Suzanne Barron 3/11/14

Chronic kidney failure, also known as chronic renal failure, chronic renal disease, or chronic kidney disease, is a slow progressive loss of kidney function over a period of several years. Eventually the patient has permanent kidney failure. Chronic kidney failure is much more common than people realize, and often goes undetected and undiagnosed until the disease is well advanced and kidney failure is fairly imminent. It is not unusual for people to realize they have chronic kidney failure only when their kidney function is down to 25% of normal.

As kidney failure advances and the organ's function is seriously impaired, dangerous levels of waste and fluid can rapidly build up in the body. Treatment is aimed at stopping or slowing down the progression of the disease - this is usually done by controlling its underlying cause. If chronic kidney failure progresses to end-stage kidney disease, the patient will not survive without dialysis (artificial filtering) or a kidney transplant.

Too much protein can cause nausea, vomiting, and more damage to the kidneys. Usually, protein is limited with renal failure. A low-protein diet reduces the end products of protein metabolism that the kidneys can no longer get rid of. However, protein may be increased once you start hemodialysis. Your doctor will tell you how many grams of protein you can have each day. (80 grams is a common daily limit for people on hemodialysis.) The protein should come from foods that contain all of the essential amino acids to prevent the breakdown of body protein (muscle). These foods include eggs, milk, poultry and meat. A high calorie diet will also help prevent the breakdown of body protein.

1 ounce cooked meat, fish, poultry = 7 g 1 large egg= 7 g 1/2 cup cooked dried beans, peas, lentils= 8 g 1/2 cup tofu= 7 g 2 tablespoons peanut butter= 7 g 1 cup milk, soy milk, or yogurt= 8 g 1/2 cup pudding or custard= 4 g 1 slice or 1 inch cubed cheese= 7 g 1/2 cup cottage cheese or ricotta cheese= 7 g 2 tablespoons Parmesan cheese= 7 g Vegetables, grains, meats, fish, poultry, and legumes (beans and peas) have protein. Most of the protein you eat should come from meats, fish, poultry (chicken) and legumes (beans and peas).

Sodium makes us thirsty and want to drink more. As we drink more fluids, we retain fluid and our blood pressure goes up which puts a strain on our kidneys and heart. Avoiding foods high in salt and sodium helps control fluid. You may eat 2000 mg (2 grams) of sodium per day. 1 TEASPOON OF SALT EQUALS 2 G OF SODIUM WHICH IS EQUAL TO YOUR SODIUM ALLOWANCE FOR THE DAY. Salt substitute: does not contain sodium but is usually made from potassium; talk with your doctor before using a salt substitute.

Processed meats Pork products (ham, bacon, sausage) Salty snacks (chips, pretzels, nuts) Pickled foods Butter, garlic salt, seasoned salt Barbecue sauce, soy sauce, ketchup, mustard Processed cheeses Limit sodium to 2000 mg each day

ApricotsHoneydew MelonYogurtTofu Avocado MilkPrunesTomato Juice Banana MolassesPumpkinsSalmon Bran Cereal Potatoes/Sweet PotatoesRaisinsTomatoes Buttermilk FigsSalt SubstitutesVegetable Juice Chard OrangesSpinachWatermelon Dried Beans/PeasPapayaSunflower SeedsWinter Squash Potassium helps muscles including the heart muscles to contract and relax. Too much potassium in your blood can cause hyperkalemia and emergency treatment should be started. Unless your doctor tells you otherwise, limit potassium to 2000 mg each day.

Most foods have phosphorus in them. Too much phosphorus can cause calcium to come out of bones, making bones brittle and easier to fracture or break. Most people with kidney failure should limit phosphorus to mg a day. Baking powderCheese (except cottage cheese) Dried peasOrgan meats (brain and liver) BeerChocolateEggsNuts, peanuts, and peanut butter Gran cerealsDark cola beveragesFishPoultry Dreads raised with baking powder Caramel Dried beansMilk and milk products Whole grains, whole wheat bread

Breakfast DAY 1DAY 2 PROTEIN EggCanadian bacon STARCH BagelCinnamon toast, jelly FRUIT StrawberriesFruit Cocktail FAT Cream cheeseMargarine DRINK/FAT Coffee w/nondairy creamer

Lunch DAY 1DAY 2 PROTEIN Tuna Salad made with EggsBeef patty STARCH BreadHamburger bun VEGETABLE CeleryLettuce, onions FRUIT PearPineapple FAT Mayonnaise SWEET CookiesApple Pie DRINK TeaLemonade

Dinner DAY 1DAY 2 PROTEIN Fried chickenGrilled Fish STARCH CornbreadYeast Roll VEGETABLE Squash (yellow), Green Beans Grilled Asparagus and Corn on the Cob FRUIT StrawberriesBlueberries FAT Margarine SWEET Pound cakeCheesecake DRINK Tea

References Roth, R. (2011). Nutrition & diet therapy. (10th ed.). Clifton Park, NY: Delmar. Schmidler, C. (2012). Renal diet for people with kidney failure or disease. Retrieved from care/renal-diet/