Diet for chronic kidney failure

Renal failure is defined as the loss of the functional capacity of the nephrons. There are two types of renal failure: acute renal failure (ARF) and chronic renal failure (CRF).

The kidney is in charge of purifying the blood of our organism, expelling all the toxins and waste products in the form of urine to the outside. For this, it acts as a strainer, through which the molecules that have an adequate size pass (all the normal waste products) and the rest return to the blood.

When kidney function fails, substances that should not be excreted are excreted in the urine, and instead, others that should be expelled accumulate in the blood, such as creatinine and waste substances that cause damage to our body.

For this reason, an adequate diet is part of the treatment of renal failure. In the following video, I explain the principles that a diet for people with this  should have.

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Renal Failure Degrees

Creatinine is the substance used to quantify the degree of renal failure that is suffered, with the so-called glomerular filtration. The glomerular filtration rate is the volume of blood that is released from creatinine as it passes through the kidneys in one minute. The lower this is, the more kidney damage there is.

Chronic renal failure is a progressive and irreversible deterioration of renal function that leads to a chronic decrease in the glomerular filtration rate and/or renal damage with alteration of all renal functions.

Renal failure is considered when glomerular filtration is less than 60, stage 3, where the start of a dietary-nutritional intervention is mandatory. When glomerular filtration is very low and renal failure is irreversible, dialysis or kidney transplantation are necessary.

Stadium                                                                 Description                                                      F.G.

–                                                                           increased risk                                    > 60 with risk Factors

1                                                               Kidney damage with normal GFR                                >90

2                                                            Kidney damage with decreased GFR                             60-89

3                                                                 GFR moderately decreased                                      30-59

4                                                                   GFR severely decreased                                         15-29

5                                                                           Kidney failure                                        >15 or dialysis

Causes, complications, and symptoms of CKD

Diabetes is a common cause of CRF in developed countries. Renal involvement occurs after 10 years of the evolution of diabetes, although it manifests clinically at 20 years of age. Therefore, one of the therapeutic objectives of the therapy is to maintain HbA1c levels below 7%.

Another frequent cause is arterial hypertension (which, curiously, is also a possible complication of CRF), since an overload occurs in the entire vascular tree, producing a thickening of the vessel wall, giving excessive work to the glomerulus, and producing renal failure. It is necessary to maintain BP levels of 130/80 mmHg or 125/75 mmHg if more than one gram of protein is excreted in the urine. It is also necessary to maintain LDL levels below 100 mg/dl, TC levels below 175 mg/dl, and HDL levels above 40 mg/dl.

As part of its therapeutic objectives, it is also found to correct the associated complications, such as anemia and elevated levels of K and P in the blood. The ultimate goal is to achieve an optimal nutritional state while avoiding protein and energy malnutrition and obesity.

CRF can cause complications such as high blood pressure, anemia, weak bones, and nerve damage. It also increases the risk of cardiovascular disease.

The most characteristic symptoms of CKD are: feeling more tired and with less energy; difficulty concentrating, poor appetite, sleep problems; muscle cramps at night; swollen feet and ankles due to fluid accumulation; and more frequent urination, especially at night.

Eating in CRI

When you have CKD, it is important to reduce your protein intake since proteins have a high molecular weight (they are large molecules) and can affect the kidney (the strainer) more than it already does.

The meat ration should be 100–125 grams and the fish 140–150 grams (the size for a healthy person is around 200 grams).

As mentioned in the previous section, it is necessary to provide the necessary calories to avoid malnutrition and obesity.

Other things to keep in mind
In the absence of dyslipidemia (high blood triglyceride levels) and obesity, consume whole or semi-skimmed dairy since they contain a lower amount of phosphorus.
Include foods low in saturated fat, trans fat, and cholesterol in menus: olive oil; meat; and white fish.
Reduce the presence of: red meat, lamb, sausages, butter, pastry products and industrial pastries, ready meals, palm oil, coconut, and hydrogenated fat.
If fluid control is required. Control of breaths that are liquid at room temperature.
Exclude foods high in sodium.
Do not add table salt.
Salted foods, cured products, ready meals, shellfish, preserves, and pickles
Snacks
You go out of your routine.

Potassium is a mineral found in many foods we eat. Its function is to keep the heartbeat regular and the muscles functioning properly. The kidneys are responsible for maintaining the proper level of potassium in the body. When the kidneys fail, it is necessary to keep potassium within limits by restricting some foods that can increase potassium to dangerous levels.

If the potassium level is high, the symptoms that can be found are weakness, numbness, and tingling. If it is too high, it can cause a heart attack.

use of frozen vegetables,
Consumption of canned and cooked fruits
Desalted canned vegetables
Legume consumption once per week
Soaking technology for vegetables, mushrooms, and legumes
Double firing technology
Not recommended:
Fruits and nuts
Fruits: apricots, black grapes, black currants, bananas, avocados, coconut, and natural and commercial fruit juices.
Chocolate and chocolate milk derivatives
Whole-grain foods
diet food products
Natural and packaged fruit juices
Phosphorus in the IRC
Phosphorus is necessary for the formation of bones, among other functions.

Healthy kidneys are able to remove extra phosphorus from our bodies, but when suffering from CKD, the P is not removed properly.

High levels of P can harm our body as it causes the expulsion of calcium from the bones, making them weaker. Also, high levels of calcium and phosphorus can lead to dangerous calcium deposits in the blood vessels, lungs, eyes, and heart.

For these reasons, it is very important to keep P levels under surveillance.

Recommended:
½ servings of dairy a day.
Legumes as a single dish 1-2 times/week
Preferential consumption of white fish over blue
1-2 egg yolks per week
Not recommended:
Enriched milk, chocolate milk derivatives, spreadable, semi-hard, and hard cheeses
Fruits and nuts
Fresh and frozen peas, mushrooms, and mushrooms
Soy
Breakfast cereals: oatmeal, muesli, and pastries
egg pasta
entrails and gizzards
Smoked and salted fish, shellfish, crustaceans, and molluscs
Sweets: Pastry, confectionery, chocolate, and cocoa
Integral products
Sodium in CRF
When the kidneys are not healthy, sodium and fluid build up in our bodies. This can cause swollen ankles, swelling, increased blood pressure, shortness of breath, and/or fluid around the heart and lungs. It is necessary to reduce sodium in the diet.