There are two types of diets for kidney disease. One type of diet is specifically for people who have progressive chronic renal failure, or kidney failure, but are not on dialysis yet. Along with medicine, a low-protein diet may slow the worsening of kidney failure. The other more restrictive type of diet is for people on dialysis whose kidneys have totally failed and are no longer working at all. This is called end stage renal disease, or ESRD.

Today is "World Kidney Day"

Did you know......

Recent reports from the Centers for Disease Control and Prevention (CDC) estimate that one in three people in the United States will have diabetes by the year 2050. The number stands now at one in ten. Diabetes is the leading cause of kidney failure, responsible for nearly half of the new cases last year. Yet proper management and treatment of diabetes can help prevent the onset of kidney disease.

Feeling Better After Dialysis Is As Easy As Can Be!

Know The Numbers!

There are two numbers that you should know: Your KT/V and URR (Urea Reduction Ratio). KT/V and URR measure how much of the waste product, called urea, is removed from your blood. Not getting enough dialysis time and having too much urea left in your blood after dialysis will leave you feeling sick.

Knowing your KT/V and URR numbers can assure you that waste in the blood is being removed sufficiently.

Know Your Numbers!

• Goal: KT/V greater than 1.2
• URR greater than 65%

These goals are the minimum numbers for adequate dialysis. To find out your exact number, just ask the nurse, dietitian, or doctor at your dialysis center.

Know How To Reach Your Goal!

• Always go to all your scheduled dialysis treatment.
• Stay for the full treatment.
• Follow your diet.
• Avoid excessive fluid weight gains between treatments.
• Check your KT/V and URR number every month.

Adequate Dialysis Will Help You:

• Eat better and feel less nausea.
• Have fewer hospital stays.
• Feel less tired and live longer.

Signs & Symptoms of Inadequate Dialysis:

• Itchy skin.
• Poor appetite.
• Fatigue.
• Shortness of breath.
• High blood chemistries.

Dialysis removes waste products and extra fluid from your blood. Inadequate dialysis leads to a build up of waste and fluid in your blood.

Although you may feel okay without adequate dialysis, overtime you will become weak and tired.

Attending and staying for all your dialysis treatments is very important. People with less waste products in their blood feel better, are healthier and, live longer.

by Jody Gardener-Jones

Phosphorous Tips

Nutrition Facts may not list phosphorous. Check the ingredients.

Milk, nuts and dark colas are high in phosphorus.

Kidney disease can cause an unhealthy buildup of phosphorus.

Dialysis alone can’t remover all the extra phosphorus from your body.

More than 7 out of 10 dialysis patients have high phosphorus.

Dialysis helps remove extra phosphorus from your body.

If not treated, high phosphorus can be a serious condition.

Phosphorus buildup can cause bone disease and heart disease.

With high phosphorus levels, you may not feel any symptoms.

Phosphorus is a mineral found in many foods.

by Jody Gardener-Jones

Medication Tips

Ask friends how they remember to take their medication.

Refill your prescriptions before you run out of your medication.

Ask friends or family to help you remember yor medication.

Put a note on the refrigerator to remember your binder medication.

Talk to your health care provider about the mediations you take.

If you travel, remember to take your medications with you.

Which binder medication is right for you? Ask your health care provider.

Take all of your medications as directed.

by Jody Gardener-Jones

Diet/Food Tips

In your diet, replace wheat bread with white bread.

When shopping choose foods low in phosphorus.

Use information on Nutrition Facts labels to choose healthy foods.

Instead of ice cream for dessert try sherbet.

Work with your dietitian to choose kidney-friendly foods.

Ask your dietitian about proper portions size.

Talk with your dietitian before changing your diet.

Make a list of questions to ask your dietitian.

When you need answers, ask your dietitian questions.

Ask your dietitian questions while at dialysis.

Ask other dialysis patients if they have any food ideas.

Do you know which foods to limit? Ask your dietitian.

Prepare your meal and your binder medication together.

by Jody Gardener-Jones

General Tips For Dialysis Patients

It’s important to come to all of your dialysis appointments.

Stay the entire time at your dialysis appointments.

A strong support system helps you stay on track.

You have chronic kidney disease, but it’s not who you are.

Talking about kidney disease may help you cope.

Use your dialysis time wisely. Plan your meals or read.

Talk to others dialysis patients about joining a support group (I say social group).

Stay on track with your dialysis when you travel.

You are the most important player when it comes to your health.

Stay on track with diet, dialysis, and medication.

Dialysis is important. So are proper diet and medication.

Dialysis does the job of healthy kidneys.

Set realistic goals to help keep you on track.

Track your progress with your scheduled lab results.

Be active. Ask questions to help you understand your treatment.

by Jody Gardener-Jones

Dialysis, Dialysis, Dialysis...

by KMJ

Advice From The Kidney Doctor

In this article of Be Healthy, Be Happy, I’d like to discuss an issue that comes up every day in the dialysis center: fluid restriction. There is no doubt that fluid intake is the most important determinant of weight gain between one session of hemodialysis and the next, particularly in patients with minimal urine output. However, we must be careful not to neglect the importance of dietary sodium intake as well. Patients drink for one of two reasons: thirst, and because they ‘feel like a drink’ – for example, social drinking. It is very difficult for a conscious patient to ignore thirst, and severe thirst will drive a patient to find fluid wherever they can. When patients do this, it is not because they are ‘mad’, ‘totally non-compliant’ or ‘too stupid to understand the importance of fluid restriction’ – it is because it is nearly impossible to ignore such a strong physiological stimulus. The over-riding stimulus to thirst is sodium concentration. Thus, we should concentrate on advising and helping dialysis patients to limit their salt intake, which will help limit thirst. Advising dialysis patients to restrict fluid intake when they have not had advice on how to limit their salt intake is inhumane, and is a waste of time. What other factors may impact thirst and fluid gains? A certain amount of sodium is delivered to each patient during each dialysis session. This may be prescribed by your nephrologist to help keep your blood pressure from dropping. If you’re caught in a vicious cycle of increasing fluid gains and increasing symptoms during rapid fluid removal on dialysis, talk to your nephrologist about your ‘sodium profile’ and how this can be changed to promote less thirst. There’s also some evidence that ACE inhibitors, a certain class of blood pressure medication, can reduce thirst and weight gain in dialysis patients with habitually high inter-dialytic weight gain and fluid overload.

In summary, a low sodium diet with advice to drink only when thirsty has been shown in clinical trials to significantly limit weight gains. The hard part then becomes the practical difficulty of persuading patients to limit dietary sodium intake. The high sodium content of many processed foods means that simply avoiding salt at the table and in cooking will not be enough to achieve these effects. However, any reduction in salt intake is likely to have a beneficial effect in the right direction. Talk to your dietician about the possible sources of sodium in your diet, and ways to lower it. And then maybe you won’t raise as many eyebrows when you get on the scale!

Dr. Christopher Caputo
Queens Nassau Nephrology Services