Confused About Diet for Stage 3 or 4 Chronic Kidney Disease (CKD)

Posted by wietop @wietop, Dec 13, 2017

I was diagnosed with Stage 3 CKD four years ago, but my doctor didn’t tell me. When he retired and I had to find a new doctor is when I found out. I’m new to this and completely confused when it comes to diet. I am currently eating a sandwich for lunch, made with Ezekiel Low-Sodium bread, which is sprouted whole grain bread. In my research I have found some sites that say never eat whole grain bread, while others say you can eat it with no problem. My doctor has told me I don’t need to change my diet, but, as you can imagine, my trust factor is pretty low right now. I’m trying to find some solid information about which breads I should avoid and which ones are okay.

@trishanna

Ah, we're off to Chicago for Thanksgiving and the only food anyone eats there is pizza. How to manage food when one is eating every meal out is my question. I find this discussion extremely interesting but do not understand why my nephrologist seemed totally disinterested in discussing food. Shall take all your comments with me when I check in with a dietitian.

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Help is available! You (we)are not alone in this struggle.
I think it is a great time of the year to recativate the discussion – Fighting Holiday Blues Food Problems
https://connect.mayoclinic.org/discussion/fighting-holiday-blues-food-problems/
Who wants to go first!

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@rosemarya

Hi, all. Good Morning. You have me thinking and searching👀 on this Monday morning.
I want to add to thyis conversation by sharing what I have found!
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521
How kidneys work
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/multimedia/how-kidneys-work-video/vid-20207497
Low-phosphorus diet: Helpful for kidney disease? Includes a table of high and low phosphorus foods.
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/expert-answers/food-and-nutrition/faq-20058408
Effectively managing chronic kidney disease
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/multimedia/vid-20209090
Renal diet for vegetarians
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/expert-answers/renal-diet/faq-20058205
I am anxious to hear what you read that will be useful to your own situation. Remember that we are all individuals and our needs are different (as is mentioned in several of these resources).
I hope we can all learn as we learn and share ways to eat healthy and to take care of our kidneys.

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Re renal diet link, vegetarian renal diet
I noticed that beans are recommended here as well as soy. Because of high potassium content, I've been told to avoid beans. I also noticed that there's no mention of non-dairy cheese flavored products, most of which are vegetarian and many actually vegan and which my own nephrologist approved for me in stage 3 CKD.

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@rosemarya

trishanna, I want to suggest that you take a look at this link. There is a easy-to- read chart that you could copy and take with you for easy reference.
Low-phosphorus diet: Helpful for kidney disease? Includes a table of high and low phosphorus foods.
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/expert-answers/food-and-nutrition/faq-20058408
What do you think?

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@rosemarya. To say I'm surprised at what is or is not included in a low-phosphorous diet is to put it mildly! No one said word one to me about diet, not even my nephrologist. It's going to be a bit of a problem to find substitutes for some of these items, particularly milk and meat, but was already planning to see a dietitian. Now at least I'll have some idea of what my problems are. Bit difficult to substitute easily with product availability limited where I live. If anyone has suggested convenience food products that would work, I'd love to know about them. Cooking for me is somewhat of a problem and we do depend on convenience and/or restaurant foods to help! BTW, long before this conversation, I've been complaining about "fluids" added to our local fresh meat products. Butcher's tell me it's to enable a longer shelf life, but on a purely esthetic and taste level, I find these additions to be unacceptable.

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@trishanna

@rosemarya. To say I'm surprised at what is or is not included in a low-phosphorous diet is to put it mildly! No one said word one to me about diet, not even my nephrologist. It's going to be a bit of a problem to find substitutes for some of these items, particularly milk and meat, but was already planning to see a dietitian. Now at least I'll have some idea of what my problems are. Bit difficult to substitute easily with product availability limited where I live. If anyone has suggested convenience food products that would work, I'd love to know about them. Cooking for me is somewhat of a problem and we do depend on convenience and/or restaurant foods to help! BTW, long before this conversation, I've been complaining about "fluids" added to our local fresh meat products. Butcher's tell me it's to enable a longer shelf life, but on a purely esthetic and taste level, I find these additions to be unacceptable.

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I never tolerated milk well, only cooked with it. Then when I found out about having CKD I switched to kidney-friendlier unsweetened almond milk to cook with. Other than that it tends to thicken during cooking, I can't tell the difference. I even drink a half-cup now and then and find it tastes quite good.

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@trishanna

@rosemarya. To say I'm surprised at what is or is not included in a low-phosphorous diet is to put it mildly! No one said word one to me about diet, not even my nephrologist. It's going to be a bit of a problem to find substitutes for some of these items, particularly milk and meat, but was already planning to see a dietitian. Now at least I'll have some idea of what my problems are. Bit difficult to substitute easily with product availability limited where I live. If anyone has suggested convenience food products that would work, I'd love to know about them. Cooking for me is somewhat of a problem and we do depend on convenience and/or restaurant foods to help! BTW, long before this conversation, I've been complaining about "fluids" added to our local fresh meat products. Butcher's tell me it's to enable a longer shelf life, but on a purely esthetic and taste level, I find these additions to be unacceptable.

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trishanna, You are making a good choice by making an appointment with nutritionist. My suggestion, if I might add it, is to go to someone who is knowledgeable about specifics related to kidneys. Perhaps your nephrologist can suggest someone.
I hope that you can learn about the dietary adjustments that will fit into your own life situation as well as your own kidney issue and any other contributing health concerns.
One thing that I have learned over the years, is that we are not a 'one size fits all'. As we share and learn with each other we can also go to our appointments loaded with questions and hopefulky improved lab results. My current situation is that I am trying to become better aware of foods so that I can make better choices.

Trishanna, I will be interestd to hear what your nutritionist suggests about convenience and/or rrstaurant foods that you (and many of us) depend on. I hope to hear from you soon.

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Can't remember if I posted this here or somewhere else, if it's a repeat please forgive me,
Please check for errors, always read labels, ask renal care providers if ok to eat.
Mac & cheese:
1 C cooked macaroni-approx ½ C dry (61.6 mg K, 81.2 mg P)
¼ C chopped onion (29.3mg K, 7.3mg P)
1 C non-dairy mozzarella flavored shreds (40 mg K, 40 mg P)
Sauté onion in sm amt EVOO, drain, stir into mac, stir in 1 C shreds, micro 1-2 min to melt
Total 140.9 mg K (7 %) 128.5 mg P (13 %)

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Vegan spaghetti w/ meat-free crumbles & no-salt tomato sauce:
2 C cooked angel hair pasta (123.2 mg K, 162.4 mg P)
¼ C microwaved meatless crumbles (95 mg K 148.7 mg P)
¼ C chopped onion (29.3 mg K, 7.3mg P)
1 clove garlic, minced (12 mg K, 4.6mg P)
¼ C No-Na tm sce 226.2 mg K, 19.5 mg P
Sauté onion & garlic in sm amt EVOO
Add crumbles
Add sauce
Stir into pasta
Total 485.7 mg K (24 %) 342.5 mg P (34 %)

Liked by sissieann

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I’ve been wanting spaghetti….sounds so gooood…..help….where do I find “crumbles” and is the red sauce any “brand” tomato sauce….thxs

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@kamama94

Can't remember if I posted this here or somewhere else, if it's a repeat please forgive me,
Please check for errors, always read labels, ask renal care providers if ok to eat.
Mac & cheese:
1 C cooked macaroni-approx ½ C dry (61.6 mg K, 81.2 mg P)
¼ C chopped onion (29.3mg K, 7.3mg P)
1 C non-dairy mozzarella flavored shreds (40 mg K, 40 mg P)
Sauté onion in sm amt EVOO, drain, stir into mac, stir in 1 C shreds, micro 1-2 min to melt
Total 140.9 mg K (7 %) 128.5 mg P (13 %)

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Me again…where did you find the “non-dairy mozz flavored shreds? Thxs

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@sissieann

I’ve been wanting spaghetti….sounds so gooood…..help….where do I find “crumbles” and is the red sauce any “brand” tomato sauce….thxs

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Here are some of the ingredients I use in many of my meals:

Morning Star Farms
Veggie Sausage Patties 120 mg K 107 mg P 260 mg Na
Grillers Original 130 mg K 124 mg P 260 mg Na
Chik’n Strips 110 mg K 105 mg P 510 mg Na
Meal Starters Grillers Crumbles 100 mg K 4 1 mg P 240 Na
America’s Original Veggie Dog 60 mg K 165 mg P 580 mg Na
America’s Original Corn Dog 60 mg K 139 mg P 500 mg Na

Go Veggie Cheese
Go Veggie cheddar & provolone flavor slices
10-15 mg K (0%) 180-200 mg P (11%) 200-240 mg Na
Vegan Cream Cheese 8 – 50 mg 40 – 50 mg

Daiya Cheese
Plain Cream Cheese Spread 5 mg K 20 mg P
Mozzarella Style Shreds 20 mg K 20 mg P
Cheddar Style Slices 15 mg K 20 mg P
Dairy-Free Homestyle Ranch Dressing 10 mg K 0 mg P

The tomato sauce I use (very sparingly) is a sodium free store brand but Hunt's also makes one.

Since I'm homebound (not related to CKD) I order all my groceries from a regional store, Hy-Vee, and either have them delivered or one of my caregivers picks them up.

I'm still having trouble posting links and have not heard back from any of the moderators but you could google Morningstar Farms, Go Veggie and Daiya to find their pages online, each has a tool to find where their products can be found in your area.

There are other brands of vegan and vegetarian meat and cheese substitutes but these are my favorites.

I would appreciate it if you could check my math and my values and correct any errors I might have made. Also, if you try a recipe and it doesn't work for you, feel free to tell me.

Happy cooking!

Liked by sissieann

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@sissieann

Me again…where did you find the “non-dairy mozz flavored shreds? Thxs

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Go Veggie and Daiya foods both make cheese-flavored substitutes. I think WalMart carries some of these.

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I want to share the following information that a member just now shared with me.

Webinar – Eating healthy with diabetes and kidney disease
Wednesday, November 28, 2018 from 1:00 – 2:00 p.m. EST
Speaker: Lori Martinez-Hassett, RD, CSR,
Topics: Diabetes • Diet • ESRD • Nutrition

http://www.kidneyfund.org/training/webinars/eating-healthy-with-diabetes-and-kidney-disease.html

If you are interested in attending this webinar, you will need to register. There is a place to add your own comments and/or questions. @sissieann, @trishanna, @spiritualgangster, @wietop, @predictable, @kamama94

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As always, check with your renal care team beforehand and feel free to tell me about any errors in this recipe. Since it's so low in potassium and phosphorus, I often double the serving.
Vegetarian Omelet with cheese and veggies 189 mg K (9 %) 70.4 mg P (7 %)
Egg Beater ¼ C 127.8 mg K, 43.2 mg P
Daiya non-dairy mozzarella-flavored shreds 20 mg K, 20 mg P
1 T chopped onion 24.9 mg K 5.3 mg P 1
T chopped bell pepper 16.3 mg K, 1.9 mg P
Sm amt EVOO
Saute onion and bell pepper in sm amt EVOO in small skillet or in nonstick skillet without EVOO, remove and drain, turn heat to low
Pour 1 svg Egg Beater into pan and cook slowly, lifting up edges to allow uncooked egg to run underneath
Sprinkle pepper and onion over cooked egg, top with mozzarella shreds
Fold over and remove omelet to plate
For those who don’t tolerate bell pepper and/or onion, celery can be substituted 27 mg K 2.3 mg P

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I've noticed that many low-K and low-P foods also are low in oxalates and vice versa. So far the renal vegetarian diet I follow seems to be helping to slightly improve renal function. I'm wondering if there are any further dietary considerations which might enhance more improvement. With my hx of kidney stones I'm curious about the relationship of oxalates and potassium and phosphorus. Anybody have some info or ideas?

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@kamama94

I've noticed that many low-K and low-P foods also are low in oxalates and vice versa. So far the renal vegetarian diet I follow seems to be helping to slightly improve renal function. I'm wondering if there are any further dietary considerations which might enhance more improvement. With my hx of kidney stones I'm curious about the relationship of oxalates and potassium and phosphorus. Anybody have some info or ideas?

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Here is a related discussion in the Diabetes and Endocrine Group.
https://connect.mayoclinic.org/discussion/healthy-eating-for-diabetics-with-kidney-disease/
Someone there might have some additional insight about this question.
Have you registered for the webinar – Eating Healthy with Diabetes and Kidney Disease? When you register, you are given an opportunity to post questions. I think that this is a good question.

@retiredteacher and I are both participating in the webinar, and we hope that you will join our after-webinar conversation there.

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