Fluid/Sodium
As your kidneys fail, you may
notice an increase in your weight even as your
appetite diminishes. This increase is probably due
to excess fluid in your body often referred to as
'fluid retention'; not an actual increase in body
mass. It is important to closely monitor your weight
so you can notify your doctor if you have a rapid
increase over just a few days.
To prevent fluid
retention, it is important to discuss how much fluid
is appropriate for you to drink in one day. Fluid is
not only found in beverages you drink (soda, coffee,
milk, juice, and water), but is also found in soups,
jello, ice chips, and popsicles. It is important to
monitor all sources of fluid to make sure you are
not consuming too much.
Lowering the amount of salt
or sodium in your diet can also help decrease the
amount of fluid you retain. Sodium is found in most
processed foods such as canned soup, boxed pasta
with a sauce, anything pickled, and gravies. Read
food labels carefully, as even foods that do not
seem salty have substantial amounts of sodium.
Excess sodium intake can lead to increased thirst,
resulting in fluid retention. In addition, too much
salt can raise blood pressure, especially in people
with CKD. A common goal for sodium intake for many
people with kidney disease and hypertension is 2
grams (2000 mg) per day.
Potassium
Potassium is an electrolyte that is necessary for your body to
function properly. Specifically, if potassium levels go too low or too
high, the result could be dangerously abnormal heart rhythms. It is your
kidney's job to regulate the amount of potassium in your body by
eliminating excess potassium in your urine. As your kidneys fail, they
are unable to do this job properly.
Therefore, you may need to assist the kidneys by monitoring the
amount of potassium in your diet. People with CKD will vary as to when
they need to start restricting potassium from their diet. Foods that
contain higher amounts of potassium are fruits and vegetables. However,
some have lower potassium content than others. For instance, grapes and
apples have less potassium than bananas and oranges. Also worth
remembering is that some salt substitutes contain potassium. Therefore,
use salt substitutes that are a mixture of herbs and spices instead.
Discuss with your kidney professional what the right amount of potassium
is for you.
Phosphorus
Phosphorus is another mineral that is closely regulated by the
kidneys. As your kidney function declines, phosphorus levels may
increase which can cause disturbances in bone metabolism. Elevated
levels of phosphorus in the blood have been linked to increased health
complications and even death.
Phosphorus containing foods include:
- dairy products, such as milk, cheese, pudding, yogurt and ice
cream
- dried beans and peas, such as kidney beans, split peas and
lentils
- nuts and peanut butter
- beverages such as cocoa, beer and cola soft drinks
- most fast food items
These foods are suitable for people with CKD, but portions must be
closely monitored. The typical recommendation for phosphorus intake is
800 to 1200 mg per day. Substituting non-dairy creamer for milk can help
meet these guidelines. In addition, your renal healthcare provider may
recommend a medication to bind the phosphorus in your food to prevent it
from being absorbed by your body. These binders are often taken with
meals, and are usually necessary in the later stages of CKD. Talk to
your renal healthcare provider to see if restricting phosphorus in your
diet or taking phosphorus binders is right for you.