• Definition
  A diet used in the treatment of renal (kidney) disease. It may be low-sodium(Sodium chloride is simply salt), low-potassium(for a list of foods high in potassium click here)and protein(e.g eggs and chicken)and fluid restricted.

• Alternative names
  renal disease - diet; kidney disease - diet

• Food Sources
  This diet controls the amount of fluid, protein, sodium, and potassium. The controlled amounts of each of these nutrients are based on the person's blood levels of potassium, sodium, and urea, as well as the fluid balance, creatinine clearance, and blood pressure. If the blood levels indicate the need to adjust the intake of calcium and phosphorus, then the amounts allowed in the diet are changed.

• Functions
  The purpose of a diet that restricts protein, sodium, and potassium is to help the body decrease the waste products produced by metabolism, which are toxic if they are not eliminated from the body. This occurs from certain types of liver and kidney diseases.

• Recommendations
  a)The amount of protein allowed in the diet is determined by checking the amount of protein (and protein metabolic wastes) in the person's blood. Laboratory tests may include chem-20, creatinine, albumin, and blood urea nitrogen. Low-protein diets may prevent or slow the progress of some kinds of kidney disease. The amount of protein the person can eat is based on how well the kidneys are functioning and the amount of protein needed to maintain good health. Dialysis and the type of dialysis also influence protein needs.
  
  b)The sodium content of a person's daily intake is controlled. This helps in maintaining fluid balance in the body to avoid dehydration or fluid retention. Reduced amounts of sodium in the diet helps control high blood pressure and congestive heart failure.
  
  c)The daily intake of potassium is also controlled. This helps prevent hypokalemia (a low level of potassium, rarely a problem for people with renal disease) as well as hyperkalemia (a high level of potassium, a common problem for people with renal disease).
  
  d)The mineral phosphorus is often controlled in this particular diet. When the amount of phosphorus is decreased by the reduced intake of dairy products and other foods high in phosphorus, there is a need to provide calcium supplements to prevent bone disease. The amount of phosphorus in the diet is controlled by the use of phosphorus binders (medications that bind the phosphorus in the food and make them unavailable to the body).
  
  e)During renal failure, the amount of urine the body produces is decreased. The recommended daily amount of fluid is based on the amount of urine produced in a 24-hour period. Other considerations are the amount of fluid retention present, the level of dietary sodium, the use of diuretics, and the presence or absence of congestive heart failure.
  
  f)People with renal disease are more prone to cardiovascular (heart) disease, so a diet with most of the calories from complex carbohydrates is recommended. Calories from fats should be from monounsaturated and polyunsaturated fats. The daily calorie intake needs to be adequate to maintain the person's nutritional status at an optimal level and to prevent the breakdown of body tissue. The person's weight and protein status should be monitored regularly, even daily.
  
  g)Vitamin supplementation is very individualized. It is dependent on the various dietary restrictions, the extent of renal failure, and dialysis. The requirements for the fat-soluble vitamins (A, D, E, and K) are usually met by the diet. Vitamin D may need to be supplemented; this is an individual medical decision. The intake of water-soluble vitamins is often inadequate, as several good food sources of water-soluble vitamins are restricted on this diet. There is also loss of water-soluble vitamins from dialysis, the cooking methods for leaching potassium, and altered metabolism of vitamins.
  
  h)The minerals that are also monitored include calcium, iron and magnesium. The recommended supplementation of daily calcium is 1,000 to 1,500 milligrams per day. Iron supplementation is based on the person's need. Magnesium supplementation is not recommended, as it can cause an increase in the magnesium levels in a person with renal disease.
  

  Note: not all people with kidney disease need dietary supplements. "When I was first transplanted every kind of food containing a small amount of salt was strictly forbidden for consumption.But now after my second transplantation,I'm actually encouraged by my Doctor to eat very salted food.?Go figure? The point is that every kidney is different and has different requirements. By the way for sodium-low Jewish patients,nowadays sodium-free Kosher articles like bread,potato chips,cheese etc are readily available.

  
  Side Effects
  A low-protein diet can be deficient in some of the essential amino acids; the vitamins niacin, thiamine, and riboflavin; and the minerals phosphorus, calcium, and iron.
  
  Benefits of implementation:
  It is helpful for a long-term feeling of well-being to adhere to the diet as closely as possible. Nonadherence can aggravate the symptoms of renal disease and interfere with recovery.
  
  Notes:
  The Kidney Foundation has chapters in most states and is an excellent resource for educational and materials, programs for people with renal disease and their families.
  
  Registered dietitians are also a resource for nutrition information specific to kidney disease; some are specialists in renal diets.
  

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  Food Guide Pyramid

  A Guide to Daily Food Choices (applicable for non-renal patients and must eventually be adapted for Kidney patients)(click on the image to access the original page this graphic comes from)

Food Group Serving Size