Chronic kidney disease carries dietary restrictions

July 10th, 2010

DEAR DR. GOTT: I have been diagnosed with chronic kidney disease. I was shocked when the nephrologist told me this, as I have no symptoms. I decided I would get a second opinion. The second doctor said my first diagnosis was correct and put me on a strict low-sodium, low-phosphorus, low-protein diet with very few things I could eat. I went back to the first nephrologists, who said, with all the trials done on the kidneys, it was found that I wouldn’t live one day longer on the diet. She said instead to limit my protein somewhat and to watch my sodium. What is your feeling on this strict diet? I’m a 76-year-old woman. I am having surgery soon to provide an access, as it takes six months for it to heal so I can have dialysis.

DEAR READER: Chronic kidney disease is the gradual loss of kidney function. Conditions such as diabetes, kidney stones, enlarged prostate, vasculitis and hypertension are often associated with the disorder.

The kidneys filter waste and excess fluids from the blood that are excreted in urine. With chronic kidney failure, waste products cannot be eliminated as readily, resulting in an accumulation in the blood. This causes dangerous chemical imbalances to occur. While there is no cure, treatment can help reduce any complications and slow the progression of the disease.

Treatment might begin with controlling the hypertension, taking prescription drugs to lower cholesterol levels, supplementing calcium and vitamin D to protect your bones, diuretics to rid the body of excess fluid buildup or the inclusion of a low-protein diet. A dietician will likely be recommended to review your diet and suggest methods by which your kidneys will not have to work so hard. This might include reducing your salt intake and eating foods lower in potassium. What your first nephrologist recommended was to have you incorporate a diet that would reduce the amount of work required of the kidneys.

Protein reduction includes lowering the amount of red meats, eggs and milk products in your diet. It’s not necessary to delete them, but to lessen your consumption. Fresh fruits, vegetables, cereals or breads might act as substitutes. Foods high in potassium include bananas, potatoes and tomatoes. An easy transition might be made to substitute apples, carrots, grapes and green beans. A sodium reduction can be accomplished by avoiding canned soups and vegetables, fast foods, processed luncheon meats, hot dogs, kielbasa, cookies made with tropical oils and countless other products. Here is where education and label-reading come into play.

Progressing to the later stages of the disease, dialysis, of which there are two types, might be recommended. The first is hemodialysis and involves pumping blood out of the body and into a machine that acts as a healthy kidney would. Once the waste is removed, the blood is pumped back into the body. The second type is peritoneal dialysis, which pumps a solution into the abdominal cavity and utilizes the body’s blood vessels to transport the waste products and additional fluids to the abdominal cavity, where the solution absorbs them. That solution is then pumped out of the body, taking the unwanted waste and fluids with it. A final option is kidney transplant from a healthy donor.

To provide related information, I am sending you a copy of my Health Report “Kidney Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.