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Suggest A Diet Plan For An End Stage Kidney Patient

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Posted on Wed, 11 Oct 2017
Question: Hi, I am an End-stage kidney patient , on Haemodialysis since 2 months and my average creatinine is 6.5 ; I am also having Hypertension and Non-diabetic. Please suggest a "suitable" diet plan for me which can keep me energetic during the day. Also what kind of protein sources are good for me and which food items I should restrict /eat in moderation may be mentioned please.
doctor
Answered by Dr. Geeta Sundar (8 hours later)
Brief Answer:
Fundamentals of diet in renal failure---

Detailed Answer:
Hi welcome to health care magic,
Fundamentals of diet in renal failure--from my book 'Health After Forty'
Protein
Too much intake of protein increases blood acidity and muscle breakdown. The products of protein breakdown can further damage the kidneys. Protein intake should therefore be restricted to 0.8-1g per kg body weight. Further lowering is recommended only in those patients where blood pressure cannot be controlled. High protein supplements should definitely be avoided. A higher intake (1-1.2 g per kg is recommended during haemo dialysis and 1-1.5g per kg in peritoneal dialysis.) The diet you are taking is fine.
Sodium (salt)
Sodium chloride should be reduced to keep blood pressure under control and avoid fluid accumulation. It should not exceed 2500 mgs a day. Do not use low sodium salts since they contain a lot of potassium.
Potassium
Potassium should be restricted in advanced kidney disease when the levels are high. Good sources of potassium include bananas, citrus juices (such as orange juice), cantaloupes (melon), tomatoes, potatoes, lima beans, flounder, salmon, cod, chicken, and other meats. These foods should be avoided.
Drugs that increase potassium levels like ace inhibitors and ARB’s, spironolactone, amiloride, triamterine—should also be avoided.
Fluid (liquid)
Fluid intake should be normal—1.5-2 litres a day. Or measure the amount of urine passed in 24 hours and add 500 ml. (750 ml during dialysis) Fluid is restricted only if there is a lot of oedema (fluid accumulation).
Phosphate
High phosphate foods should be avoided especially nuts like peanuts, cashew and walnuts; seeds like sunflower, pumpkin and sesame; roasted soya, rice XXXXXXX wheat germ, bacon and cheese.
If phosphate levels are very high then drugs like calcium acetate have to be given to lower them.

Energy
Appetite can be low in renal failure, so it is important to make sure that small frequent meals are eaten to provide sufficient calories and multi vitamin supplements can be given.
Calcium
Bones often lose calcium around the time of a transplant. Some of this is due to steroid treatment. Calcium supplements may be given for this.
Calcium rich diet—especially milk, and milk products, green leafy vegetables and nuts should also be taken.
I will be happy if this helps you.
Regards


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Geeta Sundar (3 hours later)
Hi doctor, thanks for your valuable guidelines about renal diet. I would like to further ask if I can take egg/paneer/ rajma /chickpeas(chole)for my protein requirement on the days of my regular Dialysis ; I have currently twice a week haemodialysis.
doctor
Answered by Dr. Geeta Sundar (50 minutes later)
Brief Answer:
On the days of Dialysis you can take one of these

Detailed Answer:
On the days of Dialysis you can take one of these---but it is always better to check with your Neprologist too since he is the one taking care of you--regards
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
Dr.
Dr. Geeta Sundar

Internal Medicine Specialist

Practicing since :1975

Answered : 1329 Questions

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Suggest A Diet Plan For An End Stage Kidney Patient

Brief Answer: Fundamentals of diet in renal failure--- Detailed Answer: Hi welcome to health care magic, Fundamentals of diet in renal failure--from my book 'Health After Forty' Protein Too much intake of protein increases blood acidity and muscle breakdown. The products of protein breakdown can further damage the kidneys. Protein intake should therefore be restricted to 0.8-1g per kg body weight. Further lowering is recommended only in those patients where blood pressure cannot be controlled. High protein supplements should definitely be avoided. A higher intake (1-1.2 g per kg is recommended during haemo dialysis and 1-1.5g per kg in peritoneal dialysis.) The diet you are taking is fine. Sodium (salt) Sodium chloride should be reduced to keep blood pressure under control and avoid fluid accumulation. It should not exceed 2500 mgs a day. Do not use low sodium salts since they contain a lot of potassium. Potassium Potassium should be restricted in advanced kidney disease when the levels are high. Good sources of potassium include bananas, citrus juices (such as orange juice), cantaloupes (melon), tomatoes, potatoes, lima beans, flounder, salmon, cod, chicken, and other meats. These foods should be avoided. Drugs that increase potassium levels like ace inhibitors and ARB’s, spironolactone, amiloride, triamterine—should also be avoided. Fluid (liquid) Fluid intake should be normal—1.5-2 litres a day. Or measure the amount of urine passed in 24 hours and add 500 ml. (750 ml during dialysis) Fluid is restricted only if there is a lot of oedema (fluid accumulation). Phosphate High phosphate foods should be avoided especially nuts like peanuts, cashew and walnuts; seeds like sunflower, pumpkin and sesame; roasted soya, rice XXXXXXX wheat germ, bacon and cheese. If phosphate levels are very high then drugs like calcium acetate have to be given to lower them. Energy Appetite can be low in renal failure, so it is important to make sure that small frequent meals are eaten to provide sufficient calories and multi vitamin supplements can be given. Calcium Bones often lose calcium around the time of a transplant. Some of this is due to steroid treatment. Calcium supplements may be given for this. Calcium rich diet—especially milk, and milk products, green leafy vegetables and nuts should also be taken. I will be happy if this helps you. Regards