According to the National Kidney Foundation 10% of the world population is affected by Chronic Kidney Disease (CKD).  The leading causes of CKD are uncontrolled blood pressure and uncontrolled diabetes.  If you have any of these conditions then maintaining a healthy weight, blood pressure, and good blood sugar control will help to prevent the development of kidney disease.

The main function of your kidneys is to filter blood, removing certain waste products and balancing the amount of fluid in your body.  Your kidneys also control red blood cell production and release hormones that help to regulate blood pressure.

CKD occurs when your kidneys become damaged and their filtering capacity is reduced, resulting in high levels of waste in the blood that cannot be cleared which can make you feel quite sick.

CKD is classified according to your Glomerular Filtration Rate (GFR) which refers to the rate at which your kidneys filter blood.

There are 5 stages of CKD:

• Stage 1: Normal or high GFR (GFR >90ml/min)
• Stage 2: Mild CKD (GFR 60-89ml/min)
• Stage 3A: Moderate CKD (GFR 45-59ml/min)
• Stage 3B: Moderate CKD (GFR 30-44ml/min)
• Stage 4: Severe CKD (GFR 15-29ml/min)
• Stage 5: End stage CKD (GFR <15ml/min)

A lot of people do not recognise the symptoms of early CKD so it is very important to screen for it as early detection is vital.  If kidney function deteriorates to a point where your kidneys are only functioning at 15% of the norm (End Stage CKD) then you may have to start dialysis where your blood will be diverted to a dialysis machine to be filtered.  It is important to talk to your doctor about CKD during your annual visit especially if you already have high blood pressure and/or diabetes.

Warning signs of kidney disease include the following:

• High blood pressure
• Blood/protein in urine
• Changes in urine production
• Swelling of legs and feet (known as edema)
• Glomerular filtration rate GFR <60
• Raised Blood Urea Nitrogen and Creatinine levels

Nutrition and CKD

Those with CKD need to follow a certain diet in order to control the amount of waste products they are taking in and how much waste the kidney needs to filter.  Controlling the amount of protein, electrolytes (namely sodium, potassium and phosphate), and fluid in your diet will help your kidneys to function better as they will not need to work as hard to remove excess waste.

Protein

A diet high in protein will result in a greater increase in the waste products so you will need to follow a diet lower in protein.  Your body still needs protein to be healthy so having a diet too low in protein can cause other problems. Your dietitian will help you to ensure you have the optimal amount of protein daily.

Sodium

Your kidneys help to regulate the amount of sodium in your blood but if you have CKD they are unable to do so effectively.  This can lead to increased blood pressure and therefore increased strain on your heart, and a buildup of fluid (swelling) in your tissues may occur.

Potassium

This electrolyte is vital for correct muscle functioning. If your potassium levels are too low or too high it can cause problems with your heart (remember your heart is also a muscle).

Phosphate

Eating foods high in phosphate can cause a build up of phosphate in your blood.  High phosphate levels cause calcium to be drawn out of your bones which leads them to weaken.  Your doctor may prescribe a phosphate binder to help with this, however diet plays a crucial role as well.

Fluid

Remember your kidneys also help to balance fluid in your body.  If you have too much fluid In the early stages of CKD a fluid restriction may not be indicated but if your CKD worsens a fluid restriction may be given to you by your doctor.

If you have CKD it is important to see a Registered Dietitian in order to work out the best eating plan for you according to which stage of CKD you have.   To book an appointment click here.