Diet and renal disease long term management

Detail of diets in kidney disease

1. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 2011This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 2011
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Eating Well with Chronic Eating Well with Chronic
Kidney DiseaseKidney Disease
Pre-dialysis EducationPre-dialysis Education
Queensland Health NEMO Renal GroupQueensland Health NEMO Renal Group

2. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Why Nutrition?Why Nutrition?

To keep healthy and well nourished.To keep healthy and well nourished.

To prevent build-up of unwanted To prevent build-up of unwanted
nutrients and waste products.nutrients and waste products.

To help help slow the progression of To help help slow the progression of
kidney disease.kidney disease.

3. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Keeping Healthy is important!Keeping Healthy is important!
You need to be in tip top shape!You need to be in tip top shape!

Why?Why?

Well nourished people do better.Well nourished people do better.
–Less chance of problems with dialysis.Less chance of problems with dialysis.
–Improved ability to fight infection.Improved ability to fight infection.
-Less time in hospital.Less time in hospital.
-You feel better.You feel better.

4. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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How’s your nutrition?How’s your nutrition?

Ask yourself a few simple questions.Ask yourself a few simple 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?

5. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Your Healthy Weight RangeYour Healthy Weight Range
BMI(body mass index) = weight(kg)/Ht x Ht(m)

6. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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If you are underweight…If you are underweight…

Eat small meals regularly. Eat small meals regularly.

Make every mouthful count…Make every mouthful count…
–Choose nutritious foods that are Choose nutritious foods that are
energy dense.energy dense.
–Make sure your drinks are nutritious.Make sure your drinks are nutritious.

See a Dietitian.See a Dietitian.

7. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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If you are overweight…If you are overweight…

Your kidneys work harder if you are Your kidneys work harder if you are
overweight.overweight.

Losing weight can help your kidneys Losing weight can help your kidneys
work as well as they can for as long work as well as they can for as long
as they can.as they can.

See a Dietitian.See a Dietitian.

8. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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The kidneys are your body’s The kidneys are your body’s
waste disposal unitwaste disposal unit

Healthy kidneys remove waste Healthy kidneys remove waste
products from the bloodstream.products from the bloodstream.

In Chronic Kidney Disease…In Chronic Kidney Disease…
–Waste products can build up in your blood.Waste products can build up in your blood.
–Some of these waste products come from the Some of these waste products come from the
food we eat.food we eat.
–You may need to limit some foods.You may need to limit some foods.

9. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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How to tell if you need to How to tell if you need to
limit some foodslimit some foods

Regular blood tests will show Regular blood tests will show
if any waste products are if any waste products are
building up in your blood.building up in your blood.

The Kidney Team will let you The Kidney Team will let you
know if you need to limit any know if you need to limit any
particular foods.particular foods.

10. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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When will you see a When will you see a
Dietitian?Dietitian?

You will see a Dietitian through the You will see a Dietitian through the
Chronic Kidney Clinics.Chronic Kidney Clinics.

If you start dialysis, you will see a If you start dialysis, you will see a
Dietitian as your diet will change.Dietitian as your diet will change.

11. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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What to expect from the What to expect from the
DietitianDietitian

The Dietitian will look at your…The Dietitian will look at your…
–Medical History,Medical History,
–Weight History,Weight History,
–Blood Levels,Blood Levels,
–Recent Dietary Intake with a Diet Recent Dietary Intake with a Diet
History.History.

12. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Taking a Diet HistoryTaking a Diet History

Your Dietitian will ask you lots of Your Dietitian will ask you lots of
questions about what you normally eat.questions about what you normally eat.

No right or wrong answers! No right or wrong answers!

Used to see if you are getting too much Used to see if you are getting too much
or too little of any particular nutrient.or too little of any particular nutrient.

13. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Which nutrientsWhich nutrients

Protein,Protein,

Sodium (Salt),Sodium (Salt),

Fluid,Fluid,

Potassium,Potassium,

Phosphate.Phosphate.

14. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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ProteinProtein

Protein is found in red and white meats, Protein is found in red and white meats,
fish, eggs, dairy products and legumes.fish, eggs, dairy products and legumes.

It’s important to have the right amount of It’s important to have the right amount of
protein you need for growth, healing and protein you need for growth, healing and
fighting infection.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
Urea.Urea.
Too little Too little
protein could protein could
lead to under lead to under
nutrition.nutrition.

15. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Sodium or SaltSodium or Salt

Most people eat too much salt.Most people eat too much salt.

You don’t need to add salt to get too much You don’t need to add salt to get too much
salt.salt.
–75% of salt comes from processed foods.75% of salt comes from processed foods.
–Corned, smoked, pickled and takeaway foods. Corned, smoked, pickled and takeaway foods.
Tinned and packet soups, sauces.Tinned and packet soups, sauces.

Too much salt Too much salt causes fluid retention and causes fluid retention and
increases blood pressure.increases blood pressure.

16. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Hints to cut down on SaltHints to cut down on Salt

Salt is an acquired taste.Salt is an acquired taste.

Limit processed foods, Limit processed foods,

Limit takeaway foods,Limit takeaway foods,

Avoid adding salt in cooking and at the Avoid adding salt in cooking and at the
table,table,

Do not use Salt Substitutes.Do not use Salt Substitutes.

17. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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FluidFluid

Excess fluid can cause:Excess fluid can cause:
–High blood pressure,High blood pressure,
–Swelling in the ankles, hands and face,Swelling in the ankles, hands and face,
–Shortness of breath.Shortness of breath.

Check with your Renal Team regularly Check with your Renal Team regularly
about how much fluid you should drink.about how much fluid you should 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
temperature.temperature.

18. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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PotassiumPotassium

Potassium is a mineral needed by the body Potassium is a mineral needed by the body
to make your muscles and cells work.to make your muscles and cells work.

High or Low blood levels can be dangerous High or Low blood levels can be dangerous
for your heart.for your heart.

Not everyone needs a low potassium diet.Not 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..

19. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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What does a low potassium What does a low potassium
diet look like….?diet look like….?

Potassium is found in a variety of foods.Potassium 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
dietitian will check…dietitian will check…
1.1.The amount and type of fruit you eat,The amount and type of fruit you eat,
2.2.If you are having too many dairy foods,If you are having too many dairy foods,
3.3.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 chips, substitutes, caramels, chocolate, liquorice, potato chips,
tomato sauces, coffee.tomato sauces, coffee.

20. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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PhosphatePhosphate

Phosphate is a mineral that is important for Phosphate is a mineral that is important for
strong bones and teeth.strong bones and teeth.

High levels can weaken your bones and High levels can weaken your bones and
damage your blood vessels.damage your blood vessels.

21. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Treating a high PhosphateTreating a high Phosphate

Phosphate bindersPhosphate binders
–Tablets that you take with meals.Tablets that you take with meals.
–Act like a sponge to suck the phosphate out of Act like a sponge to suck the phosphate out of
your food before you absorb it.your food before you absorb it.
–Cal-sup, Caltrate, Titrilac, Renagel, Alutab.Cal-sup, Caltrate, Titrilac, Renagel, Alutab.

Low Phosphate DietLow Phosphate Diet
–Not everyone needs a low phosphate diet.Not everyone needs a low phosphate diet.
–You will only need to start a low phosphate diet if You will only need to start a low phosphate diet if
your blood levels are high.your blood levels are high.

22. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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What does a low Phosphate What does a low Phosphate
Diet look like…?Diet look like…?

Phosphate is found in a variety of foods.Phosphate is found in a variety of foods.

If you need a low Phosphate Diet, the dietitian If you need a low Phosphate Diet, the dietitian
will check …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 foods.dairy foods.
2.2.If you are getting too many high phosphate foods, If you are getting too many high phosphate foods,
particularly between meals.particularly between meals.
e.g. chocolate, cola drinks, nuts and seeds, some e.g. chocolate, cola drinks, nuts and seeds, some
types of fish.types of fish.

23. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Everyone is different…Everyone is different…

Your kidney team will tell you if you Your kidney team will tell you if you
need to start a special diet.need to start a special diet.

There is no need to avoid potassium There is no need to avoid potassium
or phosphate foods unless your or phosphate foods unless your
blood levels are high.blood levels are high.

24. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Everyone is different…Everyone is different…

There is no one special diet for There is no one special diet for
people with renal disease.people with renal disease.

It all depends on… It all depends on…
–Your level of renal function.Your level of renal function.
–What your blood tests show.What your blood tests show.
–What kind of dialysis you choose.What kind of dialysis you choose.

25. This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 201
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Any Questions?Any Questions?