Eating Well with Eating Well with Chronic Kidney DiseaseChronic Kidney Disease

Why Nutrition?Why Nutrition?

To keep healthy and well nourishedTo keep healthy and well nourished

To prevent build-up of unwanted To prevent build-up of unwanted nutrients and waste productsnutrients and waste products

To help slow the progression of To help slow the progression of kidney diseasekidney disease

Keeping Healthy is Keeping Healthy is important!important!

You need to be in tip top shape!You need to be in tip top shape!

Why?Why?

Well nourished people do betterWell nourished people do better– Less chance of problems with dialysisLess chance of problems with dialysis– Improved ability to fight infectionImproved ability to fight infection- Less time in hospitalLess time in hospital- You feel betterYou feel better

How’s your nutrition?How’s your nutrition?

Ask yourself a few simple Ask yourself a few simple questions.questions.

– How is your appetite?How is your appetite?– Have you gone off protein foods?Have you gone off protein foods?– Have you lost weight without trying?Have you lost weight without trying?– Are you in your healthy weight range?Are you in your healthy weight range?

Your Healthy Weight Your Healthy Weight RangeRange

BMI(body mass index) = weight(kg)/Ht x Ht(m)

If you are underweight…If you are underweight…

Eat small meals regularlyEat small meals regularly

Make every mouthful count…Make every mouthful count…– Choose nutritious foods that are Choose nutritious foods that are

energy denseenergy dense– Make sure your drinks are Make sure your drinks are

nutritiousnutritious

See a DieticianSee a Dietician

If you are overweight…If you are overweight…

Your kidneys work harder if you Your kidneys work harder if you are overweightare overweight

Losing weight can help your Losing weight can help your kidneys work as well as they can kidneys work as well as they can for as long as they canfor as long as they can

See a DieticianSee a Dietician

The kidneys are your The kidneys are your body’s waste disposal body’s waste disposal unitunit Healthy kidneys remove waste Healthy kidneys remove waste

products from the bloodstreamproducts from the bloodstream

In Chronic Kidney Disease…In Chronic Kidney Disease…– Waste products can build up in your bloodWaste products can build up in your blood– Some of these waste products come from Some of these waste products come from

the food we eatthe food we eat– You may need to limit some foodsYou may need to limit some foods

How to tell if you need to How to tell if you need to limit some foodslimit some foods

Regular blood tests will Regular blood tests will show if any waste products show if any waste products are building up in your are building up in your bloodblood

The Kidney Team will let The Kidney Team will let you know if you need to you know if you need to limit any particular foodslimit any particular foods

When will you see a When will you see a Dietician?Dietician? You will see a Dietician through You will see a Dietician through

the Chronic Kidney Clinicsthe Chronic Kidney Clinics

If you start dialysis, you will see a If you start dialysis, you will see a Dietician as your diet will changeDietician as your diet will change

What to expect from What to expect from the Dieticianthe Dietician

The Dietician will look at your…The Dietician will look at your…– Medical HistoryMedical History– Weight HistoryWeight History– Blood LevelsBlood Levels– Recent Dietary Intake with a Recent Dietary Intake with a

Diet HistoryDiet History

Taking a Diet HistoryTaking a Diet History

Your Dietician will ask you lots of Your Dietician will ask you lots of questions about what you normally questions about what you normally eateat

No right or wrong answers! No right or wrong answers!

Used to see if you are getting too Used to see if you are getting too much or too little of any particular much or too little of any particular nutrientnutrient

Which nutrientsWhich nutrients

ProteinProtein Sodium (Salt)Sodium (Salt) FluidFluid PotassiumPotassium PhosphatePhosphate

ProteinProtein

Protein is found in red and white Protein is found in red and white meats, fish, eggs, dairy products and meats, fish, eggs, dairy products and legumeslegumes

It’s important to have the right amount It’s important to have the right amount of protein you need for growth, healing of protein you need for growth, healing and fighting infectionand fighting infection

too much protein can too much protein can lead to a build up of a lead to a build up of a waste product called waste product called UreaUrea

Too little Too little protein could protein could lead to under lead to under nutritionnutrition

Sodium or SaltSodium or Salt

Most people eat too much saltMost people eat too much salt

You don’t need to add salt to get too You don’t need to add salt to get too much saltmuch salt– 75% of salt comes from processed foods75% of salt comes from processed foods– Corned, smoked, pickled and takeaway foods Corned, smoked, pickled and takeaway foods

Tinned and packet soups, saucesTinned and packet soups, sauces

Too much salt Too much salt causes fluid retention and causes fluid retention and increases blood pressureincreases blood pressure

Hints to cut down on SaltHints to cut down on Salt

Salt is an acquired tasteSalt is an acquired taste Limit processed foods Limit processed foods Limit takeaway foodsLimit takeaway foods Avoid adding salt in cooking and at Avoid adding salt in cooking and at

the tablethe table Do not use Salt SubstitutesDo not use Salt Substitutes

FluidFluid

Excess fluid can cause:Excess fluid can cause:– High blood pressureHigh blood pressure– Swelling in the ankles, hands and faceSwelling in the ankles, hands and face– Shortness of breathShortness of breath

Check with your Renal Team regularly Check with your Renal Team regularly about how much fluid you should about how much fluid you should drink.drink.

Fluid is not just water Fluid is not just water – Count anything that is liquid at room Count anything that is liquid at room

temperaturetemperature

PotassiumPotassium

Potassium is a mineral needed by the Potassium is a mineral needed by the body to make your muscles and cells workbody to make your muscles and cells work

High or Low blood levels can be High or Low blood levels can be dangerous for your heartdangerous for your heart

Not everyone needs a low potassium dietNot everyone needs a low potassium diet– You will only need to start a low You will only need to start a low

potassium diet if your blood levels are potassium diet if your blood levels are highhigh

What does a low What does a low potassium diet look potassium diet look like….?like….? Potassium is found in a variety of foodsPotassium is found in a variety of foods

– not just bananas!not just bananas!

If you need a low potassium diet, your If you need a low potassium diet, your dietician will check…dietician will check…1.1. The amount and type of fruit you eatThe amount and type of fruit you eat2.2. If you are having too many dairy foodsIf you are having too many dairy foods3.3. Your intake of high potassium foods Your intake of high potassium foods

e.g. dried fruit, nuts, seeds, juices, fruit cake, salt e.g. dried fruit, nuts, seeds, juices, fruit cake, salt substitutes, caramels, chocolate, liquorice, potato substitutes, caramels, chocolate, liquorice, potato chips, tomato sauces and coffee.chips, tomato sauces and coffee.

PhosphatePhosphate

Phosphate is a mineral that is important Phosphate is a mineral that is important for strong bones and teethfor strong bones and teeth

High levels can weaken your bones and High levels can weaken your bones and damage your blood vesselsdamage your blood vessels

Treating a high PhosphateTreating a high Phosphate

Phosphate bindersPhosphate binders – Tablets that you take with mealsTablets that you take with meals– Act like a sponge to suck the phosphate Act like a sponge to suck the phosphate

out of your food before you absorb itout of your food before you absorb it

Low Phosphate DietLow Phosphate Diet– Not everyone needs a low phosphate dietNot everyone needs a low phosphate diet– You will only need to start a low You will only need to start a low

phosphate diet if your blood levels are phosphate diet if your blood levels are highhigh

What does a low What does a low Phosphate Diet look Phosphate Diet look like…?like…? Phosphate is found in a variety of foodsPhosphate is found in a variety of foods

If you need a low Phosphate Diet, the If you need a low Phosphate Diet, the dietician will check …dietician will check …

1.1. If you are getting the right amount of protein and If you are getting the right amount of protein and dairy foodsdairy foods

2.2. If you are getting too many high phosphate If you are getting too many high phosphate foods, particularly between mealsfoods, particularly between meals

e.g. chocolate, cola drinks, nuts and seeds, some e.g. chocolate, cola drinks, nuts and seeds, some types of fishtypes of fish

Everyone is different…Everyone is different…

Your kidney team will tell you if Your kidney team will tell you if you need to start a special dietyou need to start a special diet

There is no need to avoid There is no need to avoid potassium or phosphate foods potassium or phosphate foods unless your blood levels are highunless your blood levels are high

Everyone is different…Everyone is different…

There is no one special diet for There is no one special diet for people with renal diseasepeople with renal disease

It all depends on… It all depends on… – Your level of renal functionYour level of renal function– What your blood tests showWhat your blood tests show– What kind of dialysis you chooseWhat kind of dialysis you choose

Any Questions?Any Questions?