Dialysis

[Dangermom13]

In other countries, far fewer patients end up on dialysis. I don't know if Americans have more of the underlying or related problems or what. My nephrologist and I have agreed that if I ever get to that point, it's my choice. I am borderline Stage 2/3 as I'm radical about following the renal diet.

[orangecity41 NKF Ambassador]

My e GFR shows same as yours (2to3), however have other indicators of higher level, and I too watch closely the CKD diet. Good point you mention about other countries not doing dialysis as much? Could be many reasons?

[HealthBuddyMelissa]

This is just my opinion and only my opinion. Dialysis is a huge money maker in USA. I think that is one factor. But Americans also have horrible diets. Not all but a lot. The Western Diet is atrotious. I do not want to be on Dialysis if I can at all avoid it.

[Dangermom13 in reply to HealthBuddyMelissa]

I think we're in the same ballpark on this. A vegan diet would help people with other conditions related to the strain on their kidneys: high blood pressure, diabetes, obesity, etc. My kidneys were damaged as a result of a car accident.

[HealthBuddyMelissa in reply to Dangermom13]

I am not Vegan but I do eat a lot of fruits and veggies. I also very rarely eat dairy of any kind and meat portions are 3 oz of good quality meats.

[HealthBuddyMelissa in reply to HealthBuddyMelissa]

They don't know why my left kidney failed for sure. They think it might be genetic. I can attest to the fact though that diet change helps a lot.

[Dangermom13 in reply to HealthBuddyMelissa]

Renal diet recommends no more than 2oz of meat at a time for less stress on kidneys, but seems like you're doing fine

[orangecity41 NKF Ambassador in reply to Dangermom13]

On my prescribed diet is 1 oz of meat or substitute at a serving and no more than 6 oz total a day. Other blood work taken into consideration (maybe age too) . I use Davita Diet Planning and Tracker to be sure I get a proper amount for the day, so when snack do manage to get enough protein.

[HealthBuddyMelissa in reply to Dangermom13]

I am stage 3 and have had no restrictions put on my diet except sodium. I eat about 3-4 oz meat at a time. 1- I need the Iron. 2- I need the protein because I exercise 6 days a week and lift weights. I try to eat only high quality proteins. Those blanket recommendations are just that. We are all different and our bodies have different requirements. That is why it is hard to answer such questions on a forum. One should always go by their labs and doctor advice.

[Hawaiilover]

That's interesting. I'm at stage 4 & IGA Nephropathy and when I ask about diet changes he really didn't say I had to at this point. He told me at some point I will need dialysis or transplant. Wouldn't diet help slow progression? What kind of diet restrictions have you been following.

[orangecity41 NKF Ambassador in reply to Hawaiilover]

I am on a Chronic Kidney Disease diet and in my case restricts phosphorus, potassium and sodium. The diet was prescribed by my Doctor, and based on blood work results. I was diagnosed at stage 3b.

[Hawaiilover in reply to orangecity41]

I really need to discuss diet more with my doctor. I have heard this from several people now that changing diet helped the numbers. I really need to stop this thing before the number drop any more.

[HealthBuddyMelissa in reply to Hawaiilover]

Yes yes yes. Insist your doctor teach you about a pre dialysis diet that meets your bodies needs and situation.

[lowraind in reply to Hawaiilover]

Yes, diet will slow progression. Diet changes have helped me go from 34 to 54 egfr. Lots written about it:

National education, support and advocacy organizations:

• DaVita Kidney Disease and Dialysis Forums is well known for their recipes but they also have a forum for patients too.

• Renal Support Network provides many support and advocacy services including a phone support line.

• AAKP is a comprehensive resource focusing on the quality of life for kidney patients through education, advocacy, patient engagement and the fostering of patient communities.

• National Kidney Foundation provides a portal for patients too.

Some healthy kidney diet foods:

1. Red bell peppers--1/2 cup serving red bell pepper = 1 mg sodium, 88 mg potassium, 10 mg phosphorus

Red bell peppers are low in potassium and high in flavor, but that’s not the only reason they’re perfect for the kidney diet. These tasty vegetables are also an excellent source of vitamin C and vitamin A, as well as vitamin B6, folic acid and fiber. Red bell peppers are good for you because they contain lycopene, an antioxidant that protects against certain cancers.

Eat red bell peppers raw with dip as a snack or appetizer, or mix them into tuna or chicken salad. You can also roast peppers and use them as a topping on sandwiches or lettuce salads, chop them for an omelet, add them to kabobs on the grill or stuff peppers with ground turkey or beef and bake them for a main dish.

2. Cabbage--1/2 cup serving green cabbage = 6 mg sodium, 60 mg potassium, 9 mg phosphorus

A cruciferous vegetable, cabbage is packed full of phytochemicals, chemical compounds in fruit or vegetables that break up free radicals before they can do damage. Many phytochemicals are also known to protect against and fight cancer, as well as foster cardiovascular health.

High in vitamin K, vitamin C and fiber, cabbage is also a good source of vitamin B6 and folic acid. Low in potassium and low in cost, it’s an affordable addition to the kidney diet.

Raw cabbage makes a great addition to the dialysis diet as coleslaw or topping for fish tacos. You can steam, microwave or boil it, add butter or cream cheese plus pepper or caraway seeds and serve it as a side dish. Cabbage Rolls Made with Turkey are a great appetizer, and if you’re feeling fancy, you can stuff a cabbage with ground meat and bake it for a flavorful meal bursting with nutrients.

3. Cauliflower--1/2 cup serving boiled cauliflower = 9 mg sodium, 88 mg potassium, 20 mg phosphorus

Another cruciferous vegetable, cauliflower is high in vitamin C and a good source of folate and fiber. It’s also packed full of indoles, glucosinolates and thiocyanates—compounds that help the liver neutralize toxic substances that could damage cell membranes and DNA.

Serve it raw as crudités with dip, add it to a salad, or steam or boil it and season with spices such as turmeric, curry powder, pepper and herb seasonings. You can also make a nondairy white sauce, pour it over the cauliflower and bake until tender. You can pair cauliflower with pasta or even mash cauliflower as a dialysis diet replacement for mashed potatoes.

4. Garlic--1 clove garlic = 1 mg sodium, 12 mg potassium, 4 mg phosphorus

Garlic helps prevent plaque from forming on your teeth, lowers cholesterol and reduces inflammation.

Buy it fresh, bottled, minced or powdered, and add it to meat, vegetable or pasta dishes. You can also roast a head of garlic and spread on bread. Garlic provides a delicious flavor and garlic powder is a great substitute for garlic salt in the dialysis diet.

5. Onions--1/2 cup serving onion = 3 mg sodium, 116 mg potassium, 3 mg phosphorus

Onion, a member of the Allium family and a basic flavoring in many cooked dishes, contains sulfur compounds which give it its pungent smell. But in addition to making some people cry, onions are also rich in flavonoids, especially quercetin, a powerful antioxidant that works to reduce heart disease and protects against many cancers. Onions are low in potassium and a good source of chromium, a mineral that helps with carbohydrate, fat and protein metabolism.

Try using a variety of onions including white, brown, red and others. Eat onions raw on burgers, sandwiches and in salads, cook them and use as a caramelized topping or fry them into onion rings. Include onions in recipes such as Italian Beef with Peppers and Onions.

6. Apples--1 medium apple with skin = 0 sodium, 158 mg potassium, 10 mg phosphorus

Apples have been known to reduce cholesterol, prevent constipation, protect against heart disease and reduce the risk of cancer. High in fiber and anti-inflammatory compounds, an apple a day may really keep the doctor away. Good news for people with kidney disease who already have their share of doctor visits.

This kidney diet winner can be paired with the previous good-for-you food, onions, to make a unique Apple Onion Omelet. With versatile apples you can eat them raw, make baked apples, stew apples, make them into apple sauce, or drink them as apple juice or apple cider.

7. Cranberries--1/2 cup serving cranberry juice cocktail = 3 mg sodium, 22 mg potassium, 3 mg phosphorus

1/4 cup serving cranberry sauce = 35 mg sodium, 17 mg potassium, 6 mg phosphorus

1/2 cup serving dried cranberries = 2 mg sodium, 24 mg potassium and 5 mg phosphorus

These tangy, tasty berries are known to protect against bladder infections by preventing bacteria from sticking to the bladder wall. In a similar way, cranberries also protect the stomach from ulcer-causing bacteria and protect the lining of the gastrointestinal (GI) tract, promoting GI health. Cranberries have also been shown to protect against cancer and heart disease.

Cranberry juice and cranberry sauce are the most frequently consumed cranberry products. You can also add dried cranberries to salads or have them as a snack.

8. Blueberries--1/2 cup serving fresh blueberries = 4 mg sodium, 65 mg potassium, 7 mg phosphorus

Blueberries are high in antioxidant phytonutrients called anthocyanidins, which give them their blue color, and they are bursting with natural compounds that reduce inflammation. Blueberries are a good source of vitamin C; manganese, a compound that keeps your bones healthy; and fiber. They may also help protect the brain from some of the effects of aging. Antioxidants in blueberries and other berries have been shown to help slow bone breakdown in rats made to be low in estrogen.

Buy blueberries fresh, frozen or dried, and try them in cereal or , topped with whipped topping, in a fruit smoothie. You can also drink blueberry juice.

9. Raspberries--1/2 cup serving raspberries = 0 mg sodium, 93 mg potassium, 7 mg phosphorus

Raspberries contain a phytonutrient called ellagic acid which helps neutralize free radicals in the body to prevent cell damage. They also contain flavonoids called anthocyanins, antioxidants which give them their red color. An excellent source of manganese, vitamin C, fiber and folate, a B vitamin, raspberries may have properties that inhibit cancer cell growth and tumor formation.

Add raspberries to cereal, or puree and sweeten them to make a dessert sauce or add them to vinaigrette dressing.

10. Strawberries--1/2 cup serving (5 medium) fresh strawberries = 1 mg sodium, 120 mg potassium, 13 mg phosphorus

Strawberries are rich in two types of phenols: anthocyanins and ellagitannins. Anthocyananins are what give strawberries their red color and are powerful antioxidants that help protect body cell structures and prevent oxidative damage. Strawberries are an excellent source of vitamin C and manganese and a very good source of fiber. They are known to provide heart protection, as well as anti-cancer and anti-inflammatory components.

Eat strawberries with cereal, smoothies and salad,or slice and serve them fresh or top them with whipped topping. If you’d like a more elaborate dessert, you can make strawberry pudding or sorbet, or puree and sweeten them to serve as a dessert.

11. Cherries--1/2 cup serving fresh sweet cherries = 0 mg sodium, 160 mg potassium, 15 mg phosphorus

Cherries have been shown to reduce inflammation when eaten daily. They are also packed with antioxidants and phytochemicals that protect the heart.

Eat fresh cherries as a snack or make a cherry sauce to serve with lamb or pork. Cherry juice is another way to consume this tasty food.

12. Red grapes--1/2 cup serving red grapes = 1 mg sodium, 88 mg potassium, 4 mg phosphorus

Red grapes contain several flavonoids that give them their reddish color. Flavonoids help protect against heart disease by preventing oxidation and reducing the formation of blood clots. Resveratrol, a flavonoid found in grapes, may also stimulate production of nitric oxide which helps relax muscle cells in the blood vessels to increase blood flow. These flavonoids also provide protection against cancer and prevent inflammation.

Buy grapes with red or purple skin since their anthocyanin content is higher. Freeze them to eat as a snack or to quench thirst for those on a fluid restriction for the dialysis diet. Add grapes to a fruit salad or chicken salad. Try a unique kidney diet recipe for Turkey Kabobs that feature grapes. You can also drink them as grape juice.

13. Egg whites--2 egg whites = 7 grams protein, 110 mg sodium, 108 mg potassium, 10 mg phosphorus

Egg whites are pure protein and provide the highest quality of protein with all the essential amino acids. For the kidney diet, egg whites provide protein with less phosphorus than other protein sources such as egg yolk or meats.

Buy powdered, fresh or pasteurized egg whites. Make an omelet or egg white sandwich, add pasteurized egg whites to smoothies or shakes, make deviled egg snacks,or add whites of hard-boiled eggs to tuna salad or garden salad to add extra protein.

14. Fish--3 ounces wild salmon = 50 mg sodium, 368 mg potassium, 274 mg phosphorus

Fish provides high-quality protein and contains anti-inflammatory fats called omega-3s. The healthy fats in fish can help fight diseases such as heart disease and cancer. Omega-3s also help lower low-density lipoprotein or LDL cholesterol, which is bad cholesterol, and raise high-density lipoprotein or HDL cholesterol, which is good cholesterol.

The American Heart Association1 and American Diabetes Association2recommend eating fish at least two times a week. Fish highest in omega-3s include albacore tuna, herring, mackerel, rainbow trout and salmon.

1American Heart Association: Fish and Omega-3 Fatty Acids

2American Diabetes Association: Seafood – A Smart Choice for Diabetes

15. Olive oil--1 tablespoon olive oil = less than 1 mg sodium, less than 1 mg potassium, 0 mg phosphorus

Olive oil is a great source of oleic acid, an anti-inflammatory fatty acid. The monounsaturated fat in olive oil protects against oxidation. Olive oil is rich in polyphenols and antioxidant compounds that prevent inflammation and oxidation.

Studies show that populations that use large amounts of olive oil instead of other oils have lower rates of heart disease and cancer.

Buy virgin or extra virgin olive oil because they are higher in antioxidants. Use olive oil to make salad dressing, in cooking, for dipping bread or for marinating vegetables.

[Dangermom13 in reply to lowraind]

I can do everything here. Did the cabbage for a year and then my system started reacting to the chemical in cabbage that signals the colon to void in some folks.

And a vegan diet in which you limit phosphorus, potassium, and sodium works great for not just kidney issues but high blood pressure, obesity, and even diabetes type 2 since no sugar is included.

[Hawaiilover in reply to Dangermom13]

I may have to look into that and try it. I need to do something before it's too late.

[Hawaiilover in reply to lowraind]

Thank you for all the information. I have read about many of these items but finding it hard as most are items I don't really like. I have eaten a lot more of the fruits and cut out taboo items but my number still dropped. All the extra fruits seem to go right through me, so I guess I may not be keeping as hydrated as I should. I need to find a balance that works.

[Dangermom13 in reply to Hawaiilover]

I'd try going vegan to help your numbers, but nothing high in potassium, phosphorus, or sodium. Yes, cabbage and some other recommended vegetables and fruits can give you the runs.

[horsie63 in reply to Hawaiilover]

Keep in mind that fish can be high in potassium and phosporus.

[Darlenia]

There are several reasons why more Americans wind up on dialysis some of them are poor diet behavior, poor access to preventative medical care, a for-profit medical establishment, etc. One of the biggest problems is that the US has overly stringent rules (my opinion) regarding the age of kidney donors. In France, for example, the average age of kidney donors is 56 years, compared to 39 years in the United States. So France has a much larger pool of available kidneys, hence fewer people on dialysis. Sadly, the US discards thousands of viable kidneys. Our country could do better.

[Dangermom13 in reply to Darlenia]

That's so true. For profit health care and a diminished pool of donors don't help. It's also true that many other countries accept the end of life without all the expense and effort we require.

[Hidden in reply to Darlenia]

The FDA (Federal Delay Authority) has an apparent mandate to keep the US from catching up with the rest of the world. They are above the law or good sense (follow the money?). It takes years to get a new treatment to the public, rather than a few weeks, and a two or three year monitoring period. Our nephrologists refuse, or are forbidden, to be trained in Eastern (Chinese) medicine. The Chinese have several thousand years of experience so have a pretty good handle on it.

[steve680 in reply to Hidden]

This also most likely explains why the FDA would rather shutdown the stem clinics in the USA than help bring things to market. A lot more is being done with stem cells outside of the USA.

[htpi1543 in reply to Hidden]

All because of liability. USA lawyers are very hungry.

[Dangermom13 in reply to Darlenia]

I had NO idea kidneys were discarded. Shameful.

[steve680]

I just recently started hemodialysis at Satellite. My initial observation is that most people who are on dialysis are diabetic. This is just a guess since I noticed a lot of overweight people and people with amputations. Something like 40 percent of Americans are obese, or so I heard. It also seems like a lot of the people on dialysis are also low income, older, male and dark skinned (Pacific Islander, Hispanic, African American, etc.). I think kidney disease might be seem as a "poor persons" disease and so doesn't get enough attention/research. After all, you can just put a person on dialysis when they hit stage 5, and nephrologists won't work with you to improve the GFR as they feel it's a lost cause.

[Hidden in reply to steve680]

AMEN !