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Chronic Kidney Disease: Symptoms, and Diet for CKD Management

By Dr. Pawan Kesarwani in Urology , Robotic Surgery , Kidney Transplant

Jun 13 , 2024 | 2 min read

Chronic Kidney Disease (CKD) is characterized by a gradual loss of kidney function, often caused by diabetes and hypertension. Dr Pawan Kesarwani, Senior Director, Nephrology at Max Super Speciality Hospital, Patparganj, says, "CKD can lead to serious complications such as cardiovascular issues, anemia, and electrolyte imbalances". Dr Shailesh Sahay, Director, Urology at Max Hospital, Patparganj, adds, "The condition remains asymptomatic for a long time".

Symptoms of Early Stage and Advanced Stage CKD

1. Early Stage Symptoms

  • Fatigue and weakness
  • Difficulty concentrating
  • Changes in urination frequency or volume
  • Foamy or bloody urine
  • Fluid retention leads to swelling (oedema), particularly in the legs and ankles.

2. Advanced Stage Symptoms

  • Persistent nausea and vomiting
  • Loss of appetite and unintended weight loss
  • Itching (pruritus)
  • Muscle cramps and twitches
  • Shortness of breath, often due to fluid buildup in the lungs (pulmonary oedema)

Dietary Modifications for CKD

Dietary management is a cornerstone in treating chronic kidney disease (CKD) patients holistically.

A. Sodium Reduction - The effects of high sodium on kidney health:

Dr Kesarwani says, "Excessive sodium consumption leads to increased blood pressure and fluid retention, putting extra strain on the kidneys. Additionally, high sodium levels can impair the kidneys' ability to remove waste and regulate electrolyte balance, leading to further complications such as oedema and cardiovascular issues". Individuals with more advanced CKD may need to restrict sodium intake further under the guidance of a doctor.

B. Protein intake, metabolism and kidney workload:

Protein metabolism generates waste products that must be filtered and excreted by the kidneys. Dr Sahay emphasizes, "In individuals with CKD, excessive protein consumption may increase the workload on the kidneys, potentially accelerating the decline in kidney function." However, protein is needed for maintaining muscle mass and overall health, so balancing protein intake is crucial for CKD patients. 

C. Phosphorus Management- The impact of phosphorus on kidney health:

Phosphorus plays an important role in bone health, energy metabolism, and cell function. However, in individuals with CKD, impaired kidney function can lead to difficulty excreting phosphorus, resulting in high blood levels of phosphorus, known as hyperphosphatemia. Elevated phosphorus levels can contribute to bone disease, cardiovascular complications, and other adverse health outcomes in CKD patients.

CKD patients are advised to limit their intake of phosphorus-rich foods, including dairy products, nuts, seeds, whole grains, and processed foods containing phosphate additives. Additionally, certain protein-rich foods, such as meat, poultry, and fish, contain significant amounts of phosphorus, so portion control is essential for managing phosphorus intake.

D. Potassium Regulation

In individuals with CKD, impaired kidney function may cause hyperkalemia or high blood potassium levels. It may cause symptoms such as muscle weakness, irregular heartbeats, and even cardiac arrest. Therefore, controlling potassium intake is essential for managing CKD and preventing complications.

CKD patients must limit their intake of high-potassium foods such as bananas, oranges, tomatoes, potatoes, and leafy green vegetables. Instead, they should focus on consuming moderate- to low-potassium alternatives like apples, berries, cabbage, carrots, and green beans. Cooking methods such as boiling or leaching can also reduce the potassium content of certain foods.

E. Hydration and Fluid Intake

Proper hydration is key for kidney health and overall well-being. In general, CKD patients are advised to drink enough fluids to stay adequately hydrated without overloading their kidneys. Doctors may provide specific fluid intake recommendations based on individual needs and circumstances.

In conclusion, dietary modifications are pivotal in managing chronic kidney disease (CKD), serving as a cornerstone in preserving kidney function and mitigating disease progression.