What diet can a chronic kidney disease patient follow?

Question

Hello doctor,

I am a 67-year-old male with a weight 143 lbs and height of 171 cm. I have been suffering from chronic kidney disease and post PTCA care for 17 years. I was diagnosed 15 months back with serum creatinine to be around 5 and am on medications for 15 months. I am a non-diabetic. In the last 15 months, I have lost 30 lbs. Monthly renal lab tests are being done. Six months ago, my serum creatinine was 4.4, hemoglobin was 12.9, uric acid 3.7.

I want to know about my diet. I am a non-vegetarian. Presently I am taking 50 to 60 g of chicken or one egg white or two small pieces of fish thrice a week. I am on restricted use of pulses, tamarind, lemons, milk products, fruits in any form, limited to one liter of water per day, very less salt, no cool drinks, outside food, spices, sweets. I am hungry all the day. My urine output is 1500 mL per day. Protein is 2+.

Please advise me the suitable diet particularly non-veg. I am at present on rice in lunch and rice items for both breakfast and dinner with vegetables like capsicum, bottle guard, ladies finger, cauliflower, carrot, and cabbage. I do not take chilies. How can I improve the quality of life and eating? I am able to walk slowly for 30 minutes daily. I am not able to stand in a queue for not more than five minutes. If I sit for five minutes I am alright.

I am on the following medicines:

Tablet KetoCheck two tablet three times daily.

Tablet Sevanix 400 mg three times daily.

Tablet Nocidos 500 mg three times daily.

Tablet Celerab 20 one daily.

Capsule Nephrovit-Fe one daily.

Capsule Lobun Forte one daily.

Capsule Calci CZ one daily.

Tablet Febuget 40 mg once daily.

Met XL 50 mg once daily.

Clopilet 75 mg once daily.

I have also enclosed recent lab reports for your reference. Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through the attachments (attachment removed to protect patient identity)

Your reports are fine. Albumin is good that shows that your nutritional status is fine.

Potassium is low that accounts for generalized weakness. So now decrease your food restrictions by 20%.

You increase the intake of fruits by one a week.

Regarding non-vegetarian diet what you are taking is more than enough because above that it will increase your phosphorus.

You can increase the intake of pulses.

There are specific books that you can read to cook food for a CKD (chronic kidney disease) diet.

You should give maximum focus on salt restriction rather than other things.

Chillies can be used as per flavor. THere is no harm.

Need to take water in summers and should take at least 1.5 liters of water that is equal to your urine output.

In winters, the intake should be slightly less.

Medications are all fine. The mainstay to control CKD progression is strict blood pressure control.

So keep your blood pressure checked at home in the mornings and evenings and keep a target of less than 130/80.

For more information consult a nephrologist online

Answer 2

Hello,

Welcome back to icliniq.com.

Potatoes can be taken. Protein intake should be 0.8 g per kg per day.

First class protein is 60% of the egg white that would be fine but not more.

The exact calculation will need a help of a registered dietician. Follow the below:

Protein 0.8 g per kg per day.

Low salt 4 to 6 g per day.

Moderate potassium restriction.

Fluids as per urine output.

Low phosphate.

For more information consult a nephrologist online