CKD diet

[Coasties]

I’ve heard different things about CKD diets. Some say don’t eat animal products, others say don’t eat much protein. Does anyone have any links to reliable info?

[pheebee]

I think it depends on what stage the CKD is, but animal protein is harder than plant protein for the kidneys to process. At stage 3 I try to be mainly plant based, but with a little fish and chicken.

[orangecity41 NKF Ambassador]

My CKD diet was prescribed by my Primary Doctor and was based on CKD level and blood work for protein, sodium, phosphorus and potassium. Perhaps discuss this with your Primary Doctor if you have no nephrologist.

[Blackknight1989]

Usually there is no one-size-fits-all CKD diet like diabetes since CKD affects us differently…if high phosphorus that’s one diet, high K another, low K another etc…thus it is best you have a physician or renal dietitian prescribe the proper diet based on your labs and the unique way CKD affects you.

[userotc]

Here's a link which indicates restricted protein intake may be overplayed, at least for stage 3, then another that indicates better mortality with protein for mild CKD. The 3rd presents reports on toxicity of meat for CKD but protein is an important nutrient and its easier to get from meat. Red meat may be more toxic.

For my mum (stage 3), we restrict red meat primarily for acid reasons but dont eliminate (yet).

If in doubt, see a qualified Nutritional Therapist specialising in the area. I believe renal dieticians may be more/too restrictive, at least for milder CKD.

pmc.ncbi.nlm.nih.gov/articl...

jamanetwork.com/journals/ja...

pmc.ncbi.nlm.nih.gov/articl...

[lawntonmedicals]

A healthy diet for chronic kidney disease (CKD) focuses on limiting sodium, potassium, and phosphorus while ensuring adequate protein intake. It's important to work with a dietitian to create a personalized meal plan that meets individual health needs. Here are some reliable resources for CKD diets:

Eating Right for Chronic Kidney Disease: This guide offers advice on what to eat and drink to help slow CKD progression. It emphasizes working with a dietitian for tailored meal plans.

Kidney-friendly Eating Plan: This resource explains how to follow a healthy eating plan for CKD, highlighting the importance of limiting certain foods.

KDOQI Clinical Practice Guideline for Nutrition in CKD: This guideline provides evidence-based recommendations for nutrition in CKD, including protein management and dietary adjustments.

These links should help clarify the dietary recommendations for CKD.

[Akbarprm76]

Research PRAL diet online. Make sure it is a site of a registered kidney dietician.

[lowraind]

There are many "experts" out there. For my part, I rely on advice from Mayo Clinic, Johns Hopkins Medicine and Cleveland Clinic.

[drmind]

Diet to your labs and your medical problems. Everyone has different medical problems and different GFRs. On the whole, however, low or no salt fits all our diets as well as little to no red meet, limited to no animal protein. Hope this helps.

[barbara55109]

The #1 rule is "eat to your labs." Many of the CKD dietary recommendation, including those from licensed dieticians, treat everyone the same. But we aren't all the same. CKD has many different causes. CKD has different stages. We are all unique. Stock advice is to reduce sodium, potassium, phosphorus and animal proteins. For me, my sodium and potassium are LOW because my CKD is from dehydration. So I have to ignore that guidance. Several studies show that going to a plant based diet can slow the progression of CKD, yet most nephrologists don't even bother to suggest it. Mine said most people just won't do it. It is more difficult for our bodies to process red meats over chicken, turkey and fish. Processed meats, like deli meats, pepperoni and such are harder on our bodies. There are meats you don't realize are processed, but are. Trained renal dieticians are few and far between and all the dietician appointments I've had are useless. They just read out of a CKD textbook. I am not a textbook case. Many insurances won't pay for dieticians until someone starts dialysis. The dialysis diet is also very different than the dietary recommendations at other stages. In addition to processed meats, other processed foods are difficult for our bodies. Here is a Mayo article that explains processed foods. mayoclinichealthsystem.org/...

[WildIris]

Here's a quote from a review of research done in 2022 from the National Institutes of Health, (the link was posted above by UserOTC) then a summary, by me:

"Another possible explanation for the conflicting signals [about the effects of protein on kidney health] is that we are looking at the wrong aspect of dietary protein. It may not be the quantity of protein but rather the quality of protein. Not all proteins produce the same amount of acid that needs to be neutralized. Animal protein, specifically red meat, tends to be higher in methionine and cysteine, both of which generate sulfuric acid in their catabolism. Lew et al. used the Singapore Chinese Health Study to look at total protein and the types of protein in more than 63,000 people and examined the risk of ESKD (End Stage Kidney Disease) with 15.5 years of follow-up (17). Although total protein was related to the risk of ESKD, it was not dose related. However, there was a strong dose-dependent relationship with red meat intake and increased risk of ESKD. This wasn’t seen with other protein sources (poultry, fish, eggs, or dairy products)."

My summary: Red meat is clearly not good for weakened kidneys, but getting plenty of protein is important for overall health.

Also, lest you be confused about it, its not necessary to limit potassium and phosphorous unless your labs show that your values are too high.

The article also mentioned the newer SGLT2 inhibitor drugs like Ozempic and Farxiga as really good for kidneys as well as diabetes and weight loss, though these drugs are expensive in the U.S. and have many side-effects and are not for everyone.