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Kidney-Friendly Diet: The Medical Nutrition Therapy (MNT)

Implementing dietary changes may help preserve remaining kidney function, prevent and correct symptoms and complications and delay the need for renal replacement therapy.

What is a kidney-friendly diet

A  “kidney-friendly” diet describes a diet that is low in protein, sodium, phosphorus, and, depending on your needs, low in potassium.

  • A kidney-friendly diet is recommended for patients suffering from CKD. The recommended daily protein intake is 0.6 – 0.8 g per kg of body weight (compared to the typical average intake of 1.2-1.5 g per kg).
  • The low protein diet preserves residual kidney function and may slow the progression towards end-stage renal failure in about 32% of cases. This diet also reduces uremia symptoms and prevents complications.
  • In some cases of later-stage CKD (stage 4/5), a low protein diet with supplemental essential amino acids and keto-analogues may be useful. In comparison to a normal low protein diet this diet has a very low protein intake (0.3 – 0.4 g of protein per kg of Body weight), which may indicate a vegetarian diet that is also low in phosphorus, sodium, and potassium.

For patients with CKD, adequate calorie intake is critical for reducing the risk of malnutrition.

The KDOQI (Kidney Disease Outcomes Quality Initiative) guidelines on CKD management, published by the National Kidney Foundation (NKF) advise:

  • For CKD patients, a protein intake of 0.6-0.75 g per kg of Body weight is recommended.
  • For CKD with diabetes, a protein intake of 0.8 g per kg of body weight is recommended.
  • In general, the protein intake should not exceed 1.3 g per kg of body weight.
  • For most people, daily sodium intake should not exceed 2.0 g. However, daily sodium should not exceed 1.5 g for individuals with hypertension. 1 g sodium = 2.5 g salt

Example:

CKD with diabetes, 70 kg body weight => 56 g protein per day

In order to meet energy needs while following a protein restriction, an increase in the proportion of calories from carbohydrates and fat is necessary. The meal plan must be monitored by a a registered dietitian and should be re-evaluated every three months.

High protein intake places stress on the kidneys, so protein intake should be reduced in CKD patients. Because of this, adequate caloric intake is extremely important for maintaining a good nutritional status. Systemic inflammation resulting from kidney failure often leads to decreased appetite, which may cause malnutrition.

The MNT for Individuals with CKD

The perfect diet doesn’t involve reducing the amount of food consumed. Instead it involves adjusting certain nutrients and food quantities to optimize nutrition status and prevent further kidney function decline.

This means:

  • Appropriate calorie intake of no less than 80% of the daily needs. Supplements may be taken if necessary.
  • Reduced protein intake preventing build-up of metabolic waste.

Further recommendations:

  1. Reduced phosphorus and sodium intake. This should be periodically monitored so that any necessary restrictions can be set.
  2. Monitoring serum potassium accumulation and the possible restriction of potassium-containing foods if Serum levels are elevated.
  3. Appropriated fiber intake to manage blood sugar.
  4. For advanced stages of CKD, it is important for patients to take vitamin D supplements and medications that help reduce phosphorus build-up in the blood, in order to prevent bone damage.

FLAVIS – National Kidney Foundation partnership

In collaboration with the National Kidney Foundation (NKF), we are promoting medical nutrition therapy for chronic kidney disease patients to help them delay dialysis.

<< Click here to learn more about our partnership >>

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