What the Heck Am I Supposed to Eat With CKD?

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March 19, 2017 by Leah

“So there’s really nothing I can do?” I say to my nephrologist. He reiterates there’s not until we can change medications when I wean the baby.

He tells me my potassium is going up so I should lay off the oranges. (I don’t eat a ton of oranges except we’ve been getting a lot of mandarins lately because they’re in season.)  And he mentions that a lower sodium diet will help with the blood pressure, and that diet may or may not have an impact on the cholesterol. We also know that, since my potassium levels are rising, phosphorus levels will probably not be too far behind.

I’ve always thought food can have a big impact on health, so I am kind of frustrated with the idea that my nephrologist thinks I shouldn’t bother with lifestyle changes until things are so dire that I have to make the changes. Surely lightening the load on my kidneys could potentially preserve their function a little longer, along with my now-controlled blood pressure and the exercise routine I finally restarted a month ago? Anything that is good for the blood pressure will help my kidneys, according to a naturopath I saw.

After the oranges comment, I started looking up what foods have potassium in them. Bananas, potatoes, sweet potatoes, beans and legumes, leafy greens, milk and yogurt, avocados, tomatoes and tomato sauce, winter squash…  (A dish I make literally every week is sweet potato, bean, and spinach enchilada casserole. Topped with avocados and plain yogurt.) Then foods that are high in phosphorus: whole grains, seeds, nuts, meats, poultry, beans, dried fruits, and dairy. Obviously avoiding sodium and watching my cholesterol means I should avoid fast food, restaurant food, convenience food, and cheese, oh! and “reduced sodium” processed foods often have potassium chloride as a salt replacement.

So, if I want to eat a kidney-friendly diet, what the heck do I eat?

Well. This is a lot harder than figuring out what not to eat. Garlic, onions, peppers, zucchini, summer squash, eggplant, cucumbers, carrots, celery, cauliflower, broccoli, corn, mushrooms, lettuce, green beans, berries, apples, pineapple, stone fruits, white or sourdough bread (or English muffins, or bagels, or whatever), pasta, heart-healthy protein like chicken and fish, and eggs seem to be okay. Also, booze is okay (hallelujah).

I’ve been concentrating on the intuitive eating of a nutrient-dense diet for several years now, so limitations are really foreign (and unwelcome) to me. Additionally, I’m both exclusively breastfeeding and trying to increase my milk supply so I can get milk into the freezer by pumping a few times a day, so I need calories and nutrition. And I exercise a few times a week and generally need to keep up with my three small children.

Some things I’ve been eating include:

  • Oatmeal with berries and cinnamon
  • Breakfast burrito (scrambled eggs with sautéed peppers and mushrooms in a white tortilla topped with hot sauce)
  • Cream of wheat
  • Cod and cabbage (sautee carrots and garlic with chopped cabbage, throw white fish on top, add lid, put in oven until cooked, serve with bread or noodles)
  • Chicken and veggie stir fry (seasoned with fresh garlic and ginger) with white rice
  • Chicken and rice soup
  • Sauteed veggies (cauliflower, zucchini, peppers, mushrooms, and loads of garlic with olive oil and crushed red pepper) with pasta
  • Toast, English muffins, or bagels with jam
  • Roasted eggplant rounds with a sprinkle of Romano cheese on sourdough bread with olive oil and balsamic vinegar
  • Braised cabbage with apples and onions, sometimes topped with a poached egg

I’m saving my potassium and phosphorus for whole milk in my coffee and occasional use of sharp cheeses or cottage cheese as a topping (both of which are high in sodium too, hence the sparing usage). Since I’m not clinically required to limit phosphorus yet, I’m also continuing to try to eat oatmeal since it’s good for milk production. I’m using chicken broth in place of milk in recipes, and snacking on toast, apples, cucumbers, or hard-boiled eggs (if I haven’t had eggs already during the day). I’ll put marinara sauce out on the table for the rest of the family while I eat my pasta with garlicky sautéed veggies.

This is not as terrible as I thought it would be initially, but it is a major shift. It takes a lot of time, thought and effort, takeout and drive-thrus are out, and “grab and go” type foods are hard, as is keeping up much of an appetite with all these limitations. I had been hoping to go vegetarian, but I’m not comfortable enough with this new paradigm to make that shift now, so that’s feeling like a loss. It would be culturally appropriate for me to say something about “losing weight, yay!” but in the short term I’d like to keep my milk supply robust and in the pipe dream I’d like to have all my organs working again.

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