Kidney diet: a brief fact check by a Kidney Dietitian

As the name suggests, a kidney dietitian is a diet expert who is trained in dietary management of kidney disorders.  A kidney dietitian is also known as a Renal Dietitian where Renal refers to the kidneys. A kidney dietitian is trained at providing dietary guidance for kidney stones, gout, chronic kidney disease, dialysis, kidney transplant, etc. You may find a kidney dietitian in either multi speciality hospitals or standalone dialysis centers or nephrology clinics

Kidney diets are usually prescribed for individuals who have chronic kidney disease. There are several myths associated with kidney diet and hence, before embarking on a renal diet journey, it is ideal to get facts checked with a kidney/ renal expert.

Below are a few myths busted by our Kidney Dietitian – Dr Rachana Jasani:

1. All millets should be preferred as they are great sources of vitamins, minerals and dietary fiber

Fact: Millets are no doubt very good sources of vitamins, minerals as well as dietary fiber; however, weak kidneys are at times not able to process the heavy mineral load especially during advanced stages of kidney disease. Ideally, the work of mineral balance in the body is done by the kidneys i.e. balance of sodium and potassium, balance of calcium and phosphorus, balance of acid and base, etc. Weak kidneys cannot handle the heavy mineral burden and can lead to high levels of potassium or phosphates in the body.

Hence, millets that are high on minerals like pearl millet (bajra), amaranth (rajgira), finger millets (nachni/ ragi), buckwheat (kuttu) should be limited if you are at an advanced stage of chronic kidney disease.

Certain millets which are kidney friendly can be preferred like barnyard millet (locally known in India as samak chawal/ upwas ke chawal/ bhagar/ saamo/ moriyo) (Check out our kidney friendly samak chawal recipe here)

2. Soyabean should not be preferred as it has high protein content

Fact: In kidney diets, we do not completely zero down protein intake. We only try to reduce as per stage of kidney disease and as per body requirement. For example, if one has chronic kidney disease stage 4, we can reduce the protein intake by 20% as compared to someone who has healthy kidneys. Furthermore, if one is on certain medicines like alpha ketoanalogues, then we may have to further drop down the protein intake down by another 30-40%. This depends on what medicines the patient is on.

If the patient is not on these alpha ketoanalogues, then drastic reduction of proteins is not required. On the other hand, soya is a good quality plant-based protein, it should not be banned for kidney patients. Infact, several researches have shown that soya has reno protective and at the same time also cholesterol reducing properties. Hence, soya is a good option but how much soya to be introduced in the diet should be calculated by your kidney dietitian. To gain answers to such frequently asked questions about kidney diet, click here

3.Salts with low sodium content help in lowering BP & hence are best for chronic kidney disease

Fact: The fact is just the opposite. Low sodium salts have high potassium content. This high potassium levels can lead to irregular heartbeats which can lead to heart issues.
At times, these low sodium salts are THE number one reason behind dangerously high potassium levels in kidney patients. No doubt that they are healthy for normal people who have well maintained kidney function. But they are not advisable for patients with kidney issues including chronic kidney disease. They can lead to fatal issues such as heart attacks or cardiac arrest and eventually death.
Hence, kidney patients should prefer only normal iodized salt. Salt should be preferred in less quantity. If you have kidney disease, you should seek guidance form your kidney dietitian about how to manage the salt intake

4.Sendha namak (upwas ka namak) is best option for kidney patients

Fact: All different salt alternatives including sendha namak or rock salt can contribute to extra burden of minerals including potassium. Hence, they are not advisable for patients who have weak kidney function. These patients can prefer normal iodized sodium chloride salt i.e. regular salt but, in less quantity, or as advised by their Nephrologist/ renal dietitian

5. Rice can lead to weight gain and increase in blood sugar, hence it should be completely avoided

Fact: Rice contains lesser proteins, minerals, vitamins as compared to other cereals and grains like wheat, jowar, bajra, ragi, etc. Hence, can be preferred for people with weak kidneys as it does not lead to high potassium neither high level of phosphorus.

In advanced kidney disease, rice is the preferred option to maintain weight and provide enough calories that are needed to avoid muscle loss. You should talk to your kidney dietitian to know tips how to manage your blood sugars with rice. You should also check with him/her about the quality and quantity of rice as well as its frequency

6. Green leafy vegetables like spinach (palak, methi subji, etc) should be completely stopped

Fact: Green leafy vegetables are good sources of dietary potassium. This mineral can sometimes pose a problem mostly (but not limited to) during advanced stages of kidney disease. Inorder to manage this potassium, it is sometimes imperative to avoid these green leafy vegetables. However, this may not hold true for all kidney patients.
These vegetables may be asked to be limited only for a certain time period when the serum potassium levels are high. Once they settle down, they may be introduced again. Patients are then usually trained how to cook these vegetables so that they do not lead to high levels of serum potassium

7. All vegetables should be leached before cooking

Fact: Leaching is a process that involves peeling, chopping, and soaking vegetables in large quantity of water for 2 hours and then discarding that water. This process is usually prescribed when the serum potassium of patient is higher than 5.5 mEq/ L. However, if the serum potassium is within normal range, then leaching is not recommended. And patients do not need to leach all their vegetables if their potassium level is within normal limit

On the contrary, leaching at all the times can also lead to loss of nutrients, hence leaching should be considered only when the serum potassium is high

8. Kidney patients need to drink more water to flush out toxins

Fact: Water that we drink is handled by the kidneys in our body. The amount of fluids that we drink is supposed to be flushed out by the kidneys. Weak kidneys lose their ability to flush out water completely & hence it may start to accumulate in the body. This leads to swelling on feet/ face or accumulation of water in the lungs, etc. Once water gets accumulated in the lungs, it can lead to breathlessness

Hence, to avoid this fluid burden, it is essential to avoid drinking excess water. You should always ask your doctor about the amount of fluids that you can drink on daily basis. And also remember that fluid means everything that is liquid at room temperature, which includes ice, ice creams, dals, milk, buttermilk, curd, etc

9. Coriander juice should be preferred by kidney patients as it helps to form adequate amount of urine as well as flush out toxins

Fact: Chronic kidney disease may affect the functioning of kidneys which mainly includes formation of urine. If urine is not formed adequately, patients start to retain that. This lost kidney function cannot be regained by having any juices including coriander juice or any other juice. For patients with chronic kidney disease, these juices are completely USELESS

10.Vegetable soups are good options to loose weight, so if you are looking forward to loose weight and manage diabetes along with chronic kidney disease, you should cut down your dinner to just soups

Fact: Vegetable soups are definitely good options but only for the ones who are on their fitness journey and have strong kidneys. Individuals with weak kidneys may face issues like swelling due to extra fluid intake through soups or high levels of potassium in the blood.
Hence, one should discuss about his/ her strategies for weight loss or blood sugar management with their kidney dietitian and not adopt any juices or soups.

NutriKonnect is a expert nutrition consultation platform for diabetes, kidney disease, dialysis, kidney transplant etc. Dr Rachana Jasani; is one of the most trusted kidney dietitians in Mumbai providing personalized kidney diet counselling. She is also a premium instructor at UDEMY and has 12 recipe courses in UDEMY.

To gain access to out Complete Guide to Indian Therapeutic Kidney Recipes, click here

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