Lower the boom on fiber?

[Dixidude39]

I am CKD4 with a eGFR of 27. I had my right kidney surgically removed 18 months ago due to cancer directly related to bladder cancer (bladder removed 30 months ago). I'm looking forward to the live session with a renal dietitian on Jan. 31st. I've previously been advised to eat low-fiber foods (corn flakes and rice crispies, for instance, rather than Fiber One or raisin bran). Do kidneys have trouble dealing with fiber?

[orangecity41 NKF Ambassador]

From my renal diet I found high fiber cereal have higher phosphorus content than other cereals. I look for cereals with low phosphorus content. There might be some higher fiber cereals with less phosphorus?

[Dixidude39 in reply to orangecity41]

Too bad not enough packaged goods list the phosphorous content. There may be preservatives that involve phosphorous too. My potassium has been running above the normal limits. A nephrologist I see in Houston, TX (where we often winter -- our permanent home is in Richmond, VA) put me on a new potassium binder called Valtassa. The company has been providing it free since March 2017. Also, although it requires some time, I have found that some products list the phosphorous content by going on-line. I'm going to take a closer look at the cereals I'd like to eat (like Original Fiber One, Kashi cereals, etc.). Thanks!

[Hidden]

I've previously posted that I lost a lot of weight and then found I had CKD. When I spoke to my RD I found out that the foods I had switched to were by and large no longer good for me as they are not kidney-friendly. I have about six articles in my file on Fiber. This one is one of the best because of the details it provides and the information on soluble and non-soluble fiber. I hope it helps

Fiber in the Kidney Diet

What is fiber?

Dietary fiber is defined as the component of carbohydrate that cannot be digested by enzymes in the human small intestine. Fiber provides structure for plant cells. It’s found in fruits, vegetables, grains, legumes, and nuts. Unlike fats, carbohydrates, and proteins, fiber cannot be broken down or absorbed when passing through your digestive system.

Soluble vs. insoluble

Your body needs two types of fiber. One type is soluble fiber which dissolves in water and absorbs fluid as it passes through the digestive system, creating softer, larger stools. Food sources of soluble fiber include oat bran, apples, oranges, berries and various vegetables. Supplements such as Metamucil, Citrucel, and Fiberall are also considered soluble fiber.

The other type is insoluble fiber (roughage). It absorbs water and makes stool bulkier to help bowel movements pass more easily. Examples of insoluble fiber foods are barley, corn, rice, bran, whole wheat, vegetables and apple and pear skins.

Benefits of fiber

Adequate fiber in the kidney diet can be beneficial to people with chronic kidney disease (CKD) because of it:

Keeps GI (gastrointestinal) function healthy

Adds bulk to stool to prevent constipation

Prevents diverticulosis (pockets inside the colon)

Helps increase water in stool for easier bowel movements

Promotes regularity

Prevents hemorrhoids

Helps control blood sugar and cholesterol

How much fiber does a person need?

The average American diet contains 5 to 15 grams of fiber a day, which is below the 14 grams of fiber for every 1,000 calories you consume, as recommended by the U.S. Dietary Guidelines. The Food and Nutrition Board suggests 25 grams of fiber a day for women and 38 grams of fiber a day for men under the age of 50. For people over age 50, women should get 21 grams of fiber a day and men should get 30 grams of fiber a day in their diet. If you’re following a low potassium, low phosphorus plan, fiber intake may be more difficult to include in your kidney diet.

Adding fiber to the kidney diet

Many people with CKD don’t get enough fiber because many fiber sources are too high in potassium and phosphorus. Increasing your fiber intake, can cause gas, bloating and cramps. Talk to your dietitian about gradually increasing fiber and adjusting fluid intake.

Good fiber food choices for the kidney diet

These are the best high fiber foods for people with CKD:

Apple, unpeeled

Figs

Apricot

Fruit cocktail

Asparagus

Grapefruit

Beets

Grape-Nut Flakes

Berries

Green beans

Broccoli

Green peas

Brussels sprouts

High-fiber white bread

Cabbage, raw

Lettuce

Carrots

Mustard greens, cooked

Cauliflower

Okra

Celery

Onion

Cherries

Peach

Collard greens

Pear, unpeeled

Corn

Plums

Pineapple, raw

Summer squash

Eggplant

Tangerines

Constipation in people with chronic kidney disease

Sometimes fiber is not enough to relieve constipation, as the amount of fiber varies from person to person. Increasing your physical activity, taking a doctor-recommended laxative or drinking warm beverage can help ease constipation.

Tips to increase fiber in the kidney diet

Have regular meal times so you know when you get fiber and from what.

Eat all the allowed servings of kidney-friendly fruits and vegetables suggested by your meal plan.

Eat peelings on fruit and vegetables when reasonable.

Snack on unsalted popcorn and raw vegetables.

Include a breakfast cereal with fiber (one that is approved by your dietitian).

Eat whole fruit instead of drinking juice.

Try fiber supplements as recommended by your dietitian.

Top 10 high-fiber recipes on DaVita.com

Recipe

Fiber per serving

Barley and Beef Stew

6.3 grams

Quick and Easy Ground Beef Soup

4.3 grams

Curry Turkey with Pineapple Rice

4.8 grams

Cauliflower Latkes

4.0 grams

Gourmet Green Beans

4.0 grams

Apples Baked in Cider

3.9 grams

Crispy Eggplant French Fries

3.9 grams

Vegetable Paella

3.8 grams

Carrot-Apple Casserole

3.8 grams

Very Berry Galatte

3.6 grams

Cabbage Rolls made with Turkey

3.5 grams

Southwestern Posole

3.4 grams

Related kidney diet articles on DaVita.com

Carbohydrates and the Kidney Diet

Dialysis Diet Differences: Hemodialysis and Peritoneal Dialysis

Snacks to a Kidney Diet

[Dixidude39 in reply to Hidden]

Wow! Thank you so much. I am about to print this article for the section of my 3-ring binder dedicated to nutrition --- and in fact make a second copy for a handy place in our kitchen!!!

[orangecity41 NKF Ambassador in reply to Hidden]

Great information Mr Kidney. Very valuable for ones digestive health and kidney disease.

[Hidden]

Glad I could help. I've had to move all of my files on CKD to a flash drive. It's gotten awfully big and it's easier for me to find if I just put the drive into the computer and search for the topic. My computer can also do that but it takes too much time.

[Dixidude39 in reply to Hidden]

That's a bit above my pay grade. However, I have friend who is a computer geek, and I shall ask him to teach me how. I have too much stuff in 3-ring binders. It's too easy to forget that I clipped an article on "X" three years ago. I suppose I would have to scan-in paper docs. I also have considerable computer Documents and Downloads.

[Hidden in reply to Dixidude39]

Hey, whatever works for us. When I was teaching I had to stay one jump ahead of my students and they were born computer literate.

[Dixidude39 in reply to Hidden]

I know. I occasionally say "I wasn't born with a computer in my crib."

[Bet117 NKF Ambassador in reply to Hidden]

Myself as well. I have six flash drives. Good idea to put articles etc on one.

[LJMusgrove]

healthaliciousness.com/nutr...

Hello I found this site today that has over 8000 products & items listed you can compare ALL nutritional information including fibre, phosphorus & potassium. You can compare up to 3 items at once. Just go to the TOOLS at the top of the page & you will find it, type in key words like bread, rice, cereals, milks etc & it will give you various options for each one. Once you have entered the info, scroll down the page until you see what tou are looking for. Hope this helps you & others. I was so happy to find it!

[orangecity41 NKF Ambassador in reply to LJMusgrove]

Thanks, I saved the link. Great information.

[TaffyTwoshoes27]

FYI:. My nephrologist told me that 99% of commercial cereals at the grocery store are chocked full of phosphorus. And, "Dixidude39", we can thank (or blame) the good ol' FDA for the reason Phosphorus and potassium are not listed on all product ingredients lists. The FDA does not require manufacturers to provide that info, so you are right to call the manufacturer for it. DaVita.com also has a great Food Analyzer tool that breaks down that information. Watch out for the phosphorus content in many of the "protein" and "breakfast" bars. I take Fosrenol 1,000 mg chewable phos binders and Shire (the manufacturer) has a Patient Assistance Program (if your insurance company does not pay for it). It costs about $1,000 (either a month or three months...I cannot remember). The application for PAP is shirecares.com.

[orangecity41 NKF Ambassador in reply to TaffyTwoshoes27]

Tried the web site and is very helpful. I also google or look at companies web site for nutrition information. Do the same for chain restaurants for nutrition info to help figure out what will order. Some have good nutrition menus.