The RenalTracker Team
May 19, 2020

Learn what to do and what not to do to reduce your risk factors for kidney disease

Chronic Kidney Disease progression is preventable. You can take a dynamic role in taking care of your kidney while still maintaining a fruitful life by making changes in your lifestyle.

This article addresses many lifestyle concerns you and other people with CKD may have and offers tips that can make accomplishing your daily activities more convenient. 

Slow Down CKD progression

Here are practical steps that you can do to slow down your CKD progression.  

1. Minimize Sodium Intake 

Recommended Salt Limit for CKD patient

Studies conducted by the University of California – San Francisco Hospital suggests that people with CKD should eliminate the salty foods from their diet and reduce the amount of salt in cooking, both sea salt and regular table salt.

Reducing your salt intake will lower your blood pressure. Importantly, your blood pressure medication works much better when your salt intake is lower. This may even mean that you need to take fewer pills!

Sodium: Foods to Eat and Avoid

This is a list of high sodium foods and their good alternatives.

Low Sodium Foods

  • Dry peas and beans (not canned)
  • Milk, yogurt, ice cream and ice milk
  • Unsalted popcorn, chips and pretzels
  • All rice and pasta, but do not to add salt when cooking
  • Spices such as cumin, nutmeg, cinnamon, pepper, tarragon, oregano. 

High Sodium Foods

  • Bouillon, canned, and instant soups 
  • Bacon, corned beef, ham, hot dogs, luncheon meat, sausage
  • Boxed mixes, like hamburger meals and pancake mix
  • Canned tomato products, including juice
  • Frozen meals
  • Seasoning mix and sauce packets

Conclusion:

Sodium is found in many canned, packaged, and “fast” foods, as well as in many condiments, seasonings, and meats. Low sodium is defined as 140 mg of sodium per food serving. The National Institute of Diabetes and Digestive and Kidney Diseases advises that, for CKD patients, the diet should contain less than 2300 mg of sodium per day. Current daily intake in the country is at 9.4 gm/day (3700 mg sodium). WHO suggests a  reduction to <2 g/day sodium (5 g/day salt) in adults.

It’s time to forget about the salt shaker and sugar jar from the table and season your foods with alternatives such as natural and organic herbs and spices. 

2. Consult a registered dietitian. 

A registered dietitian can personalize an eating plan that contains the nutrients that you need to deal with your CKD. Your RD will help you understand nutrition labels and recommend inexpensive food alternatives when cooking and especially when dining out. Through your RD’s guidance, you can follow a safer, more realistic and long term dietary plan and practical lifestyle. 

Meanwhile, the NKF KDOQI suggests a diet plan which contains mostly vegetables, fruits that contain 200mg or less potassium or phosphorus per serving i.e, lean proteins, and low-fat dairy products. These include:

Vegetables

  • Beets
  • Cauliflower
  • Red bell peppers

Whole Grains

  • Barley
  • Wild Rice

Fruits

  • Berries
  • Apple
  • Cherries
  • Red grapes

Lean Proteins

  • White-fleshed fish
  • Plain Greek Yogurt
  • Lite Tofu and other soy foods 
  • Shellfish

 It is still best to check with your registered dietitian for your custom needs. 

 3. Consult a doctor before taking any medication, herbs or supplements.

 Do not self-medicate. There are a lot of risks in self-medication. These include incorrect self-diagnosis of illness, delays in seeking medical advice from the proper medical professional when needed, dangerous interactions between the drugs consumed, improper manner of administration and dosage, and risk of dependence and abuse of particular drugs.

Even over-the-counter medication like ibuprofen and aspirin (NSAIDs) are dangerous to the kidney. You should talk to your nephrologist before taking food supplements and over the counter medication such as painkillers, anti-inflammatory medicines, oral expectorants, nasal sprays, decongestants, and antihistamines. Some medicines—most especially medicines you can buy without a prescription—can actually make your kidney failure worse.

It is imperative to inform your doctor about ALL medications and supplements that you are taking so your medical provider can also advice regarding drug interactions. For example, Alka-Seltzer®, the most common antacid and pain reliever in the market has too much sodium content which, as we know, is bad for the kidney. 

4. Switch to plant-based protein. 

Protein could be tricky for CKD patients. While it may be one of the essential nutrients for a healthy, normal kidney, too much protein is bad for a malfunctioning one.

A plant-based diet is beneficial if you have early kidney disease. Plant-based foods have fewer calories compared to its animal-based counterpart. Studies show that people with kidney disease puts their heart at risk.

This type of diet helps blood pressure and cholesterol thereby reducing heart-related diseases. It also improves antioxidant levels that fight against cell damage. Minimizing animal-based food lowers acid build up in the blood, which puts less stress on the kidneys.

It is recommended to eat just small portions of protein foods which may be sourced from animals, e.g. chicken, fish, meat, eggs, and dairy, and from plants, e.g. beans, nuts, and grains. Recommended sources of proteins for CKD patients include fish, chicken breast, low-fat soy products, and low-fat dairy products. Talk to your dietitian to get the specific amount of protein that your body—especially your kidney—needs.

Animal-based Protein Foods

  • Meat, such as pork, beef, chicken, turkey, duck
  • Eggs
  • Dairy products, such as milk, yogurt, cheese
  • Fish

Plant-based Protein foods

  • High Protein Content
    • Beans, peas, lentils
    • Soy foods, such as soy milk, tofu
    • Nuts and nut spreads, such as almond butter, peanut butter, soy nut butter
    • Sunflower seeds
  • Low Protein Content
    • Bread or tortillas
    • Oatmeal, grits, or cereals 
    • Pasta, noodles, or rice
    • Rice milk (not enriched)

5. Track progress. 

Take note of your renal diet, physical activities and other lifestyle changes and write it in a journal. Check your blood pressure regularly too. Having a health journal keeps you accountable and allows you to see your effort in managing or slowing down CKD. If you are an online savvy, there are a lot of free applications on your desktop or smartphone that make tracking your exercise routines very easy such as MyFitnessPal or MyPlate Calorie Tracker.

6. Exercise regularly.

Regular Exercise to Slow Down CKD

Obesity (which correlates with high blood pressure and extra weight thus forcing the kidneys to work harder than normal) places people with CKD at greater risk. Generally, regular exercise reduces a person’s risk for obesity, high blood pressure, and certain types of diabetes. 

The NKF KDOQI recommends people with CKD to make time: 30 minutes of physical activity five times weekly, may it be hitting the gym, weightlifting, an evening or morning walk or run with friends and loved ones, or doing house chores like gardening or trimming the lawn. Consult with your doctor before starting an exercise regimen.

7. Limit or avoid smoking and drinking alcohol and caffeine

Excessive drinking can overwork your kidneys. A kidney of someone who drinks alcohol actually works overtime. Maintaining this kind of lifestyle doubles the risk of having an unhealthy kidney compared to those who do not drink alcohol.  

Recommended intake/consumption of alcohol to maintain health is 1 unit per day for women and 2 units for men day, max 3 times per week.

8. Minimize caffeine intake

The recommended dosage of coffee should not be more than 300 milligrams per day which is more or less 4 cups daily. However, some people with CKD are prescribed a restricted fluid diet so if you are in one, include coffee along with water and other liquids you consume in your daily fluid allowance. Coffee is high in phosphorus as well which isn’t good for the kidneys. 

9.  Avoid or quit smoking.

If you want to slow down CKD progression, then you should think twice about puffing a cigarette. Smoking narrows the blood vessels thus reducing the blood flow in the kidney. Such risk even increases dramatically if you are a heavy smoker.  It can also affect the medicines that are used to treat high blood pressure. It hinders absorption of Vitamin C and with low levels of Vitamin C, weakens the immune system and proper uptake of iron in the body.

According to the Multiple Risk Factor Intervention Trial (MRFIT), smoking is one of the leading risk factors that can lead to end-stage renal failure. Smokers with kidney diseases should stop smoking to not just slow down CKD progression but also prevent heart failure.

10. Stay hydrated.

Water accounts for 60% - 70% of our body. The Harvard Medical School found out that “a healthy person needs 30-50 ounces of fluid per day.” That’s almost 6 glasses per day which is manageable!

Man drinking water

Water promotes a healthier cardiovascular and skeletal system by helping muscles and joints work better. It keeps our body cool, especially during the summer season. Not only that, water is a necessary component for proper digestion, elimination, metabolism, lubrication, growth and repair of the body. Water is responsible for all biochemical processes in the body.

So what to do? Swap your bottle of soda with water.  Keep a reusable and refillable bottle of water with you everywhere you go especially during the day. If you are not ready to make this big change, try soda water infused with berries and mint. As you start your exercise regimen, make sure you drink water before, during, and after a physical activity. You may also drink in between meals.

Indulging yourself with your favorite foods and other activities that you enjoy every once in a while is okay, especially if it motivates you to stick to your CKD lifestyle. Following these doable steps above can help slow down CKD while living a meaningful and productive life. 


Sources:

The importance of staying hydrated | Harvard Medical School

https://www.health.harvard.edu/staying-healthy/the-importance-of-staying-hydrated 


Eating Right for Chronic Kidney Disease |National Institute of Diabetes and Digestive and Kidney Disease

https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/eating-nutrition 


10 Exercise Do's and Don'ts |The National Kidney Foundation 

https://www.kidney.org/news/ekidney/october13/10Fall_Exercise_Dos_and_Donts


Kidney Disease Outcomes Quality Initiative | The National Kidney Foundation 

https://www.kidney.org/professionals/guidelines


Guidelines for a Low Sodium Diet | UCSF (University of California – San Francisco) Health 

https://www.ucsfhealth.org/education/guidelines-for-a-low-sodium-diet


Nutrition and Chronic Kidney Disease | The National Kidney Foundation

https://www.kidney.org/sites/default/files/11-50-0114_docsnutrikidfail_stage1-4.pdf