The major parts of the renal diet part 2 (micro nutrients)
The most important foods to control are those containing protein, potassium, sodium, phosphorous and fluid. Your dietitian will help you set up a meal plan which will contain the right amount of these nutrients for you, depending on body size, type of dialysis and medical condition. Protein and Potassium I covered in part 1
What is sodium?
Sodium is also an electrolyte. Sodium is important in the maintenance of normal water balance, nerve cell functioning and contraction of muscle. Healthy kidneys get rid of excess sodium in the urine. As kidney function slows down, sodium and fluids build up in your body
Sodium is found naturally in almost all foods. Salt is sodium chloride and is 40% sodium. Salt is found in most processed foods such as cheese, soup, luncheon meats, pickles, bacon, snack foods, tinned meat/fish, peanut butter, potato chips, olives, seasoning salt, soya sauce and “fast foods”.
It is wise to avoid these foods unless your dietitian advises you how to include them in your diet.
If you are just starting a low sodium diet, it will take a while for your taste buds to adjust to the new flavours. Your taste for salt will eventually disappear.
To help the food taste better, use herbs and spices as flavouring agents, e.g. garlic, dry mustard, mixed spices, pepper, thyme, onion, lemon, parsley, sugar, paprika and nutmeg.
What is phosphorous?
Phosphorous is a mineral, which combines with calcium in the body to keep our bones and teeth strong. When the kidneys become diseased, the body is unable to use calcium very well or remove phosphorous. When this happens, you may have too little calcium and too much phosphorous in the blood.
A symptom of high phosphorous may be itching. The body tries to correct this by taking calcium from the bones. If this is not treated, the bones will become weak.
It is important to control the phosphorous in your diet. Phosphorous is found in almost all foods, but it is especially high in milk, cheese, dried beans, liver, nuts, and dairy products.
It is impossible to get rid of all the phosphorous from the diet, so your doctor may prescribe a phosphorous binder such as an antacid (Amphogel) or a calcium supplement (Tritralac). These medications bind phosphorous and prevent it from being absorbed in the blood. The “bound-up” phosphorous passes out of the body through the stool. This helps keep your calcium and phosphorous in balance. It is important to take these medications with every meal.
Calcium is a mineral essential for bone development, growth, and maintenance. Main sources are milk and milk products.
Magnesium is a mineral essential for all living cells. It is vital in the formation of energy and protein, muscle relaxation and transport of nerve impulses. Main sources are green leafy vegetables, legumes, nuts, and whole-wheat foods.
As the nutritional needs of each person varies, specific vitamin/mineral supplementation must be determined and included in the diet prescription on an individual basis by the nephrologist and the renal dietitian.
What about fluids?
Healthy kidneys remove fluids as urine. When kidney function slows down, you make less urine and fluids build up in your body. When this occurs your hands and feet will swell, you may gain weight and perhaps feel short of breath. Your blood pressure may also go up. You will need to restrict your fluid intake.