Kidney Disease and Your Diet

If you have chronic kidney disease (CKD), you must be vigilant regarding potential medical malpractice. An estimated 26 million of us in the United States have chronic kidney disease, so chances for malpractice are high – thousands have suffered needlessly because of a misdiagnosis, a misprescribed drug, or a surgical error. If you are a CKD patient, and if your condition deteriorates because of an incident that you believe was medical malpractice, discuss your circumstances at once with an experienced kidney diseases attorney.

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A second ongoing concern for kidney disease patients is diet. When someone is diagnosed with chronic kidney disease, some changes in the diet are usually necessary. Most CKD patients will want to limit their fluids and adhere to a low-protein diet that restricts salt, phosphorous, and potassium. If a patient’s kidney disease progresses or if the patient eventually undergoes kidney dialysis, more significant changes to the diet will probably be required.

Ask your doctor to send you to a registered dietitian who can help you design the diet that’s right for you. Some dietitians specialize in diets for kidney disease patients. A dietitian can also recommend a diet that takes your other health needs into account. You must consume sufficient calories each day to maintain your health and to stop the breakdown of body tissue. Ask your doctor and dietitian what your ideal weight should be, and weigh yourself each day to monitor your progress toward that goal. Listed here are some general diet suggestions for CKD sufferers from the National Kidney Foundation:

PROTEIN

Depending on the progress of your CKD and other health factors, your doctor or dietitian may recommend a low-protein diet or a moderate-protein diet. However, if you begin kidney dialysis, you will require more protein, so eating fish, poultry, pork, or eggs at every meal may be appropriate to help you replace body tissue. Dialysis patients should eat eight-to-ten ounces of high-protein foods daily. Your doctor or dietitian may recommend additional egg white powder or protein powder.

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CARBOHYDRATES

For kidney disease patients, carbohydrates are a great energy source if you have no other health problem that keeps you from enjoying them.  Fruits, breads, grains, and vegetables provide carbohydrates as well as vitamins, minerals, and fiber. Most candies, pies, cakes, and other desserts are okay in moderation, but CKD patients should restrict desserts made with dairy products, chocolate, bananas, or nuts.

FATS

Kidney disease patients should use monounsaturated and polyunsaturated fats (like canola oil, olive oil, or safflower oil) for coronary health. While most fats can be a good source of calories, a CKD patient should discuss fats and cholesterol with his or her doctor and dietician, because fats may increase a kidney disease patient’s risk for heart problems.

FLUIDS

When CKD is diagnosed in the early stages, a patient may not need to limit fluid intake immediately, but as the disease progresses, restricting fluid intake may become necessary. Patients undergoing dialysis who allow too much fluid to build up in the body may find themselves short of breath and in need of emergency medical attention. If your doctor restricts your fluid intake, he or she will give you precise instructions, and you’ll need to avoid foods that contain a lot of water – grapes, lettuce, melons, tomatoes, most soups, and treats like Jell-O and popsicles. You’ll also in that case need to avoid salty foods and keep cool when it’s hot outdoors.

CALCIUM AND PHOSPHOROUS

At every stage of chronic kidney disease, a patient’s phosphorous and calcium levels should be monitored regularly. Too much phosphorous in the blood reduces your calcium level, making your bones weaker and more apt to break. Dairy products – especially milk, yogurt, and most cheeses – contain substantial levels of phosphorous, so kidney patients will need to restrict consumption of dairy products. Some patients may require calcium supplements to avert bone disease. Others may need vitamin D or drugs called phosphorous binders to regulate the balance of calcium and phosphorous.

IRON

Patients with advanced CKD may have anemia and require extra iron. Many food items provide iron – beef, pork, liver, chicken, lima and kidney beans, and iron-fortified cereals. A CKD patient should talk with his or her doctor or dietitian about which foods with iron to eat and about whether or not taking iron supplements may be appropriate.

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SODIUM AND POTASSIUM

Lowering the amount of sodium in your diet reduces thirst, keeps your body from retaining extra fluid, and helps you control high blood pressure. Almost all CKD patients will need to reduce their sodium intake. When you shop, look for low-sodium and unsalted items, and avoid any packaged food with salt near of top of the ingredients list. Do not use salt when cooking or from the salt shaker as you eat. Do not use a salt substitute that contains potassium. Most herbs are safe, and a dietician can make personal recommendations for you.

Normal levels of potassium are vital for coronary health, but when you have CKD, too much potassium can build up and threaten your heart. Potassium is found in many food groups, including fruits and vegetables. Fruits to avoid because of high potassium levels include oranges (and orange juice), bananas, cantaloupe, honeydew, prunes, kiwis, raisins or other dried fruit, and nectarines. Vegetables to avoid include asparagus, squash, pumpkins, avocadoes, potatoes, tomatoes or tomato sauce, and cooked spinach.

A study published in 2015 shows that a diet high in potassium and sodium can make a patient’s chronic kidney disease worse. The study was funded by the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. It was posted online last year in the Journal of the American Society of Nephrology. The study’s head researcher, Dr. Jiang He of Tulane University, said “These data warrant future clinical trials to test the effect of a moderate reduction in dietary sodium and potassium intake on CKD progression in patients with high dietary sodium or potassium intake.”

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If you are a victim of medical malpractice related to chronic kidney disease, you should speak to a kidney diseases attorney who works exclusively on behalf of kidney disease patients. Any medical malpractice linked to someone’s kidney disease – such as a misdiagnosis or a misprescribed medication – can cause serious injury and potentially lead to kidney failure. If you are a CKD patient, you must be vigilant about your doctor – as well as your diet.

By: Jed Kurzban

Medical malpractice attorney Jed Kurzban graduated from the University of Alabama in 1992 and earned his Juris Doctor from the University of Miami School of Law in 1995. He is a member of the Dade County Bar Association, the Florida Bar Association, the American Association for Justice, the Academy of Florida Trial Lawyers, and the American Bar Association. Mr. Kurzban is happily married and the father of two.