Kidney Disease

stopping the rapid decline in GFR

I was diagnosed with stage 3 kidney disease one year ago. I see my nephrologist every 6 months. In the last 4 months my GFR has declined over 11 points so now I am at the bottom of stage 3. I have altered my diet a lot eliminating bread products chocolate, I have eliminated many of my normal things in addition to reading labels to be carefully to avoid hidden sodium , in the last year. So now do I give up sugar and peanut butter and oranges to add to my list of no no foods.. I will drink more water but am feeling a bit depressed that my dietary changes that have done little to stop the progression of this disease.

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Some of the foods you mentioned that you are still eating, even only sparingly can bring down your GFR. I didn't hear you say anything about smoking, drinking alcohol, exercise, and medications.

You also didn't mention anything about other underlying health issues and what, if any, medications you are taking. Have you been sick? Taking any antibiotics? Remember everything you eat and drink in one way or another has some effect on your kidneys. Your GFR is just a snapshot of that moment when the blood was drawn.

Have you taken the Kidney Smart class? You can find a free 90 minute class in your area by going to the davita.com website and finding one. That will go a long way to understanding health issues with CKD. A Renal Dietitian is a good source for you to check with about a good kidney-friendly meal plan. Not just a nutritionist, but a Renal Dietitian.

Try using drugs.com to check on all of your current and future meds and whether or not they will help you maintain your healthy numbers. Sometimes you will have to make a choice between a medication that may be necessary for one thing but potentially harmful to you CKD. That's the reason to obtain as much knowledge as you can about anything that can affect your health. KNOWLEDGE IS POWER. Best of luck.

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sorry, I am an otherwise healthy 67 yr old female, in my thoughts anyway. I have never smoked and drink alcohol only sparingly..maybe one glass of wine a week. I have had high blood pressure for almost 20 yrs that was perfectlly controlled for 15 yrs...... It is again under control though it has been a struggle getting it under control. I take lebatalol 400 per day and lisinopril 40 per day and levathoryxine. I usually do pilates and yoga and walk a bit though I have recently discovered I have spondylolidthesis so have limited my walking . I was also diagnosed with a bisucpic heart valve at age 66 thinking that might have been a part of my high Blood pressure . I will look into a renal dietition. I was originally told I had to be in Stage 4 for insurance to pay for a dietitican but maybe I will just go on my own since things are not going so well.

I did a kidney class with my nephrologist but it was basic info.

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Well put Mr._Kidney! I totally agree!

We all eat as healthily as we can and watch labs.

Portion control and moderation is the best key!

Hang in there!

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I was diagnosed at CKD level 3 over 2 years ago and put on a pre-dialysis diet. You might want to ask your Doctor what diet is appropriate for you. My eGFR levels also vary. Peanut butter is a meat substitute on my diet, but at a prescribed amount per serving.

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thank you I will search our a dietition I believe..

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FYI, Not prying into your insurance but for everyone else, Original Medicare covers a visit to a Renal Dietitian. Mine was referred by my then PCP and covered two initial visits. Glad I brought my truck with me as I had so much information to take home. It took several days to go through everything and select the meal plan that was beneficial for me. I use davita.com because it provides all of the information I need to control my potassium, phosphorous, protein, calcium, and sodium with each meal.

Biking is a great way to get exercise without too much strain. I had my bike with me yesterday since we had a really great day for being outside in January.

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Hi Portlandpam!

That is no good! I am new to all this but I have been on the internet every day looking at whatever I can & I came across a book called "Stopping Kidney Disease" by Lee Hull. It is written from the point of view of a stage 3 ckd patient who changed his diet radically to an alkaline forming diet and also became vegan, except for egg whites. He started researching 20 years ago so his diet has obviously paid off. It is mostly easy to read although some chapters have a lot of technical information (I just skipped over most of those bits) and got to the conclusion of each chapter. It was soooo helpful. Learn something new about ckd every day & stay curious. It is amazing where google can lead you. Anyway I wish you an improvement in your health. It may take a tadical change but it is worth it. I have pretty much kissed my previous esting habits goodbye & am hoping for a positive change in my next test. I am not even sure what is happening with me yet either but hope this helps you too. xo

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I'm sorry to hear about your decline in kidney function. Do you know what is causing your kidney disease? Sometimes even when people do everything "right" kidney function continues to decline - this may be due to your underlying cause of kidney disease. Keep doing what you are doing! Ask your doctor about any dietary restrictions before you start. Or find a dietitian to help guide you. It's important that you maintain a healthy, balanced diet.

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One of the CKD dietary restrictions my nephrologIst stressed is the limitation of FLUIDS. That includes foods, like fruit, jello, veggies, whatever, that contain fluid. I was told to limit fluid intake to 2 qts + whatever I eliminated in urine a day. I was a huge water drinker -- always having water to drink by my side. My neph said that high quantities of fluid intake contribute to high blood pressure as well as swelling in your ankles, etc. See, good kidneys are responsible for filtering and regulating the amount of fluids that get into your blood to keep your heart and lungs healthy, as well as your blood pressure lower. My doctor said once a person's nephrons have been compromised (died off), theperson could drink a swimming pool of water, but the kidneys are shot and are NOT going to filter or regulate the fluid intake. Even ppl with healthy kidney can actually die of over-hydrating!

I recommend you consult your doctor or the davita.com website about fluid limitations/restrictions. You are never going to "flush" your kidneys with water. You are, in essence, adding to the problem.

Please watch your protein, potassium, sodium and phosphorus intake. BEWARE: the FDA does not require food manufacturers to list the content of potassium and phosphorus in foods on the ingredient listing.

Ask your doctor/nephrologist about Phosphorus binders. And, if you are seeing a general practitioner for CKD and/or kidney advice, I suggest you see if your insurance covers seeing a nephrologist. Most "regular" doctors are not subjected to nearly enough education regarding kidneys as a nephrologist. I believe it because an Emory University educated Internist (M.D.) overlooked my GFR and signs of CKD for an additional 4 months while I continued to suffer from symptoms she should have known were related to CKD.

Stay safe and watch your diet!

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ugh. I was told to drink more water and I am doing just that. I guess I need to read more about all this . I see my nephrologist in 2 months.

I will also ask more about diet. I have given up sodium...now most sweets. I have eliminated so many things

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The following is from Davita.com. Have you experienced additional swelling in ankles/legs, shortness of breath, fatigue since your GFR is dropping? Well, read this:

Why people with CKD need to control fluid

Water is extremely important to your health but too much can create serious difficulties for patients whose kidneys are no longer able to remove excess fluid. For those living with CKD, having a limited ability to eliminate the fluid they take in can result in swelling of feet and legs, shortness of breath, additional strain on the heart, heart failure and fatigue. Your doctor and dietitian will provide you with a fluid-restricted diet unique to your needs to avoid these serious problems. In addition to this diet, daily monitoring of your weight and the use of prescribed diuretics (water pills) will keep you at a safe weight.

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That isn't a simple answer for those with CKD. In the latter stages, fluid intake should be a major issue and definitely those on dialysis so a proper dry weight can be accurately determined. Also from DaVita is this complete article that gives more accurate information on the when and why of fluid intake.

Food that Counts as Fluid on the Kidney Diet

The adult human body is made of more than 50 percent water and needs fluid to function properly. Most food naturally contains water, including fruits, vegetables, meat, and bread. These foods are often not considered when tracking fluid intake. Beverages like water, coffee drinks, shakes, juice, and soda are obvious sources of liquid. Ice, sherbet, gelatin, and soup also count as fluid. Generally, anything that is liquid at room temperature is counted as part of the daily fluid allowance. People in the later stages of chronic kidney disease (CKD) should limit fluid intake because as kidney function is lost the kidneys can no longer remove excess fluid, which can lead to serious complications. If you have CKD, it’s important to recognize which foods to count as fluid to help improve or maintain your health.

Why people with CKD need to control fluid

Water is extremely important to your health but too much can create serious difficulties for patients whose kidneys are no longer able to remove excess fluid. For those living with CKD, having a limited ability to eliminate the fluid they take in can result in swelling of feet and legs, shortness of breath, additional strain on the heart, heart failure and fatigue. Your doctor and dietitian will provide you with a fluid-restricted diet unique to your needs to avoid these serious problems. In addition to this diet, daily monitoring of your weight and the use of prescribed diuretics (water pills) will keep you at a safe weight.

Kidney-friendly foods that count as fluid

Although most foods naturally contain water, the amount of fluid allowed refers only to liquids or foods like gelatin and ice that turn to liquid at room temperature. Here is a list of foods to consider when you’re counting fluid intake:

Coffee and tea

Gelatin

Ice chips or cubes

Ice cream

Juice

Milk and milk substitutes

Popsicles

Sherbet

Soup

Sorbet

Some fruits and vegetables contain large amounts of water, so excess intake can add a significant amount of fluid. Watermelon, for example, contains so much water that the recommended portion is only one small wedge or about 1 cup.

Some kidney-friendly fruits and vegetables that contain fluid but don’t count as part of the fluid allowance include:

Apples

Blackberries

Blueberries

Broccoli

Cabbage

Carrots

Cauliflower

Celery

Cherries

Cranberries

Cucumbers

Eggplants

Grapes

Lettuce

Peaches

Pears

Peppers

Pineapple

Plums

Strawberries

Tangerines

Zucchini

How to control fluid

Patients have different fluid needs depending on their body size, medical condition and how much urine they make. Your doctor and renal dietitian will let you know how much liquid you should have each day and provide tips to help you manage thirst with a kidney-friendly diet. Here are some helpful tips:

Avoid salty and spicy food. They increase thirst.

Reduce or avoid salt, soy sauce, and other high-sodium condiments.

Plan ahead and spread your liquids throughout the day.

Stay cool. Don’t overheat.

Drink cold beverages instead of hot ones.

Snack on cold kidney-friendly vegetables and fruits.

Eat only the number of fruit and vegetable servings recommended in your meal plan.

Sip beverages and use smaller cups.

Make ice cubes out of your favorite beverage.

Conquer dry mouth by brushing teeth, using mouthwash and sucking on hard candy or a lemon wedge.

Take pills with very small sips of water, or try applesauce or other soft foods instead of water.

Keep a daily food and fluid journal that includes your weight.

Take your prescribed water pills.

Also, the use of diuretics can be a problem for your BP and CKD so monitor it carefully and check with your doctor on any changes.

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Super post!

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