Stage 3 Kidney Disease and Diet: What can I eat?

If you have protein in your urine, it is for sure CKD. Otherwise, dr. might have said your numbers were normal based on your age.

@czsalt64, I think you are referring to an old, old post of mine. I got shingles in late 2019 and tanked my kidney function to an eGFR of 8 - went into end stage kidney failure! - and had to go on dialysis in Aug of 2020. Made/still making a very slow recovery from the shingles damage and was able to stop dialysis in Dec of 2020. Now, in 2021, eGFR up to 19 and still improving, BUN and creatinine slowly coming back down. I feel much better, too. Part of the reason I'm alive today is a great primary doc and a great neprologist but another reason is my almost-vegan, ovovegetarian renal diet. The latest recommendation for sodium intake is 1.5 grams or 1500 mg daily but some specialists are saying it should even be reduced further. I happen to get severe cramps if I take in much less than 1500 mg and my potassium is below what it should be. 80 mg of furosemide daily is partly responsible for the salt cramps and potassium cramps and neph has said I can slightly increase the potassium. She did NOT tell me to increase my sodium but I have done that anyway, though very slightly, and no longer have the cramping. I certainly do not recommend increased or decreased sodium or potassium to others, just saying what is working for me.

So glad you found us! Lots of good people here and lots of good info. Don't hesitate to reach out. Welcome!

Holy COW!! that is awesome!! When I read these amazing stories, like the one you just told I am just in awe. My mom fought a rare stomach cancer for three years and she should have been dead in 3 months, so I know that with determination and hope, all is possible. Thanks for the diet advice. I am spilling protein, so even though I do not have high BP I was put on an ACE and that seems to be holding it back for now, but I am really paying attention to diet too. I plan to talk to a renal dietian in a couple of days, so I am curious to know what they will say, and I hope the hell they look over my blood work before the appointment.

@czsalt64 The 3000 mg sodium limit is the old (2018) recommendation for Stage Three CKD. The latest I have heard (as of August 2021) is 1500 mg or less for Stage Four CKD patients. Some kidney websites quote different amounts but what works for me personally is between 1500 and 2000 mg Na daily (including what occurs naturally in whole foods as well as - carefully used - processed foods.) If I am especially active and weather is hot, causing increased sodium loss through perspiration, I can tolerate the higher value. In such a case of perspiration loss of Na, the kidney is not called upon to excrete that which is lost through perspiration, therefore I am comfortable with a slight increase. However, I do not personally recommend ANY values, I merely share what my research shows the experts are saying and I share my own personal experience. Oh, please forgive me for a terrible pun, LOL, but we should take everything with a grain of salt. (Sorry, couldn't help myself.)

NOt a doc either haha, but we all know ourselves the best.

@kamama94 posted this comment in another thread within this group, and it fits in with our talking here.

"@gingerw, not sure where to post this info I found this AM and not positive it was DaVita but here goes: Most kidney diets start with a goal of 1,500 to 2,000 mg per day or the amount recommended by your doctor or dietitian. The sodium recommendation for stage 4 CKD is 1,000-4,000 mg/day based on fluid balance, blood pressure and other diseases that may affect sodium requirements.(DaVita?)"

What are your thoughts? How closely do you watch your daily sodium intake? While I admit to an occasional binge on tortilla chips [with red pepper hummus!], I do not watch too many labels on food, since we eat few packaged foods. For me, even low-fat cottage cheese tastes salty, as does celery! My last lab result for sodium had me within normal range, for me.
Ginger

@gingerw, your comment about celery mirrors my own experience. The less salt I use the more I notice the natural saltiness of foods, especially celery. Am in the process of re-checking recommended amts of various minerals for stage 4 CKD and will send you what I find out.

From DaVita for Stage 3:
1. Count your calories.

Adequate calories can either prevent weight loss if you’re at a desirable weight or provide extra calories if you are underweight. Weigh yourself often and keep track to see if you need additional or fewer calories. Your dietitian will determine a desirable weight and monitor your progress.

2. Eat the right kinds of fats.

If you have cardiovascular disease or your blood cholesterol is high, unhealthy fats—such as saturated fats and trans-fats—should be replaced by poly- and monounsaturated fats from vegetable oil, canola oil and olive oil. A limit on high cholesterol foods is recommended.

3. Watch for symptoms of fluid retention.

Fluid is not restricted in stage 3 CKD unless you experience fluid retention. Sudden weight gain, shortness of breath, swelling in the feet, hands and face and high blood pressure are signs of fluid retention. These symptoms may indicate a decline in kidney function and decreased urine output.

4. Reduce your phosphorus intake.

A diet with no more than 800 mg of phosphorus can help reduce the risk of too much phosphorus building up in your blood. Limit intake of foods with high levels of phosphate or phosphate additives such as organ meats, whole grain breads, processed foods, cola beverages, cheese, dried beans, liver, peanut butter, dairy products and chocolate.

5. Monitor your potassium levels.

Usually, potassium is not restricted in stage 3 CKD unless lab tests show potassium is too high. Your doctor may make medication changes or prescribe a low-potassium diet. Reduce an elevated potassium level by limiting some high-potassium foods and potassium chloride (found in salt substitute and many low-sodium processed foods), such as avocado, bananas, cantaloupe, honeydew, legumes, milk, nuts, potatoes, seeds, tomato products and yogurt.

6. Know your recommended daily intake of protein.

The recommendation for protein intake in stage 3 is 0.8 g/kg body weight, the same recommendation for a healthy 150-pound adult. Whether your doctor recommends a high- or low- protein diet, it’s important to make sure your protein intake comes from high-quality sources such as egg whites, fish, poultry, meat, soy and small of amounts of dairy.

People on vegetarian and vegan diets may find it easier than meat eaters to limit protein in their diet, but will need to monitor their phosphorus and potassium intakes more closely.

7. Decrease your sodium intake.

Limiting salt and high-sodium foods reduces hypertension, assists blood pressure medications to work more effectively and treats fluid retention. The sodium recommendation for stage 3 CKD is 1,000 to 4,000 mg/day. Speak with your doctor or dietitian to determine your recommended daily amount.

For Stage Four CKD https://www.davita.com/diet-nutrition/articles/advice/stage-4-kidney-disease-diet-focusing-on-nutrition

I also don't know what I can eat, so reading yours does help.I was about to cry, but I need to investigate this diagnosis more. Thanks for helping me realize there are foods that are acceptable.