Managing Kidney Illness

By Jane Farrell

People with kidney disease can continue to live productive lives. But you’ll probably have to make some diet and lifestyle changes to help you live a healthier and even longer life. Here, from the experts at NIH Senior Health, a division of the National Institutes of Health, are some steps you can take:

Lifestyle Changes

Keep your blood pressure at the target set by your health care provider. For most people, the blood pressure target is less than 140/90 mm Hg. Eating less sodium may help you control your blood pressure. Aim for less than 2300 milligrams (mg) of sodium each day.

If you have diabetes, control your blood glucose level. Good blood glucose control may help prevent or delay diabetes complications, including kidney disease.

Keep your blood cholesterol in your target range. Diet, being active, maintaining a healthy weight, and medicines can all help control your blood cholesterol level.

Take medicines the way your provider tells you to.

If you smoke, take steps to quit. Cigarette smoking can make kidney damage worse. Call a smoking quit line to get help.

Become more active. Physical activity is good for your blood pressure, as well as your blood glucose and blood cholesterol levels. See exercises and physical activities for older adults.

Lose weight if you are overweight. Being overweight makes your kidneys work harder. Losing weight helps your kidneys last longer. See how to tell if you are overweight.

Diet Changes

What you eat and drink may help slow down kidney disease. Some foods may be better for your kidneys than others. Cooking your food from scratch gives you control over what you eat.

Your provider may suggest you see a dietitian. A dietitian can teach you how to choose foods that are easier on your kidneys. You will also learn about the nutrients that matter for kidney disease.

The steps below will help you eat right as you manage your kidney disease. The first three steps (1-3) are important for all people with kidney disease. The last two steps (4-5) may become important as your kidneys become more damaged.

STEP 1: Choose and prepare foods with less salt and sodium.

Why? To help keep your blood pressure at a healthy level. Aim for less than 2300 milligrams of sodium each day.

Buy fresh food more often. Sodium (a part of salt) is added to many packaged foods. Most of the salt and sodium people eat come from prepared foods, not from the salt shaker.

Use spices, herbs, and sodium-free seasonings in place of salt.

Check the Nutrition Facts label on food packages for sodium. A Daily Value of 20% or more means the food is high in sodium.

Try lower-sodium versions of frozen dinners and other convenience foods.

Rinse canned vegetables, beans, meats, and fish with water before eating.

Do not use salt substitutes.

Get tips on choosing and preparing foods with less sodium.

STEP 2: Eat the right amount and the right types of protein.

Why? To help protect your kidneys.

Eat small portions of protein foods.

Protein is found in foods from plants and animals. Talk to your dietitian about how to choose the right combination for you.

Get more tips on eating the right amount and types of protein.

STEP 3: Choose foods that are healthy for your heart.

Why? To protect your blood vessels, heart, and kidneys.

Bake, roast, stew, grill, broil, or stir-fry foods instead of frying.

Cook with nonstick cooking spray or a small amount of olive oil instead of butter.

Trim fat from meat and remove skin from poultry before eating.

See Lowering Your Blood Pressure With DASH to learn about a heart healthy diet.

STEP 4: Choose foods with less phosphorus.

Why? To help protect your bones and blood vessels.

As your kidneys become damaged, you may need to eat foods that are lower in phosphorus. Ask your health care provider or dietitian if you need to eat less phosphorus.

Many packaged foods have added phosphorus. Look for phosphorus—or for words with “PHOS”—on ingredient labels.

Deli meats and some fresh meat and poultry can have added phosphorus. Ask the butcher to help you pick fresh meats without added phosphorus.

STEP 5: Choose foods that have the right amount of potassium.

Why? To help your nerves and muscles work the right way. If potassium is too high or too low, your nerves and muscles will not work normally.

As your kidneys become damaged, you may need to eat foods that are lower in potassium. Ask your health care provider or dietitian if you need to eat less potassium.

If you need to limit potassium, choose foods that don’t have added potassium chloride. Look for potassium chloride on the ingredient labels.

Do not use salt substitutes. They can be very high in potassium.

Drain canned fruits and vegetables before eating.

Get more tips on choosing foods with the right amount of potassium.

Get tips on reading food labels.

Beverages

Having kidney disease also means you may need to change what you drink.

Water. Most people don’t benefit from drinking water when they are not thirsty unless they have kidney stones. Drink as much water as you normally do.

Soda and other drinks. If you are told to limit phosphorus, choose light-colored soda (or pop), like lemon-lime, and homemade iced tea and lemonade. Dark-colored sodas, fruit punch, and some bottled and canned iced teas can have added phosphorus.

Juice. If you are told to limit potassium, drink apple, grape, or cranberry juice instead of orange juice.

Alcohol. You may be able to drink small amounts of alcohol. Drinking too much can damage the liver, heart, and brain and cause serious health problems. Talk to your health care provider first. Learn more about how our bodies process alcohol as we age.

From the  NIH SenioHealth division of the National Institute of Health. For more information, visit www.nihseniorhealth.gov.