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Treatment

Eating Right for CKD Patients

Learning how to eat well is important

When kidney function starts to decrease, pre-dialysis patients need to take their food intake into consideration to prevent excess wastes and fluid from building up. The goal is to preserve existing kidney function and to delay the progression of Chronic Kidney Disease (CKD), particularly stage 5, which then necessitates dialysis or transplant. Dietary needs of patients may vary with the progression of their kidney disease.

Remember:

  • The renal diet depends on a person’s body size, symptoms, stage of CKD, age, activity level and other health conditions
Protein
  • Pre-dialysis patients require less protein than patients on dialysis
  • Impaired kidneys are able to function in the earlier stages of CKD but they still have hard time to remove all waste products from the body
  • Consuming more protein leads to overworked kidneys which can cause more damages
  • Eating less protein helps to preserve kidney function and prevent additional stress on the kidneys. Your dietitian or doctor will tell you how much of protein you need to consume a day
Low In Sodium
  • Sodium is naturally found in all different types of foods, and more commonly in packaged and processed foods. Salt is one of the main sources of sodium
  • Sodium makes you feel thirsty and start drinking more
  • As a result, weight gain from fluid arises and consequently, an increase in blood pressure. Sodium restriction in kidney disease helps to maintain normal fluid balance
  • To help restrict salt intake:
    • Limit the salt added to your cooking
    • Avoid using stock cubes and gravy browning e.g. Bovril and Marmite
    •  Avoid taking bottled chicken extracts.
    • Read labels on processed foods and avoid items that have more than 250 mg of sodium per serving
    • Minimise the usage of canned food. If you do choose to use them, do drain the brine
    • Use fresh herbs and whole spices in replace of salt in cooking
    • Use fresh lime, lemon juice or vinegar to flavour food

Important! Renal patients should exercise caution with salt substitutes as they are often high in potassium and should not be used without consulting you doctor or dietitian.

Potassium
  • Potassium is important for the nerves and muscles function
  • Excessive potassium level in the blood can cause muscle weakness, abnormal heart rates and in extreme cases, heart failure
  • Potassium needs can be varied with the different stages of CKD
    Avoid high potassium foods such as
    •  Wholegrain cereals, bread and biscuit
    •  Nuts, seeds and related products (e.g. chocolate, peanut butter)
    • Coconuts and related products (e.g. coconut milk, kaya)
    • All fresh/canned fruit and vegetable juice, herbal medicine drinks, strong tea/coffee, cocoa and malted beverage, milk, wine
    • Brown sugar, molasses, maple syrup, toffees, liquorice
    • High potassium salt substitute, bottled sauces, meat and vegetables extract, essence of chicken, stock cube
    • Fruits and vegetables from the high potassium group

Tip! Potassium can be reduced during the preparation of vegetables by leaching or soaking.

Phosphrous
  • As the kidneys become less effective at filtering waste products, blood phosphate level rises
  • Excessive phosphate level in the blood can lead to skin itchiness, joint pain, eye irritation, and weak and brittle bones
  • Pre-dialysis patients may need to restrict phosphate intake in their diet as their Glomerular Filtration Rate (GFR) decreases and blood tests show higher phosphate levels
  • Avoid high phosphate foods such as:
    • All sorts of seafood, sardines, anchovies (ikan bilis) and dried shrimp paste
    • Processed food and canned food (e.g. canned meat or fish, sausage, meat patty)
    • Dairy products (e.g. milk, cheese, yogurt)
    • Bean products (e.g. all forms of nuts, seeds, bean soup)
    • Malt drinks (e.g. Milo, Horlicks, Ovaltine)-Oats, cereals
    • Chocolate and related products
    • Wholegrain and related products (e.g. wholemeal bread, brown rice, wholemeal noodles)
    • Organ meats (e.g. liver, intestine)-Bone-based soups (e.g. chicken feet and pork bone)
    • Colas
Fluids
  • Fluids are generally not restricted in CKD patients unless they reach end stage renal failure.

*The above information and recommendations are general guidelines, and should not be viewed as specific advice for any individual. Please consult your physician or other health care advisors for personal health decisions.

Contact Details
  • Address: 81 Kim Keat Road Singapore 328836
  • Phone: 1800-KIDNEYS (5436397)
  • Email: contact_us@nkfs.org
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The National Kidney Foundation (NKF) is deeply committed to journeying with patients every step of the way in their treatment and rehabilitative care, advocating kidney health to prevent kidney failure and making a difference in the renal landscape, to benefit the community.

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