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

Posted by carnes @carnes, Jun 11, 2018

It seems there is very little you can eat that is healthy for the Kidneys. The web site Davida has plenty of food on it but contradicts what other sources say. Anyone know anything for breakfast, lunch and dinner that does not have any sugar or flour bodies the obvious boring or bland foods good for Kidneys and I’m allergic to sugar of any kind of sweetener and flour. Thank you.

Here's part of what I'm currently working on for renal diets:

NO vs YES, A Guide To Kidney Friendly Foods:

iv INTRODUCTION

The NIH and the USDA are credible sources for nutrient value assays. It’s worth noting, however, that the USDA’s Global Branded Food Products Database includes values for some nutrients in branded and private label foods that appear on product labels which are provided by the food industry data itself.

Some USDA nutrient figures, including but not restricted to those confirmed by the manufacturers, might lead the researcher to conclude that at least a few common dietary recommendations/restrictions for renal patients could be inaccurate, depending on the type and stage of the disease process.

For instance, some kidney diets would have patients avoid tomatoes, green peppers (but not red ones,) pumpkin and other hard-shelled squashes, as well as dried beans, etc.

But a few tomato varieties do NOT contain unreasonable amounts of the minerals CKD patients need to restrict. Values are so low for, say, one small Roma tomato, it barely moves the needle on a 1000 to 1500 mg daily potassium limit recommended for some kidney diets.

Furthermore, green peppers have nearly identical nutrient values to red ones. Green peppers are just that: green, as in not ripe. Red ones are merely ripe green ones with slightly more sugar content due to the ripening. Neither needs to be avoided completely. In fact, the no-no values are so low that bell or sweet peppers can be chopped or sliced in small amounts to be added to almost any savory dish for extra body and flavor.

Pumpkin and all other squashes, especially hard-shelled, are relatively high in potassium. Should they therefore be forbidden? A cup of no-salt added pureed pumpkin is 16 tablespoons. Instead of using an entire cup, one might be able to use 1/4 cup or less safely, depending on permission from one’s renal care team. Smaller amounts still can provide binding in casseroles or baked goods or similar dishes prepared in the microwave and still can offer (albeit smaller amounts of) healthy nutrients without excessive amounts of minerals kidney patients need to restrict. If a renal cook measures carefully and uses maple sugar instead of refined white sugar, egg whites and/or applesauce for less or no actual egg, almond or coconut milk sparingly instead of dairy milk, in small portions a flour/water/healthy oil crust pumpkin pie topped with nondairy “whipped cream” might even be allowable.

Dried and canned shelled beans are high in phosphorus and potassium. Chickpeas are lower in those and 9 pecan halves are even lower. So are green beans.

v INTRODUCTION cont.

Therefore if a person with impaired kidney function craves chili, it’s possible to prepare meatless chili with beans by using an eighth of the amount of kidney beans called for in DIABETIC AND RENAL FRIENDLY VEGETARIAN-ALMOST-VEGAN RECIPES. A small number of chickpeas could account for another eighth, 9 coarsely chopped pecan halves might constitute another eighth, and no salt added green beans could provide the remaining five eighths. By adding half the amount of tomato sauce required and by extending its volume with pureed green (or red) bell pepper then adding the appropriate spices, a person might be able to sit down to a pretty tasty bowl of chili "analog."

Renal patients often are cautioned to limit consumption of potatoes but now some stores are carrying fresh, small potatoes with lower potassium content plus the home cook can peel, soak, and parboil then drain potatoes in order to consume small portions.

And there even are a few processed or ready-to-heat foods appropriate for a renal diet if taken in smaller-than-recommended servings, if eaten only occasionally, and if approved by one’s care team. Flavor and texture often are as important as, if not more important than, the serving amount.

Recommended amounts of nutrients, particularly protein and minerals such as phosphorus, potassium, and sodium, vary according to disease stage and pro-
gression and vary according to whether a person is pre-dialysis or receiving dialysis. Daily values for stages 1-3 CKD pre-dialysis recommended by the NIH are 800 to 1200 mg phosphorus, 1500 to 2700 mg potassium, 2000 to 3000 mg sodium, and 0.36 grams of protein per pound of body weight. Some care providers or experts recommend even less phosphorus, 700 to 800 mg a day, others less protein, as little as 35 grams daily, perhaps lower. The American Heart Association suggests using less sodium, 1500 mg or 1.5 grams a day instead of the common 2-gram daily recommendation.

Cooking sometimes modifies nutritional totals as well. Some USDA food values are for raw ingredients, others are for cooked servings.

Because manufacturers can change ingredients or amounts which then alter valuesfrom what someone previously might have read on product packages, it’s good tocheck labels before each purchase, maybe even to contact the companies.

At present food producers are not required to list phosphorus content on labels and many do not. But while some don’t assay phosphorus, quite a few do

vi INTRODUCTION cont.

know how much an item contains and usually will share that information with the consumer when asked.

It’s wise as well to try to find out how certain ingredients are processed. If a label says the product is vegan and is made with unbleached flour, it may very well be vegan but white flour sometimes is bleached using bone char. One brand of refrigerated pie crust claims to be “vegetable” yet whey from processing cheese is listed on the label and it is not noted as to whether the whey is from dairy milk or formed from yeast and sugar.

A certain kind of tortilla the manufacturer says is vegan contains enzymes which could be either plant or animal derived and the only way to learn which is to
inquire.

Since many renal patients often feel tired, most of the dishes in DIABETIC AND RENAL FRIENDLY VEGETARIAN-ALMOST-VEGAN RECIPES are fairly simple and relatively quick to prepare. Even those requiring a longer time to fix, like home-baked bread or maple bark, offer built-in rest times while the dough rises or the baked goods cook or cool.

Hy-Vee® store brands are among this writer’s preferred recipe ingredients but other brands can be used – check labels and/or contact manufacturers for nutrient values.

NO VS. YES lists nutrient amounts but recipes calling for such ingredients are suggestions only. Patients using this information are free to do so at their own risk and may share at will as long as it's understood that the writer is neither a physician nor a registered dietitian, just a CKD patient who likes to cook.

REPLY
@kamama94

Here's part of what I'm currently working on for renal diets:

NO vs YES, A Guide To Kidney Friendly Foods:

iv INTRODUCTION

The NIH and the USDA are credible sources for nutrient value assays. It’s worth noting, however, that the USDA’s Global Branded Food Products Database includes values for some nutrients in branded and private label foods that appear on product labels which are provided by the food industry data itself.

Some USDA nutrient figures, including but not restricted to those confirmed by the manufacturers, might lead the researcher to conclude that at least a few common dietary recommendations/restrictions for renal patients could be inaccurate, depending on the type and stage of the disease process.

For instance, some kidney diets would have patients avoid tomatoes, green peppers (but not red ones,) pumpkin and other hard-shelled squashes, as well as dried beans, etc.

But a few tomato varieties do NOT contain unreasonable amounts of the minerals CKD patients need to restrict. Values are so low for, say, one small Roma tomato, it barely moves the needle on a 1000 to 1500 mg daily potassium limit recommended for some kidney diets.

Furthermore, green peppers have nearly identical nutrient values to red ones. Green peppers are just that: green, as in not ripe. Red ones are merely ripe green ones with slightly more sugar content due to the ripening. Neither needs to be avoided completely. In fact, the no-no values are so low that bell or sweet peppers can be chopped or sliced in small amounts to be added to almost any savory dish for extra body and flavor.

Pumpkin and all other squashes, especially hard-shelled, are relatively high in potassium. Should they therefore be forbidden? A cup of no-salt added pureed pumpkin is 16 tablespoons. Instead of using an entire cup, one might be able to use 1/4 cup or less safely, depending on permission from one’s renal care team. Smaller amounts still can provide binding in casseroles or baked goods or similar dishes prepared in the microwave and still can offer (albeit smaller amounts of) healthy nutrients without excessive amounts of minerals kidney patients need to restrict. If a renal cook measures carefully and uses maple sugar instead of refined white sugar, egg whites and/or applesauce for less or no actual egg, almond or coconut milk sparingly instead of dairy milk, in small portions a flour/water/healthy oil crust pumpkin pie topped with nondairy “whipped cream” might even be allowable.

Dried and canned shelled beans are high in phosphorus and potassium. Chickpeas are lower in those and 9 pecan halves are even lower. So are green beans.

v INTRODUCTION cont.

Therefore if a person with impaired kidney function craves chili, it’s possible to prepare meatless chili with beans by using an eighth of the amount of kidney beans called for in DIABETIC AND RENAL FRIENDLY VEGETARIAN-ALMOST-VEGAN RECIPES. A small number of chickpeas could account for another eighth, 9 coarsely chopped pecan halves might constitute another eighth, and no salt added green beans could provide the remaining five eighths. By adding half the amount of tomato sauce required and by extending its volume with pureed green (or red) bell pepper then adding the appropriate spices, a person might be able to sit down to a pretty tasty bowl of chili "analog."

Renal patients often are cautioned to limit consumption of potatoes but now some stores are carrying fresh, small potatoes with lower potassium content plus the home cook can peel, soak, and parboil then drain potatoes in order to consume small portions.

And there even are a few processed or ready-to-heat foods appropriate for a renal diet if taken in smaller-than-recommended servings, if eaten only occasionally, and if approved by one’s care team. Flavor and texture often are as important as, if not more important than, the serving amount.

Recommended amounts of nutrients, particularly protein and minerals such as phosphorus, potassium, and sodium, vary according to disease stage and pro-
gression and vary according to whether a person is pre-dialysis or receiving dialysis. Daily values for stages 1-3 CKD pre-dialysis recommended by the NIH are 800 to 1200 mg phosphorus, 1500 to 2700 mg potassium, 2000 to 3000 mg sodium, and 0.36 grams of protein per pound of body weight. Some care providers or experts recommend even less phosphorus, 700 to 800 mg a day, others less protein, as little as 35 grams daily, perhaps lower. The American Heart Association suggests using less sodium, 1500 mg or 1.5 grams a day instead of the common 2-gram daily recommendation.

Cooking sometimes modifies nutritional totals as well. Some USDA food values are for raw ingredients, others are for cooked servings.

Because manufacturers can change ingredients or amounts which then alter valuesfrom what someone previously might have read on product packages, it’s good tocheck labels before each purchase, maybe even to contact the companies.

At present food producers are not required to list phosphorus content on labels and many do not. But while some don’t assay phosphorus, quite a few do

vi INTRODUCTION cont.

know how much an item contains and usually will share that information with the consumer when asked.

It’s wise as well to try to find out how certain ingredients are processed. If a label says the product is vegan and is made with unbleached flour, it may very well be vegan but white flour sometimes is bleached using bone char. One brand of refrigerated pie crust claims to be “vegetable” yet whey from processing cheese is listed on the label and it is not noted as to whether the whey is from dairy milk or formed from yeast and sugar.

A certain kind of tortilla the manufacturer says is vegan contains enzymes which could be either plant or animal derived and the only way to learn which is to
inquire.

Since many renal patients often feel tired, most of the dishes in DIABETIC AND RENAL FRIENDLY VEGETARIAN-ALMOST-VEGAN RECIPES are fairly simple and relatively quick to prepare. Even those requiring a longer time to fix, like home-baked bread or maple bark, offer built-in rest times while the dough rises or the baked goods cook or cool.

Hy-Vee® store brands are among this writer’s preferred recipe ingredients but other brands can be used – check labels and/or contact manufacturers for nutrient values.

NO VS. YES lists nutrient amounts but recipes calling for such ingredients are suggestions only. Patients using this information are free to do so at their own risk and may share at will as long as it's understood that the writer is neither a physician nor a registered dietitian, just a CKD patient who likes to cook.

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I guess because I'm new at this, it's all so confusing to me. I was a good cook but all these things confuse me. Like Vegan spread. What is that? I am writing alo t so I can remember how to do things. When I see the Kidney Dr.,do you think I'll be out on a different diet being I'm
Stage 3b? For now I think I'll make the salads and Omelets and eat fruit..I needed to loose wiegh but 60 lbs has come off so quick because of being afraid to eat.
What should I expect on first Dr. visit? Do they do blood work to find out where you are? If I'm Stage 4 by then, can I get back to stage 3?
And do you have to have kidney biopsy? I've had burst appendix and other surgeries but that scares me to death! Sorry for all the questions but wish I'd found this site three months ago when I was Stage 1.

REPLY
@jeanice

I guess because I'm new at this, it's all so confusing to me. I was a good cook but all these things confuse me. Like Vegan spread. What is that? I am writing alo t so I can remember how to do things. When I see the Kidney Dr.,do you think I'll be out on a different diet being I'm
Stage 3b? For now I think I'll make the salads and Omelets and eat fruit..I needed to loose wiegh but 60 lbs has come off so quick because of being afraid to eat.
What should I expect on first Dr. visit? Do they do blood work to find out where you are? If I'm Stage 4 by then, can I get back to stage 3?
And do you have to have kidney biopsy? I've had burst appendix and other surgeries but that scares me to death! Sorry for all the questions but wish I'd found this site three months ago when I was Stage 1.

Jump to this post

@jeanice, vegan spread is like butter only it's dairy free. https://www.smartbalance.com.

If you can go online and google vegan foods and google kidney-friendly foods you can reach various websites with information and many of them encourage you to print their information. There's a list of companies that offer kidney-friendly foods in the recipe collection i sent you – several foods and brands are vegan, several vegetarian, all kidney friendly. If you have a printer, you can download the recipe collection and print it out, it's free and people are encouraged to duplicate it. If you don't have a printer maybe you know someone who can print it out for you.

It's not unheard of to go back and forth between Stage 4 and Stage 3b, it's happened to me twice in 2 years and others have said it's happened to them.

I don't know what the new doctor will do but it's likely that you will have new blood work done to see where you are now. It would be unusual to order a kidney biopsy, at least the first visit, but I'm not saying that one positively would not be ordered, it's just not likely unless your doctor suspects kidney cancer or something similar. Many doctors will order an ultrasound or an MRI to visualize the kidneys first anywway.

Your new doctor may refer you to a dietitian. Don't be afraid to ask for a renal dietitian. If there isn't one in your area there are renal dietitians at many major hospitals and some are online. Some charge a fee, some do not. If there's a dialysis center near you, there might be a renal dietitian on the staff. Mayo Clinics have quite good diet tips and recipes for various stages of kidney illness and you can find these on the Mayo's website. Your doctor may give you a list of foods to limit or avoid or may not but a lot of kidney diet information is relatively easy to find, including in this group.

You've been diagnosed with a serious condition and it's entirely appropriate to be concerned. I know I was. But my doctors and nurses and the good people in this group encouraged me not to panic and reassured me that CKD can be dealt with. Remember that help is available and we are here for you.

REPLY

Thank you so much. You've been so helpful to me. I got plain yogurt and thought I could put some blueberries or pineapple in with it. Blueberries are my least favorite berry but with diverticulosis can't have seeds or nuts. I'm very careful about that. Did you say you have that too?

REPLY
@jeanice

Thank you so much. You've been so helpful to me. I got plain yogurt and thought I could put some blueberries or pineapple in with it. Blueberries are my least favorite berry but with diverticulosis can't have seeds or nuts. I'm very careful about that. Did you say you have that too?

Jump to this post

@ jeanice, you're very welcome. No diverticulosis, I have stage 3b CKD, diabetes, heart failure, COPD, and other things too boring to mention. Most people our age do have diverticulosis but not all of us have the inflammation of diverticulitis so I still can eat nuts and seeds. CKD patients can have applesauce and apples (I like them peeled and chopped and microwaved a few minutes with a little maple sugar and cinnamon,) tangerines or mandarin oranges, grapes, pineapple but I limit melons even though I like them due to their higher mineral contents. A dietitian told me that I can have a small bite or two of almost anything, I just need to watch how much and watch combinations and keep track of what I'm eating has how much of whatever I need to limit. Sounds harder than it is.

REPLY

I sure miss Boysenberries, Blackberries and especially Strawberries.. And most Nuts.
I have always been a binge eater, if one is good, then ten more is better. This is a real challenge for me like probably everyone else. I did get a big shock tonight! I ate a big teaspoon of low fat plain yogurt.
I was in shock how awful it was! And I know why….no sugar. So I added pineapple and blueberries and got it down. Yes, this will be a challenge.

REPLY

@jeanice, I admire your determination and your desire to learn ways to help your kidneys. You are one brave and determined person! I am not on a restricted diet since my kidney and liver transplant. But I sure was beforehand while I was on dialysis. I wish I could remember what I ate, but that was 10 years ago. I think that as you get accustomed to these new tastes, that you will wonder how you ever ate any other way.
Keep up the good work. I hope that your next labs reflect your efforts.

REPLY
@rosemarya

@jeanice, I admire your determination and your desire to learn ways to help your kidneys. You are one brave and determined person! I am not on a restricted diet since my kidney and liver transplant. But I sure was beforehand while I was on dialysis. I wish I could remember what I ate, but that was 10 years ago. I think that as you get accustomed to these new tastes, that you will wonder how you ever ate any other way.
Keep up the good work. I hope that your next labs reflect your efforts.

Jump to this post

Thank you so much. It sounds like you've been through alo t and I'm glad your transplants have worked for you. Since I see the Kidney Dr. Next week, I'm very nervous. I'm hoping I'm not Stage 4. I haven't been on the diet too long but will be glad when I know where I am.

REPLY
@jeanice

Thank you so much. It sounds like you've been through alo t and I'm glad your transplants have worked for you. Since I see the Kidney Dr. Next week, I'm very nervous. I'm hoping I'm not Stage 4. I haven't been on the diet too long but will be glad when I know where I am.

Jump to this post

@jeanice, Be a patient patient! You are moving in a good direction. And our bodies do take time to adjust to shanges. I understand your being nervous in anticipation of your kidney doctor. I have found a video – "Effectively managing chronic kidney disease" that I want to share with you. I hope that it gives you some more information about kidneys in preparation for your visit.
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/multimedia/vid-20209090
I do not have any 1st hand diet information to share with you since my kidneys failed suddenly and I followed special eating plan. I am happy to follow this conversation as @kamama94 is so generously sharing her recipies.
I am going to be thinking of you and hoping for an informative and productive visit.

REPLY
@rosemarya

@jeanice, Be a patient patient! You are moving in a good direction. And our bodies do take time to adjust to shanges. I understand your being nervous in anticipation of your kidney doctor. I have found a video – "Effectively managing chronic kidney disease" that I want to share with you. I hope that it gives you some more information about kidneys in preparation for your visit.
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/multimedia/vid-20209090
I do not have any 1st hand diet information to share with you since my kidneys failed suddenly and I followed special eating plan. I am happy to follow this conversation as @kamama94 is so generously sharing her recipies.
I am going to be thinking of you and hoping for an informative and productive visit.

Jump to this post

Thank you for your reply. I sure do need patients! I guess the best thing I need to do is wait and see what the Kidney Dr. says
And try and call down.

REPLY

VERY IMPORTANT! A few people have asked me about carb counting relative to my recipe collection. Thanks for asking! According to several reliable sources, including information from the NIH, NIDDK, and the ADA, contrary to popular belief, a diabetic diet is not necessarily a low-carb diet, nor should it be a high-protein or very low-fat meal plan. In fact, ADA recommends less emphasis on specific requirements for proteins, carbs, and fats, and more emphasis on following a whole foods approach that focuses on the quality of your diet. Feel free to copy this post and add it to your copy of the recipes.

REPLY
@kamama94

Nice to meet you! Sorry about the abbreviations. Na=sodium, K=potassium, P=phosphorus. Glad you're doing well!

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I agree. Just some breakfasts that I can stomach. Tomorrow I go for my first appt. to the Kidney Dr. I have severe panic attacks and anxiety so I am a nervous wreck to see were I stand. Also I have found a lump on my left side between the ribs.It's started to really
bother me. Please wish me luck.

REPLY
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