there are various exceptions:
- Doctors may recommend dialysis to some patients even when they are in stage 4, if they have severe complications such as uncontrollable electrolyte imbalances and fluid overload.
- Sometimes before performing kidney transplantation based on the patient’s condition.
Key indicators for starting dialysis
Glomerular Filtration Rate (GFR)
- GFR falls below 15 mL/min/1.73m².
- This indicates severely reduced kidney function.
Severe Symptoms of Uremia (build-up of toxins in the blood):
- Nausea and vomiting.
- Severe fatigue or weakness.
- Shortness of breath (due to fluid overload).
- Persistent itching.
- Swelling in the legs, feet, or face.
Fluid Retention:
- Causing high blood pressure or fluid accumulation in the lungs (pulmonary edema).
High Levels of Electrolyte Imbalance:
- Dangerously high potassium levels (hyperkalemia), which can affect heart function.
Metabolic Acidosis:
- Inability of the kidneys to balance pH, leading to dangerously acidic blood.
Diet tips for kidney dialysis patients
Patients undergoing kidney dialysis have very minimal kidney function, which is why diet plays a crucial role in maintaining their optimal health. A proper diet plan can help patients manage nutrient levels, minimize complications, and manage energy levels.
Here is a detailed diet plan specifically tailored for dialysis patients, what to eat, what to regulate, and what to completely avoid.
Protein
Dialysis treatments remove protein waste and also delete the body from protein. This is why, maintaining the protein intake is crucial, consider including these foods into your diet:
- Egg whites, lean chicken, and fish like rohu or hilsa (grilled or boiled).
- Paneer (unsalted), tofu, or low-sodium cottage cheese.
- Sprouted moong (in moderation).
- Dals in limited amounts, like moong dal (well-cooked).
Avoid: High-fat meats, processed meats, and excess pulses.
Sodium
Excessive sodium intake leads to increased blood pressure which in turn can worsen the kidney’s condition. Regulate the sodium intake to manage the blood pressure and prevent fluid retention. Include these foods:
- Freshly cooked vegetables without added salt.
- Home-cooked chapati, rice, or idli without sodium.
- Use herbs/spices like cumin, turmeric, coriander, or ginger for flavour.
Avoid
- Pickles, papads, chutneys.
- Packaged snacks (chips, namkeen).
- Restaurant foods and sauces.
Potassium
High levels of potassium can affect the heart and this affects the blood flow. It is recommended to consume low-potassium foods. Include these foods:
Low-Potassium Foods:
- Fruits: Apples, guavas, pears, or berries.
- Vegetables: Ridge gourd, bottle gourd, cabbage, cauliflower (boil and discard water).
Avoid: Bananas, oranges, mangoes, potatoes, spinach, and tomatoes.
Tip: Soak high-potassium vegetables and dals before cooking to reduce potassium levels.
Tip: Soak high-potassium vegetables and dals before cooking to reduce potassium levels.
Phosphorus
Doctors also recommend regulating phosphorus intake as it can help in preventing bone disease and calcification, a byproduct of dialysis. Here is a list of foods to include:
- Low-phosphorus options like roti, rice, poha, or upma.
- Fruits: Papaya, watermelon (in limited amounts).
Avoid:
- Dairy: Cheese, butter, and condensed milk.
- Nuts and seeds: Almonds, walnuts, and sesame.
- Soft drinks and cola (contain phosphorus additives).
Fluid management
The most important part of keeping the kidneys is the management of fluids. Without proper fluid management patients may experience swelling and high blood pressure.
Tips:
- Limit water, tea, coffee, and soups to the advised quantity.
- Avoid high-water-content fruits like watermelon and coconut water.
- Use a squeeze of lemon or ice cubes for hydration.
Energy requirements
Dialysis can be tiring and result in weight loss and weakness when done frequently. Include these foods that can help you increase your energy levels and prevent weight loss associated with the treatment.
Foods to Include:
- Healthy carbohydrates like rice, roti, suji halwa, and poha.
- Ghee, olive oil, or mustard oil. Please use at moderate levels.
- Sweets made with sugar but low in potassium, like sooji kheer (without dairy).
General Tips
- Meal Frequency: Small, frequent meals (5–6 times a day).
- Spices and Herbs: Use turmeric, coriander, and mint for taste instead of salt.
- Protein Timing: Have a protein-rich snack post-dialysis to replenish protein loss.
- Avoid Fast Foods: Stick to homemade, low-sodium meals.
Sample diet plan
| Meal | Food Options |
|---|---|
| Breakfast | 2 chapatis with unsalted paneer, mint chutney (low salt), and herbal tea |
| Mid-morning | 1 apple or guava. |
| Lunch | White rice, boiled ridge gourd, dal (moong, low potassium), and grilled fish. |
| Evening Snack | 1 boiled egg or roasted makhana (fox nuts). |
| Dinner | 2 chapatis, cabbage sabzi, curd (low potassium and unsalted). |
| Post-dialysis | Egg white or unsalted paneer (50 g). |
Conclusion
All in all, maintaining a balanced diet is crucial for patients who are suffering from kidney conditions. Always remember that dialysis is not a cure, it just helps in managing the kidney diseases until a transplant becomes the only option. Follow this diet plan strictly to avoid any complications in the future and lead a healthy life. We also recommend you consult an expert nephrologist before modifying your diet, as it can lead to various changes in your metabolism activities.
