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Living with Chronic Kidney Disease: Nutrition

 

What to avoid when you have a chronic kidney disease? How much can you eat? How much do you need? We have an answer to your question.
 

 

When your kidney cannot perform 100% of its function, poor diet may take a toll on the organ, and hasten the progress of the disease. It is crucial for patients to learn all nutrition limitation needed in order to control the disease and their own bodies.

 

Protein

Protein is a nutrient needed to repair organ and immune system. Once consumed, protein will be broken down into amino acid, and urea nitrogen.

 

How much do you need?

The daily protein requirement in stage 3 is 0.8-1 gm/kg/day and 0.6-0.8 gm/kg/day for stage 4-5 (ideal body weight in male = height-100 and ideal body weight in female = height-105). 60% of daily protein requirement should be high biological value (HBV) which consists of complete essential amino acid, and produces less waste.

 

Where to get protein?

HBV protein can be found in meat, such as, white egg, fish, chicken, pork, and beef. The low biological value consists of incomplete essential amino acid from non- meat such as bean or grain. This type of protein produces more waste, however.

One serving unit of high biological value = 7 grams of protein= 2 table spoons of meat= 70 calories

1 whole egg
2 white eggs
1 small fish
5 pieces of beef
5 pieces of chicken
5 pieces of pork
2 table spoon of pork chopped                                                                                                                                                                                                                                                            3 shrimps

 

Protein

(gm/day)

Meat

(part)

Rice and flour

(part)

Vegetable

(part)

Fruit

(part)

Good oils

(tea spoon)

Sugar

(tea spoon)

Carbohydrate with no protein

(part)

20

1.5

3

3

1

10

6

4

30

2.5

4.5

3

1

10

6

3

40

4

4

3

2

10

6

3

60

6

7

3

2

10

6

1

70

7

8

4

2

8

6

-

 

Table 1 show nutrition in chronic kidney disease according to daily protein requirement

 

Carbohydrate

Carbohydrate is a kind power source for our bodies. It can be found in rice and flour. There are two types of carbohydrate.                  

1. Carbohydrate that containing protein

2. Carbohydrate without protein

 

One serving unit of carbohydrate that containing protein = one scoop of = 70 calories

1 scoop of rice
½ scoop of sticky rice
1 scoop of rice vermicelli/fine cut white rice noodle/white rice noodle
½ scoop of egg noodle
6 crackers
1 slice of bread

One serving unit of carbohydrate without protein

1 scoop of glass noodle
1 scoop of tapioca pearls
1 scoop of shanghai noodle
1 scoop of salim
2 pieces of 2” sweet meat

 

Lipid

Lipid is a power source for our bodies as well. One serving unit of Lipid = 45 calories. There are four types of lipid as following:

1. Saturated fatty acid

1 tea spoon of lard
1 tea spoon of coconut oil
1 tea spoon of palm
1 tea spoon of butter
2 table spoons of milky cream/cream cheese
2 table spoons of shredded coconut
1 table spoon of coconut milk
1 piece fried bacon

 

2. Mono - unsaturated fatty acid

1 tea spoon of olive oil

1 tea spoon of canola oil

1 tea spoon of peanut oil

1 tea spoon of sesame oil

1 table spoon of sesame

10 pods peanut

6 seeds almond/cashew nut

 

3. Poly - unsaturated fatty acid

1 tea spoon of soybean oil       

1 tea spoon of corn oil  

1 tea spoon of mayonnaise

1 tea spoon of salad cream

1 table spoon of pumpkin/sunflower seed

 

4. Trans fat (Transformed unsaturated fatty acid to saturated fatty acid)
1 tea spoon of shortening
1 tea spoon of margarine

We recommend taking combination of mono-saturated fatty acid alternate with poly-unsaturated fatty acid to prevent coronary heart disease.

 

Sodium
Sodium is a mineral essential to our function. Excessive consumption can result in weight gain, increase blood pressure, edema and pulmonary edema. We recommend only 2,000 mg/day maximum for chronic kidney disease patient who needs to restrict high sodium diet (High sodium diet = more than 120 mg per one serving unit).
What you need to avoid
Salty seasoning, mixed seasoning, dried food, preserved and processed food.

Name

1 serving unit

Sodium (mg)

Salt

1 tea spoon of

2,000

Fish sauce            

1 tea spoon of

500

Flavoring powder

1 tea spoon of

500

Monosodium glutamate

1 tea spoon of

490

Soy sauce

1 tea spoon of

400

Seasoning sauce

1 tea spoon of

400

Baking powder

1 tea spoon of

340

Oyster sauce

1 table spoon of

450

Sukiyaki sauce

1 table spoon of

280

Sweet chili sauce

1 table spoon of

210

Chili sauce

1 table spoon of

220

Tomato sauce

1 table spoon of

140

Table 2 show sodium level in seasoning

Potassium

Potassium is a mineral essential for the function of nerve and muscle, especially cardiac muscle. In chronic kidney disease, potassium excretory function declines. Hence it may cause hyperkalemia. The symptoms and signs of hyperkalemia are muscles weakness, cardiac arrhythmia and cardiac arrest.
What you need to avoid

We recommend chronic kidney disease patients to avoid high potassium diet from  orange, banana, papaya, dragon fruit, watermelon, muskmelon, durian, jackfruit, tamarind, cantaloupe, strawberry, avocado, tomato, taro, asparagus, carrot, cauliflower, cabbage, ginger, fingerroot, red onion, garlic, neem, parkia, cassia tree, potato, broccoli, orange juice, pineapple juice, apple juice, pomegranate juice, noni juice and prune juice.

 

Phosphorus

Phosphorus is a mineral essential for bone metabolism. In patient with chronic kidney disease, phosphorus excretion decreases, therefore increases the risk of osteoporosis.

What you need to avoid

We recommend chronic kidney disease patients to avoid high phosphorus diet from  milk, dairy product, yolk, bean, grain, cereal, soft drink, tea, coffee, energy drink, baking powder or yeast added food, phosphate added frozen food, meat processing food such as sausage, Chinese sausage, dried shredded pork/chicken, fermented pork, white pork sausage and meat ball.

 

Purine

Purine is a nutrient metabolized into uric acid, which is excreted through urine and feces. Normal uric level in normal people is 3.4-7 mg/dl. In patient with chronic kidney disease, uric acid will accumulate in the body called hyperuricemia. This condition may cause gout, uric acid stone in urinary tract system, and chronic kidney disease.

 

What you need to avoid

We recommend avoid high purine diet from entrails, shrimp paste, anchovy, sardine, roe, bean, yeast, tops, cassia tree and asparagus.