Nephrology Nutrition Services

Nephrology Nutrition Staff

Nutrition Information

• Fluids
• Potassium
• Phosphorus
• Protein
• Fat
• Sodium
• Calories
• Vitamins and Minerals

Additional Resources

• Recipes
• Cookbooks
• Other resources

So My Kidneys are Failing . . . Now What? - A kidney education meeting for patients and families/friends.

Come and let us help you put the pieces together. By attending this meeting you will:

• Learn about treatments for kidney failure
• Hear from kidney staff that are trained in multiple areas
• Meet people who are already on dialysis or transplant and are living satisfying lives
• Take home resources for more information.

Click here for more information.

As kidney disease progresses, nutritional needs change. The Nephrology nutrition staff assist patients in learning about food and understanding the changes required through each stage of their disease: pre-dialysis, dialysis and transplant.

Pre-dialysis patients should ask their Nephrologist for a referral to a Nephrology dietitian as soon as possible so their regular diet can be assessed and adapted to their specific kidney function and needs.

Dialysis patients see their Nephrology dietitian regularly. Labs are reviewed and changes to diet made as needed to address any problems.

A post-transplant diet is much less restrictive, but should still be heart-healthy.

Always direct any specific diet and nutrition questions to your dietitian.

<back to top>

Sharon M. Boyd Senior Dietitian (Ann Arbor Dialysis Unit) Amy Peregord Dietitian (Ann Arbor MDS) Tracy A. Pluta Clinical Dietitian (Livonia Dialysis Unit) Julia Poole Dietitian (Acute Hemodialysis) Ann M. Twork Senior Dietitian (UM Hospital)

<back to top>

Fluids - Your kidneys may still be able to remove some fluid or they may not remove any fluid at all. That is why every patient has a different daily allowance for fluid. Talk with your dietitian about how much fluid you can have each day.

Any food that is liquid at room temperature also contains water, including soup, Jell-O and ice cream. Many fruits and vegetables contain lots of water, too, including melons, grapes, apples, oranges, tomatoes, lettuce and celery. All these foods add to your fluid intake.

The best way to reduce fluid intake is to reduce thirst caused by the salt you eat. Avoid salty foods like chips and pretzels. Choose low-sodium products. Drink from smaller cups or glasses. Freeze juice in an ice cube tray and eat it like a popsicle.

<back to top>

Potassium - Healthy kidneys keep the right amount of potassium in the blood to keep the heart beating at a steady pace. If your potassium begins to rise, talk with your dietitian about ways to limit the amount of potassium you eat.

Potassium is a mineral found in may foods, especially milk, fruits and vegetables. To control potassium levels in your blood, avoid foods like avocados, bananas, kiwis and dried fruit, which are very high in potassium. You can remove some of the potassium from potatoes and other vegetables by peeling them, then soaking them in a large amount of water for several hours. Drain and rinse the vegetables before cooking them.

<back to top>

Phosphorus - Too much phosphorus in your blood pulls calcium from your bones making them weak and likely to break. It may also make your skin itch. Talk with your dietitian about ways to limit the amount of phosphorus you eat. You may also need to take a phosphate binder to control the phosphorus in your blood.

Phosphorus is a mineral found in foods like milk and cheese, dried beans, peas, colas, nuts and peanut butter.

<back to top>

Protein - Proteins help build and maintain muscle, bone, skin, connective tissue, internal organs, and blood. They help fight disease and heal wounds. But proteins also break down into waste products that must be cleaned from the blood by the kidneys. Eating more protein than your body needs may put an extra burden on the kidneys and cause kidney function to decline faster. Talk with your dietitian about the amount of protein and the sources of protein in your diet.

Animal sources of protein such as egg whites, cheese, chicken, fish and red meats contain more of the essential amino acids your body needs. A well-balanced vegetarian meal plan can also provide these nutrients. Eating mostly high-quality proteins is important because they produce less waste than others. High-quality proteins come from meat, fish, poultry and eggs (especially egg whites).

<back to top>

Fat - Fat provides energy, helps produce hormone-like substances that regulate blood pressure and other heart functions, and carries fat-soluble vitamins. You need fat in your diet, but some fats are healthier than others. Saturated fats and trans-fatty acids can raise your blood cholesterol levels and cause clogging of blood vessels. Talk with your dietitian about healthy and unhealthy sources of fat.

Saturated fats are found in animal products like red meat, whole milk and butter. These fats are usually solid at room temperature. Trans-fatty acids are often found in commercial baked foods like cookies and cakes, and in fried foods like doughnuts and french fries. Vegetable oils like corn or safflower oil are healthier than animal fats like butter or lard. Avoid hydrogenated vegetable oils, which are high in trans-fatty acids. Monounsaturated fats - olive, peanut and canola oils - are healthy alternatives to animal fats.

<back to top>

Sodium - Too much sodium in your diet can be harmful because it causes your blood to hold fluid. The extra fluid raises your blood pressure and puts a strain on your heart and kidneys. Talk with your dietitian about ways to reduce the amount of sodium in your diet. Look for the sodium content on the nutrition labels of the foods you buy. Choose “sodium-free” or “low-sodium” food products.

Sodium is found in ordinary table salt and many salty seasonings like soy sauce and teriyaki sauce. Canned foods, some frozen foods, and most processed meats have large amounts of table salt. Snack foods like chips and crackers are also high in salt. Try alternative seasonings like lemon juice, salt-free seasoning mixes, or hot pepper sauce. But avoid salt substitutes that use potassium.

<back to top>

Calories - Calories provide energy for your body. Talk with your dietitian to determine how many calories you need each day to maintain a healthy weight.

As chronic kidney disease (CKD) progresses, you may find that foods do not taste the same, and you may lose your appetite. Your dietitian can help you find healthy ways to add calories to your diet if you are losing too much weight.

<back to top>

Vitamins and minerals - Vitamins and minerals may be missing from your diet because you have to avoid so many foods. Your Nephrologist may prescribe a vitamin and mineral supplement. Do not take vitamin supplements that you can buy off the store shelf. They may contain vitamins or minerals that are harmful to you. Talk to your dietitian if you have any questions about vitamin supplements.

<back to top>

Recipes

Low Protein Recipes

• Main Dishes
  • Apple Rice with Chicken
  • Applesauce Meatloaf
  • Chili
  • Pacific Pork
  • Pork Stir Fry
  • Sloppy Joes with Veggies
  • Tuna Macaroni Salad
  • Tuna Salad Sandwich
  • Vegetable and Beef Burger
• Vegetables
  • Orange Beets (not for use by diabetics)
• Salads
  • Sweet and Sour Cabbage
• Desserts
  • Apple Tapioca Dessert (not for use by diabetics)
  • Banana Apricot Dessert

<back to top>

Cookbooks

The Renal Gourmet
Mardy Peters
ISBN: 0-9641730-0-X
Emenar Incorporated
www.kidney-cookbook.com

Southwest Cookbook for People on Dialysis
Developed by the El Paso Chapter Council on Renal Nutrition and the National Kidney Foundation of Texas, Inc.
Published by a grant from Amgen, Inc.
www.epogen.com/patient/pdf/southwest_cookbook.pdf

Creative Cooking for Renal Diets
Cleveland Clinic Foundation
ISBN: 0-941511-00-6
Senay Publishing
http://www.patientsupport.net/renal-diet-cookbooks.htm

Creative Cooking for Renal Diabetic Diets
Cleveland Clinic Foundation
ISBN: 0-941511-01-4
Senay Publishing
http://www.patientsupport.net/renal-diet-cookbooks.htm

Kidney Friendly Comfort Foods
Shire US Inc.
http://www.fosrenol.com/Consumers/ExclusiveOffers/Default.aspx

Cooking for David
Culinary Kidney Cooks
http://www.culinarykidneycooks.com/

<back to top>

Other Resources

National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)

• Nutrition for Early Chronic Kidney Disease in Adults
• Nutrition for Later Chronic Kidney Disease in Adults
• Eat Right to Feel Right on Hemodialysis

National Kidney Foundation

• Dining Out With Confidence: A Guide for Patients with Kidney Disease
• How to Increase Calories in Your Renal Diet
• Nutrition and Chronic Kidney Disease
• Nutrition and Hemodialysis

American Association of Kidney Patients

• Kidney Beginnings: A Patient's Guide to Living with Reduced Kidney Function

National Heart, Lung, and Blood Institute Information Center

• Facts About the DASH Eating Plan

Miscellaneous

• Dietary recommendations to prevent calcium oxalate stones
• Patient Resources

<back to top>