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Certain lifestyle changes are part of the treatment plan for ESRD.

General Guidelines
Make Changes to Your Daily Diet

To make up for your reduced kidney function, you may need to make changes in your diet. A registered dietitian can help you. The most important nutrients for you to watch are:

Protein —Depending on your kidney function and treatment, you may need to limit or increase protein intake. Because your kidneys are not functioning properly, protein can build up in your blood. Eating less protein decreases strain on your kidneys. However, your body still needs protein. Your doctor will recommend a daily protein level and ask a dietitian to help you plan meals. If you begin hemodialysis or have a transplant , your protein needs will change.

Foods rich in protein include meats, poultry, and fish, as well as eggs, dairy products, soy products, and beans.

Fat and Cholesterol —A diet that is high in saturated and trans fat and cholesterol contributes to the formation of plaque in the arteries, which leads to heart disease. Choose a more healthful diet —foods that are low in cholesterol, saturated fat, and trans fat.

Sodium —Sodium contributes to fluid retention. Over the long-term, retaining excess fluid can increase your blood pressure and cause discomfort during dialysis . Try to decrease salt from both foods and fluids.

Potassium —Because your kidneys are not functioning properly, potassium may accumulate in your blood. High levels of potassium in the blood can be dangerous to your heart. Try to decrease the potassium in your diet .

Phosphorus (phosphates) —Because your kidneys are not functioning properly, phosphorus can also accumulate in your blood. Excess amounts of phosphorus interfere with bone metabolism and can weaken your bones. Phosphorus is found in many foods, making it difficult to limit in your diet. Instead, your doctor or dietitian may recommend that you take a phosphate binder, such as calcium carbonate, with your meals. Phosphate binders are included with medications .

Fluids —Excess fluid makes your heart work harder and can raise your blood pressure. Your doctor or dietitian will help you determine how much fluid you can have each day.

Check with Your Doctor Before Taking Over-the-Counter Drugs or Supplements

Over the counter (OTC) and herbal products may contain substances that can change your blood chemistry and harm your kidneys. Before you take any OTC drugs or dietary supplements, check with your doctor.

Take Medications as Ordered to Control Blood Sugar and Blood Pressure

If you have diabetes or hypertension , your doctor may order medications to control your condition. Always take these medications as directed. Do not stop taking them without consulting with your doctor.

Manage Emotional Issues with Support and Counseling

Counseling sessions with a mental health professional can improve your coping strategies for dealing with losses and limitations associated with this disease. Some patients find attending a support group helpful as well.

References:

Chronic kidney disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2013. Accessed July 2, 2013.

End-stage renal disease. National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://www2.niddk.nih.gov/Research/ScientificAreas/Kidney/KEB.htm. Updated September 15, 2010. Accessed July 2, 2013.



Last reviewed May 2014 by Adrienne Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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