Renal failure (also kidney failure or renal insufficiency) is a medical condition in which the kidneys fail to adequately filter waste products from the blood.[1] The two main forms are acute kidney injury, which is often reversible with adequate treatment, and chronic kidney disease, which is often not reversible. In both cases, there is usually an underlying cause.
Renal failure is mainly determined by a decrease in glomerular filtration rate, the rate at which blood is filtered in theglomeruli of the kidney. This is detected by a decrease in or absence of urine production or determination of waste products (creatinine or urea) in the blood. Depending on the cause, hematuria (blood loss in the urine) and proteinuria (protein loss in the urine) may be noted.
In renal failure, there may be problems with increased fluid in the body (leading to swelling), increased acid levels, raised levels of potassium, decreased levels of calcium, increased levels of phosphate, and in later stages anemia. Bone health may also be affected. Long-term kidney problems are associated with an increased risk of cardiovascular disease.
What is a renal failure diet?
A renal failure diet controls the amount of protein and phosphorus in your diet. You may also have to limit calcium, sodium, and potassium. A renal failure diet can help decrease the amount of waste made by your body, which can help your kidneys work better. It may also help to delay total renal failure. Your diet may change over time as your health condition changes. You may also need to make other diet changes if you have other health problems, such as diabetes.What kind of changes do I need to make on a renal failure diet?
You will need to limit the amount of protein you eat to help decrease waste in your blood. Foods that are high in protein are meat, poultry (chicken and turkey), fish, eggs, and dairy (milk, cheese, yogurt). Your caregiver will tell you how much protein to eat each day.You may need to limit the amount of phosphorus you eat. Your kidneys cannot get rid of extra phosphorus that builds up in your blood. This may cause your bones to lose calcium and weaken. Foods that are high in phosphorus are dairy products, beans, peas, nuts, and whole grains. Phosphorus is also found in cocoa, beer, and cola drinks. Your caregiver will tell you how much phosphorus you should have in your diet each day.
You will have to limit sodium if you have high blood pressure or extra fluid in your body. Limit your sodium intake to 1500 mg each day. Table salt, canned foods, soups, salted snacks, and processed meats, like deli meats and sausage, are high in sodium.
You may need to limit potassium if your caregiver tells you that your potassium blood levels are too high. Potassium is found in fruits and vegetables. You may have to limit fruits and vegetables that are high in potassium.
You may need to limit the amount of liquids you drink each day. If your body retains fluids, you will have swelling and fluid may build up in your lungs. This can cause other health problems, such as shortness of breath.
What foods can I include?
Ask your dietitian how much potassium, phosphorus, sodium, liquid, and protein you should have each day. Your dietitian will tell you how many servings you can have from each of the food groups below. The approximate amount of these nutrients is listed next to each food group. Read the food label to find the exact amount.Starches: These foods contain about 2 grams of protein, 90 calories, 80 mg of sodium, 35 mg of potassium, and 35 mg of phosphorus.
1 slice of bread (French, Italian, raisin, light rye, or sourdough white), small dinner roll, or 6-inch tortilla
½ of a hamburger bun, hot dog bun, English muffin, or small bagel
¾ cup of cereal
½ cup of cream of rice, cream of wheat, farina, or cooked grits
½ cup of cooked pasta (noodles, macaroni, or spaghetti) or cooked rice
4 (2-inch) unsalted crackers
1 ½ cups of plain popped popcorn
10 unsalted pretzel sticks or 9 tortilla chips
10 vanilla wafers or 4 sugar wafers, shortbread cookies, or sugar cookies
Vegetables: A serving of these foods contains about 1 gram of protein, 25 calories, 15 mg of sodium, and 20 mg of phosphorus. The amount of sodium listed is for vegetables that are canned or prepared with no added salt. One serving is ½ cup, unless another amount is given.
Low potassium (less than 150 mg):
Green beans or bean sprouts
Raw cabbage, cauliflower, eggplant
Cucumber, onions, or canned corn
All varieties of lettuce (1 cup)
1 small raw carrot or 1 stalk of raw celery
Fresh and canned mushrooms (Mushrooms have 40 mg of phosphorus or more per serving.)
Medium potassium (150-250 mg):
5 spears of asparagus
Broccoli or celery
Mixed vegetables
Green or snow peas (Peas have 40 mg of phosphorus or more per serving.)
Summer squash or zucchini
Fruits: A serving of these foods contains about ½ gram of protein, 70 calories, and 15 mg of phosphorus. Each serving is ½ cup, unless another amount is given.
Low potassium (less than 150 mg):
Apple juice, applesauce, or 1 small apple
Blueberries
Cranberries or cranberry juice cocktail
Canned pears
Grapes or grape juice
Canned peaches or pears
Pineapple or strawberries
1 tangerine
Watermelon
Medium potassium (150-250 mg):
Fresh peaches or pears
Cherries
Mango or papaya
Small grapefruit or grapefruit juice
Dairy: The following foods have about 4 grams of protein, 120 calories, 80 mg of sodium, 185 mg of potassium, and 110 mg of phosphorus.
½ cup of milk (fat free, low-fat, whole, buttermilk, or chocolate milk)
½ cup of plain or fruit-flavored yogurt, ice milk, or ice cream
1 slice of cheese
Nondairy milk substitutes: These foods have ½ gram of protein, 140 calories, 40 mg of sodium, 80 mg of potassium, and 30 mg of phosphorus. A serving is ½ cup of nondairy frozen dessert, nondairy frozen dessert topping, or nondairy creamer.
Meat and other protein foods: These foods have about 7 grams of protein, 65 calories, 25 mg of sodium, 100 mg of potassium, and 65 mg of phosphorus. Do not use salt when preparing these foods.
1 ounce of cooked beef, pork, or poultry
1 ounce of any fresh or frozen fish, lobster, shrimp, clams, tuna, unsalted canned salmon, or unsalted sardines
1 ½ ounces of crab or oysters
1 large whole egg or 2 large egg whites, or ¼ cup of low-cholesterol egg substitute
Fats: These foods have very little protein and about 45 calories, 55 milligrams of sodium, 10 milligrams of potassium, and 5 milligrams of phosphorus. Include healthy fats, such as unsaturated fats, which are listed below.
1 teaspoon margarine or mayonnaise
1 teaspoon oil (safflower, sunflower, corn, soybean, olive, peanut, canola)
1 tablespoon oil-based salad dressing (such as Italian) or 2 tablespoons mayonnaise-based salad dressing (such as ranch)
What foods should I limit or avoid?
Starches: The following foods have added sodium and phosphorus.1 small biscuit or muffin
2 x 2-inch square of cake
1 (4-inch) pancake or waffle
½ cup of oatmeal
½ cup of whole-wheat cereal or bran cereal
1 piece of cornbread
¾ ounce of salted pretzel sticks or rings
4 sandwich cookies
Meat and protein foods: The following meats and cheeses are high in sodium.
1 ounce of deli-style meat, such as roast beef, ham, or turkey
1 ounce of canned salmon or sardines
¼ cup of cottage cheese
Processed cheese, such as American cheese and cheese spreads
Smoked or cured meat, such as corned beef, bacon, ham, hot dogs, and sausage
Vegetables: The following vegetables are high in potassium. Each serving has more than 250 mg of potassium. A serving is ½ cup, unless another amount is given.
Artichoke or ¼ of a whole avocado
Brussels sprouts or okra
Potatoes
Spinach
Sweet potato (Sweet potatoes have 40 mg of phosphorus or more per serving.)
Tomatoes, regular and low-sodium tomato juice, or ¼ cup of tomato sauce
Winter squash
Fresh beets
Fruit: The following fruits are high in potassium. Each serving has more than 250 mg of potassium.
1 cup of canned or fresh apricots, or 5 dried apricots
1 small nectarine (2 inches across)
1 small orange or ½ cup of orange juice
¼ cup of dates
⅛ of a small honeydew melon
1 small banana
½ cup of prune juice or 5 dried prunes
Fats: Limit unhealthy fats, such as saturated fats, which are listed below.
1 teaspoon butter
2 tablespoons coconut
1 tablespoon powdered coffee creamer
1 teaspoon solid shortening
Other: The following foods are high in sodium.
Frozen dinners, soups, and fast foods, such as hamburgers and pizza (see the food label for serving sizes)
Seasoned salt, such as onion or garlic salt
Barbecue sauce, ketchup, mustard, and chili sauce
2 medium green olives or 3 large black olives
Soy sauce, steak sauce, and teriyaki sauce
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