Kidney Disease Diet and Kidney Stone Diet

The kidney disease diet for dialysis controls the intake of fluid, protein, sodium, potassium, and phosphorus. One question that is often asked is whether or not protein is restricted in a dialysis diet. Well, the answer is that it depends upon the status of your kidneys. Also, the amount nutrients in the diet are based on your blood levels of sodium, potassium, phosphorus, calcium, albumin, and urea. These levels are measured before and immediately after a dialysis treatment.
Fluid restriction is based on the amount of urine output and weight gain between dialysis treatments. That is, whatever goes out of your body in liquid form (including vomitus and sweat), has to be replaced with water. Monitoring and taking note of your daily weight would be a good practice to indicate fluid retention which suggests kidney deterioration.

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Preservation of renal function can delay the need for dialysis therapy. It can be accomplished by controlling the disease process, by controlling blood pressure and by reducing dietary protein intake and catabolism.
A kidney disease diet for dialysis patient depends on specific adjustments of dietary elements through the results of the client’s blood chemistry studies. Although there is some debate over whether and how to restrict proteins, keeping the daily intake of protein of high biologic value below 50 g may slow the progression of renal failure.
The amount of protein you can eat is based on how well your kidneys are functioning and the amount of protein needed to maintain good health. When protein is used by the body, waste products are formed and enter the blood. One of these wastes is called urea. Normal healthy kidneys are good at getting rid of urea. Failing kidneys are not good at this, but kidney patients should still eat protein.

As the renal disease progresses, the client’s ability and willingness to take in adequate nutrition diminish and the challenge becomes not only to maintain appropriate intake of nonprotein calories but also to satisfy protein needs. In these instances, elemental diets, enteral feedings or total parenteral nutrition may be used instead of or in addition to regular food intake. This is why kidney dialysis diet is so important in order for patients to follow a proper balance of electrolytes, minerals, and fluid in patients who are on dialysis.

This kidney disease diet for dialysis patient should be done with the approval of your health care provider. In fact, your health care provider would be so proud of you for taking a proactive approach to managing you kidney disease. Remember, ignorance is never an excuse to bad health habits.

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When you have kidney stones, the best suggestion I can give you is well, the kidney stone diet. As the name suggests, this diet tackles all the guidelines you must have to manage your kidney stone. In the first place, kidney stones happen because there is a calcification in your urinary system. They form primarily on the kidneys but they can migrate to the lower urinary system (i.e. bladder). Hence, they are typically asymptomatic until they pass into the lower urinary system and start to feel the pain.

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Up to 4% of the population in the United States has kidney stones. About 12% of the male population has renal stone by the age of 70. More than 200,000 Americans require hospitalization for treatment of stones each year. It is so recurrent to the point that half of the patients affected will develop another round of renal calculi in the next 10 years.

Most common calculi are composed of calcium oxylate (70-80%), uric acid (10%), struvite (9-17%), or cystine (<1%). The most common signs and symptoms include low urine output, high urine pH (making it alkaline), excessive urinary excretion of calcium, oxalate, uric acid, or combination of these substances.
Type and cause of stone formation provide details on how to manage kidney stones. A comprehensive dietary history taking might also be needed to be able to point out the portion of the patient’s diet that triggered the formation of kidney stones. Generally, treatment options include restrictive diet and modifications. Here are some guidelines on the kidney stone diet:

• Tailor diet to specific metabolic disturbances and individual dietary habits to ensure compliance
• Calcium restriction should be avoided
• Calcium and oxalate must be in balance
• Limit intake of spinach, rhubarb, beets, nuts, chocolate, team wheat bran, and strawberries
• Do not exceed recommended daily allowance for vitamin C as it increases urinary oxalate excretion
• Animal protein should be regulated to 1 g/kg body weight
• Salt intake should be restricted to less than 100 mEq/dl
• Potassium intake should be encouraged (five or more servings of fruits and vegetables each day
• Include high fluid intake to produce at least 2 liters of urine/day (2-3 L of water intake/day is recommended)

It is always better to try less invasive procedures until all options become exhausted. Which is why following a proper diet and drinking plenty of fluids should be your first and primary thing to do. Fortunately, most clients pass the stone naturally from the ureter and bladder. If the stone does not move, if it causes obstruction, or if X-ray suggests that the stone is too large to pass safely into the urethra, more invasive treatment is necessary.

The kidney stone diet is not rigid. In fact, it helps you work around your usual diet in order for you not to feel as though you are in a strict regimen.

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One of the most common renal diseases affecting the kidney is diabetes mellitus; kidney disease diet for diabetics has become a topic of interest nowadays. Diabetic nephropathy, a progressive process, commonly leads to renal failure.  About 30% of clients with end-stage renal disease have diabetes mellitus.  Researchers estimate that 25% to 50% of clients with insulin-dependent diabetes mellitus or type 1 diabetes have end stage renal disease within 10 to 20 years of beginning insulin therapy.

Renal disease can also occur in the non-insulin-dependent diabetic client. The incidence of proteinuria (protein in urine) is about 25% after the 20 years of diabetes.

Kidney disease diet for diabetics is a nutritional therapy to emphasize the need for a team approach to enhance the ability of each patient with diabetes to achieve good metabolic control.  In this way, by controlling diabetes mellitus, we can manage the progressive worsening condition to our kidneys thereby preventing end stage renal disease.

The kidney metabolizes 30% to 40% of insulin, and as renal function decline the degradation of insulin also decreases, resulting in a lower insulin requirement. Renal failure may be initially identified when the client is evaluated for recurrent insulin reactions.

Researchers hope that exacerbation of renal disease can be slowed by the following:

• Carefully controlling hypertension.
• Adjusting insulin therapy and carefully monitoring blood glucose to maintain normal sugar level.
• Restricting dietary protein

Regardless of diabetic control, however, renal failure inevitably develops within 5 to 10 years after the appearance of significant proteinuria.

These are some recommended dietary modification for patients with diabetes mellitus:

1. Total calories-sufficient to maintain/achieve reasonable weight in adults, or meet increased needs of children, adolescents, pregnant and lactating women and individuals recovering from catabolic illness.
2. Caloric distribution of 50-70% of carbohydrates, 20-30% of proteins and 20-30% of fat.
3. Cholesterol limit to 300 mg/day or less.
4. Carbohydrates and sweetness
5. Sodium limit to about 300mg/day, less for people with hypertension if renal complications.
6. Alcohol-moderate amounts may be allowed, contingent on good metabolic control.
7. Vitamin and mineral supplement-not necessary but may be given to individuals on reduced calorie diets (1200kcal/day or less)

There is no one diabetic diet that will suit the individual and the special need of a person with diabetes. The diet for an individual with diabetes can only be defined as a “dietary prescription based on nutrition assessment and treatment goals”. However, the kidney disease diet for diabetics can serve as a guideline on how to manage and control diabetes mellitus thus prolonging renal disease.

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