recently diagnosed 3a Ckd. Went to a renal dietician- no help- eat plant based diet and keep phosphorus and potassium low. I’ve tried my best to do this but I have not been able to get 2,000cal/day intake so I’m losing weight. My doc also says don’t lose any weight because my bmi is 21 and he doesn’t want me any skinnier. I haven’t been able to get even one days worth of calories while keeping an eye on the 3 markers listed. I’ve scoured the internet for menus but so far cannot get one days worth of meals that have enough calories, my husband says give up and just eat. I cry every day at meal time with such frustration and feel like I’m killing myself by what I eat and killing myself by what I’m not eating, I am just a wreck and don’t know where to turn.
how to keep protein potassium and phosphoru... - Kidney Disease
how to keep protein potassium and phosphorus low and get 2,000 cal/day?
Ok, there is following a diet and then there is following a life style. Diets that are so restricitve are not sustainable. As far as Pot and Phos. at this stage, your level should not be critical. Have you had lab draws to prove what those levels are currently? Anything below 5 is doable, although they like them lower.
If you are crying at meal time, you are overdoing it. Life is short and food is part of the enjoyment of life. Here are some suggestions:
See a better renal dietician. This is the best thing you can do. They can steer you to better foods that will allow you to gain weight and not harm yourself in the process. I went plant based and found it near impossible to stick with. And after almost two years, I also found out it made me feel bad. I have added eggs and chicken back into my diet. PB can be ridiculously hard for renal because of the potassium and phos levels. Things like legumes are pots and phos bombs. No good for us. Tomatoes, which make up so many recipes are out for us as well. You are correct that it is hard to follow. Maybe add some chicken or eggs back in might be good. You are 3a, so unless your levels indicate that you should be so restrictive, ease up.
Look up the foods you are eating and set up a log of your food such as MYFITNESSPAL or other apps. It will track how much Pots and Phos you are consuming. If you have something high in one meal, eat something less in the next meal.
Look to add carbs and fat into your diet. Neither is high in potassium or phosphorous unless it is nuts. Find vegetables that you like to add to your diet than are kidney safe. Lettuce, cukes, peppers, carrots, celery, radishes, make great salads and are all safe and low. The dressing is what will get you. Try olive oil and fresh herbs. I love broccoli which I leech in warm water for an hour and then boil. This is delicious with oil and garlic over pasta. I often add parm cheese for flavor. You could probably add shredded cheese for more calories. Change up and use almond milk to get your calcium but low potassium and phosphorous. Get the kind with sugar in it for more calories. It is yummy. Bread would be good for you, but watch the salt. Try adding a bagel with creme cheese and jam for a midday snack. (Bagels are over 300 calories, creme cheese has some phosphorous but not much and jam is sugar.) The purer the food, meaning little or no additives, the better. Add fat like real butter. Although it is dairy, it is better for you than processed margarine which is horrible for everyone.
The biggest culprits for potassium are potatoes, tomatoes, squash and certain fruits. Get to know what is not good, and avoid them. If potatoes are big on your favorite list, try leeching them and then boiling them and mashing them up. Add butter, cheese, sour creme and you have a calorie bomb.
I could go on for ever on foods. But here is a biggie, which I bet you did not know. Medications can rise your potassium. I was watching everything I ate and still had high potassium. Turned out it was a medication. GRRRRRR. So have your medications reviewed.
Eat more often. And your husband is sort of correct. Just eat.
I feel for you because I have been where you are. On top of phosphorous and potassium, I have to watch carbs and sugar because I am diabetic, overweight so no fat, and stage 5. I can tell you it is a challenge, but doable.
Thanks for your food and other advice.I love Japanese Sweet Potatoes. They are low potassium/phosphorus. I eat small amount for dessert. Have enough natural sugar, so is a treat.
I will try leaching potatoes, broccoli & carrots.
It has been VERY challenging eating enough calories. Have lost 37lbs since May 1, 2022, but BMI was "obese" category before.
I live in Oregon, U.S., my local grocer brings them in from maybe California? They look like a regular sweet potato (yam), dark purple skin outside, but the inside is pale, yellowish, unlike the yam/sweet potato. not orange. I hope they're available where you are.🙂🙏
oh I see Trader Joe’s and Whole Foods carry them! Gonna go get some tomorrow! Thanks for the tip!
I live in the US and I am also stage 3a. My nephrologist told me I do NOT have to follow a renal diet! I must follow a low sodium diet with small amounts of red meat. He did suggest to try to follow a "mostly" plant based diet. I was diagnosed about 3 years ago. I get very frustrated because eating better doesn't always make the numbers better. I get depressed because I feel like I have very little control over it. At one point my GFR was up to 57. I was eating well and was encouraged to continue. Six months later my GFR dropped to 50. I was very discouraged! My point is- don't stress over every bite!
do you get any feed back after your labs as to what specifically you need to do with your diet going forward? Do you get specific limits of what to eat and what to avoid ? Or are you left to figure it out by yourself? And guess.
I’ve been to a renal dietician twice asking for a menu and both times came home with general guidelines that weren’t any more specific to me than what I can get from reading online. Am I being unreasonable in thinking a renal dietician should hand me an actual diet with clear instructions, eat this and eat this much of it - an actual sample menu to follow? The sample menus online always say- talk to your dietician, But my dietician only gives broad general instructions, not actual sample menus. Millions of people have this disease why is it all so opaque as to what we need to eat and what we need to avoid? Surely someone has walked in my shoes before. I expected to follow a protocol not be left constantly wondering what to eat. Is the science behind this Ckd dieting really that unsettled and vague?
I am in the same boat,only get " no potatoes,tomatoes,oranges etc.and eat plant based:.I always ask for a sample menu for my stage 4 ckd with diabetes and mineral bone disease and I never get one.I am afraid to eat anything,but at your stage you shouldn't have to starve yourself Mainly see what your labs say and eat accordingly. Let me know if you get that menu and know your not alone !
sorry you are in the same boat. It sure isn’t fun to be adrift. I’ve been scouring the internet for clues and the best I can come up with is using my kitchen scale and iPad to clock every single thing I put into my mouth. So far I have had one single day in 2 weeks of doing this that has yielded 2,000 cal while holding protein, phosphorus and potassium to prescribed limits. Most days I’m at 15000. So slowly losing weight. I refuse to eat empty calories- white rice, white bread, jam, etc. my whole life I have eschewed empty calories. It is mind boggling to me that such foods are suggested by the kidney foundation to add calories. Honey is my go to calorie booster but only a tbsp so it isn’t really helping much. No meat and restricted dairy and a little chicken, cheese, fish. The servings are a pathetic amount compared to what I used to eat. Very depressing, especially as I have osteoporosis as well. Going to see a new dietician as the first one is useless.
Finding a renal dietitian where I live is useless, one in 40 miles.I found out more on internet than she told me.very depressing to stress about every bite you put in your mouth.Thanks for responding,it's good not to be alone
I'm sorry to say, though my renal dietitian was very knowledgeable, no menu was offered; most of the plant-based info I found through research findings and found an app that offers dietary(label) info on many foods. DaVita, NKF and Kidney.org offer info on how much protein, sodium, etc. to consume for the different stages of kidney disease. Those and my pcp recommendation on vit D3, Calcium, phosphorous intake are what has helped, BUT I've steadily been losing weight too. The weight loss has be good, as I was previously considered obese at 163#, however, can't seem to get enough calories.
I am 5ft 6in 138 and falling. Doc said don’t lose weight because he doesn’t want my BMI to get lower given my age 70.
but I can’t get enough calories/day. I need a menu. Guess I’ll have to look for another dietician associated with a different medical practice. My dietician is very experienced but her advice is too generalized to be useful. Seems since so many people are in this predicament that some brilliant computer geek would let you plug in your labs and voila - a group of balanced nutritious healthy menus would appear on your screen. Seems like a good business opportunity to me. I’d gladly pay for that level of customized service!
I was diagnosed at 3b, at age 75, and Doctor put me on a CKD diet based on blood work, and restricted on phosphorus, potassium, sodium and protein. It was a challenge and lost 25 pounds. My weight has leveled off. Davita web site has menus and diet tracking. I find too that moderation helps. I am going to look for those sweep potatoes.
Whole Foods has organic Japanese sweet potatoes from NC
Word of caution on being strict on eating. I've never been overweight so used to eat anything and everything (I have Graves Disease so high metabolism) then I found I had CKD and tried the plant based, low protein and about starved myself. I cannot get enough calories from strictly plants especially cutting out high potassium ones. So now I have low ALB (protein) and am trying to get that up. I have low potassium so now I have to eat potassium foods. I'm small to start with (4'9") but dropped to 92 lbs and while I am active on the transplant list I'd like some more pounds going into surgery. I'm now on peritoneal dialysis and have to eat more protein. It's very frustrating as now most protein sources make me gag.
So be mindful of you lab values and that's what you eat to. If potassium, sodium, phosphorus, protein are all in balance then eat those foods. Your body NEEDS those things to function properly. Don't pay attention to anyone else but your individual labs and use that to guide you.
Hey, you haven't mentioned what your lab numbers look like. If it's ok to ask, what are your current potassium, phosphorus and sodium levels from your latest labs?
watch your lab numbers. Potassium & phosphorous in plants is metabolized somewhat differently than with animal products. It’s partly due to the higher fiber content of plants. There is NO fiber in animal products. That is why plant based diets are recommended. I’m 3A, eat a mostly plant based diet, & my potassium & phosphorous levels are fine. I eat lentils, beans, grains, greens, nuts, etc. I watch my lab results. Good luck (& stress isn’t good, either!).
I am going in the direction of mostly plant based too after reading about how animal and plant food differences. So much to learn. Up until this point in my life all I really thought a was I’m hungry let’s eat! Really hard to track every little thing I eat. Exhausting…
Plant based potassium/phosphorous foods have a lower absorption % in the diet. I read between 35% and 75% less; animal protein metabolism produces higher blood Urea Nitrogen, which affects creatinine. Higher creatinine = lower eGFR. So do watch your labs. So far, this is what I've learned since April, last year and from being a member of this group.🙂🙏
wow that’s a big range for plant absorption 35% to 75% is it possible to know the rate of absorption /unit of serving for a given plant- vegetable or fruit? Is that data available and if so where?
I signed up for webinar last July, 2022, sponsored by Orgain Healthcare, Professional Education Series, a presentation "Improved Outcomes in CKD with a plant forward approach," speaker Melanie Betz MS, RD, CSR, CSG. It was informative, and reviewed research associated with the absortion of nutrients from plant based diet. Don't know if this info would be available to obtain or share? I will try.
At that time, I was distressed about new ckd diagnosis and scrambling emotionally to get a handle on what was happening to me. It's been life altering to say the least.
Hats off to all of you who contribute so much to us who are new to this disease process. I've learned so much from all your experiences.👍🙂
if one gives up meat entirely would one still need to be so fussy about what fruits/vegetables one eats? If not, then I’m all for giving up meat- but dairy is really hard since I have osteoporosis. Ideas?
This is a really tough one for me, too. Soy products often have calcium. Dark, leafy greens have calcium, although some, like spinach, don’t allow for as much absorption of calcium. Some nuts have calcium. It’s best to research what plant products have higher amounts of calcium & try to include those in your diet daily. But other nutrients matter, too. Like vitamin K & vitamin D. Nutrition can be complex & a lot of research is ongoing. My doctor has me take a calcium supplement.
What do you tell friends and acquaintances?
Can you have a kidney problem that doesn’t show in an ultrasound or blood tests?
Diet & Exercise 
I was just told I am 3a ckd and looking for guidance as the internet research has scared me
