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.

@rosemarya

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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Need more info about the webinar. is there a fee? Is it time limited? Not sure if I can attend, depends on when.

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@rosemarya

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.

Jump to this post

It is Free
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
To register: Click on this link.
Click on the Blue Register Box.
Fill in the information (I chose to use only the required fields). And there is a place to ask questions.
At the end you will clink (another) Register Box.

You will receive an email verifying that you have registered. And there are instructions for how to join the webinar on Nov. 28. You will listen and view on your computer.

I hope this helps you to register. This is new for a lot of us! It should be a fun learning experience in both health and technology:-)

kamama, let me know if you have any more problem with registering. I am new at this, too:-)

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@rosemarya

It is Free
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
To register: Click on this link.
Click on the Blue Register Box.
Fill in the information (I chose to use only the required fields). And there is a place to ask questions.
At the end you will clink (another) Register Box.

You will receive an email verifying that you have registered. And there are instructions for how to join the webinar on Nov. 28. You will listen and view on your computer.

I hope this helps you to register. This is new for a lot of us! It should be a fun learning experience in both health and technology:-)

kamama, let me know if you have any more problem with registering. I am new at this, too:-)

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@rosemarya Thanks!

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Have been researching dairy substitutes and so far I have found that rice milk is lower in oxalates than my usual almond milk but higher in potassium and phosphorus. 1 C almond milk has 35 mg K or just under 2 % recommended intake for CKD patients and 20 mg P or 2 % of the recommended amount. On the other hand, 1 C rice milk has 64.8 mg K or about 3 % of the recommended intake and 144.4 mg P or 14 %. I'm thinking the lower-oxalate rice milk might be a better choice for someone with a history of kidney stones as long as the potassium and phosphorus intake from other food sources is reduced so the total daily limits aren't exceeded. I haven't counted calories or carbs here. I would appreciate others' opinions and feedback.

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Vegan Side Salad:
Lettuce, red leaf 1 C 52.4mg K, 7.8mg 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
½ C radish slices 135 mg K, 11.6 mg P
Daiya non-dairy ranch flavor dressing 10 mg K 0 mg P
Total 238.6 mg K, 26.6 mg P
Adding non-dairy mozzarella flavored shreds or non-dairy parmesan flavored sprinkles increases K by 20 mg and P by 20 mg for total of 258 mg K, 46.6 mg P

Check with renal care provider(s) to see if ok for you. Let me know if you find any mistakes.

Liked by Jamie Olson

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@kamama94

Have been researching dairy substitutes and so far I have found that rice milk is lower in oxalates than my usual almond milk but higher in potassium and phosphorus. 1 C almond milk has 35 mg K or just under 2 % recommended intake for CKD patients and 20 mg P or 2 % of the recommended amount. On the other hand, 1 C rice milk has 64.8 mg K or about 3 % of the recommended intake and 144.4 mg P or 14 %. I'm thinking the lower-oxalate rice milk might be a better choice for someone with a history of kidney stones as long as the potassium and phosphorus intake from other food sources is reduced so the total daily limits aren't exceeded. I haven't counted calories or carbs here. I would appreciate others' opinions and feedback.

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kamama94, I am curious – Is there any variation between different brands/manufacturers?
While I am not a diabetic patient, I do try to comparison shop and sometimes see variations between brands.

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@rosemarya Yes, different brands have different amounts of potassium, for instance, or phosphorus.

One of the things I look for, especially if the nutrition label doesn't list potassium or phosphorus, are things like phosphates and/or potassium as preservatives.

The SELF nutrition data site lists some brands and so does the USDA site.

And I personally have contacted Healthy Life bread company, Daiya Foods, Go Veggie company, and others to ask for additional nutrient data and those companies in particular have been very cooperative. Some non-dairy items contain coconut or coconut milk so I always check an item's ingredients list since coconut milk contains oxalates as well as potassium and a little goes a long way. My local grocer also has been very willing to contact his store brand manufacturers for me in regard to ingredients and per cents.

I have worked for months developing a list of minerals such as sodium, potassium, and phosphorus in various food items and it's been quite an adventure, very labor intensive.

One of the things I've learned is that if a product lists a per cent of daily value, that's for "normal" people who can metabolize potassium and phosphorus more efficiently than someone with CKD. I go by mg and divide by 2000 2000 daily mg allowed for stage 3 CKD) to get the per cent for a renal patient and divide the mg of phosphorus by 1000 (1000 mg for stage 3.

TMI, sorry. I get started on one of my favorite subjects and don't know when to stop.

It can get really complicated which is why the websites I've listed previously are such a useful tool.

Liked by Jamie Olson

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A new problem has arisen. While I know that my osteoporosis is a serious problem, I also have to balance whatever I do with the health of my remaining kidney. My rheumatologist wishes to start me on Prolia (denosumab). I'm delighted that Blythe Danner is happy with the product, but is it right for my kidney. I've read some negative comments about Prolia under the discussion on osteoporosis, but right now, it's my kidney that I'm concerned about. So, if anyone has any comments, I'd be most interested.

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@trishanna

A new problem has arisen. While I know that my osteoporosis is a serious problem, I also have to balance whatever I do with the health of my remaining kidney. My rheumatologist wishes to start me on Prolia (denosumab). I'm delighted that Blythe Danner is happy with the product, but is it right for my kidney. I've read some negative comments about Prolia under the discussion on osteoporosis, but right now, it's my kidney that I'm concerned about. So, if anyone has any comments, I'd be most interested.

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@trishanna I’m diabetic, have CKD stage 3-4 and osteoporosis too. My endocrinologist put me on Prolia because it is the least problematic for kidneys. That is what my doctor said and my nephrologist agreed. My new problem is that my insurance doesn’t cover it anymore. For the past 6 years they have but next year they won’t. My next injection is due in January. I also have a diabetes medication that isn’t covered. Their suggested alternatives are not supposed to be used by people with the GFR that I have. ☹️

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@cehunt57

@trishanna I’m diabetic, have CKD stage 3-4 and osteoporosis too. My endocrinologist put me on Prolia because it is the least problematic for kidneys. That is what my doctor said and my nephrologist agreed. My new problem is that my insurance doesn’t cover it anymore. For the past 6 years they have but next year they won’t. My next injection is due in January. I also have a diabetes medication that isn’t covered. Their suggested alternatives are not supposed to be used by people with the GFR that I have. ☹️

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Oh crap…I’m stage 4 and seeing a doc in February for osteoporosis…I’ve been thinking about the same thing as you…I’m way more concerned about my kidneys than I am about my old bones! I’ll be keeping an eye on your post….good luck! Dang insurance!

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Hey, everyone, osteoporosis and stage 3-4 CKD also. I have Part D Medicare but the co-pays on my insulin and other meds are horrendous. Never thought I'd say this but being in a wheelchair might be an advantage for me now, less chance of stress fracture. (Forgive my awful sense of humor.)

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@kamama94

Hey, everyone, osteoporosis and stage 3-4 CKD also. I have Part D Medicare but the co-pays on my insulin and other meds are horrendous. Never thought I'd say this but being in a wheelchair might be an advantage for me now, less chance of stress fracture. (Forgive my awful sense of humor.)

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@kamama94 My doctor and diabetic nurse switched me to an insulin pump in August. When you are on the pump, your insulin is covered by Part B instead of Part D. It might be worth checking into.

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@marvinjsturing

@kamama94 My doctor and diabetic nurse switched me to an insulin pump in August. When you are on the pump, your insulin is covered by Part B instead of Part D. It might be worth checking into.

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@marvinjsturing, Thank you, good idea. A friend has one but I was under the impression there were co-pays for the pump. Will ask primary about this.

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@cehunt57. You mentioned no side effects for the six Years you've been on Prolia. I shall take that as good news. The insurance bit is really beyond my understanding – it makes no sense. Hope there's a solution for you. @sissieann. I feel exactly the same as you do – I'll take a chance on breaking a bone, but am not prepared to risk my kidney!!!

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Kamama94, my husband has had CKD for 20 years and it is a struggle to keep up with current nutrition guidelines. We were also told to stay away from whole grain breads, sourdough bread was recommended by our nutritionist and that is where we are now, spinach is ok raw but not cooked, sweet potatoes and Irish potatoes are better if leeched (boiling then soak, pour water off and repeat) my husband loves potatoes. We have switched to light salt for years and seem to be working. Our problem now he was in ICU and has lost a good bit of lean body mass, to regain muscle he has to up his protien intake as well as exercise to regain his LBM and strength, I’m wondering if vegan protein supplement would be better than the whey protein. We have increased his meat consumption also

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