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The kidney plays an important role in the body by helping in various vital functions — from eliminating toxins and waste via urine, to maintaining the correct levels of important chemicals, to controlling blood pressure and increasing red blood cell production.

But all of these functions can get affected in chronic kidney disease (CKD), because the kidneys themselves are affected and do not work efficiently.

Medications are given to manage symptoms and complications of CKD. However experts recommend that people living with CKD should make healthier choices in their food and lifestyle, in order to better manage their disease and overall health.

Here are some healthy choices to make:

1. Opt for less salt (sodium) food
When the blood pressure is too high, it puts a strain on the blood vessels in the kidneys. Less salt in the food will help to control blood pressure, and here's how you can do it:
  • Opt for fresh foods instead of packaged food, since salt is added to many packaged foods.
  • Season food with fresh herbs, or sodium-free seasonings, instead of salt.
  • Rinse canned foods (beans, meats, vegetables etc.) before eating.
  • Look for and select food labels such as: low sodium, sodium free, salt free, light in sodium etc.
Patients with hypertension and CKD could ask their doctors about the DASH diet (which stands for "Dietary Approaches to Stop Hypertension").

2. Look out for potassium, phosphorous and calcium
In addition to the salt, patients often have to monitor their intake of potassium, phosphorous and calcium.
  • Potassium: Some patients need less potassium, while others need more, depending on how the kidneys are functioning. Usually, patients in the early stages do not have to be very particular about restricting their potassium intake, but this becomes more important in the later stages.
  • Phosphorous: In CKD, the kidneys may not be able to remove excessive amounts of phosphorous from the food so patients may have to avoid certain foodstuffs that are high in phosphorous, for e.g., cheese, dairy products, oatmeal.
  • Calcium: Patients with CKD need calcium for their bones, but foods that are high in calcium are often unfortunately high in phosphorous as well. Because of this, a doctor may have to recommend certain supplements.
3. Select the right protein.
Selecting the right protein, in the right amount, is important for your kidneys. Here's how to do this:
  • Learn to identify what foods are rich in protein and opt for smaller portions of those, e.g., eggs, chicken, beans, nuts, dairy are usually rich in protein.
  • Ask your dietician to help you with a meal plan that has smaller protein portions.
4. Choose heart-healthy foods
Choosing heart-healthy foods will help to prevent the build-up of fat in the blood vessels. Here's how to do this:
  • Avoid deep-frying. Instead, bake, grill, roast, or stir-fry.
  • Cut down on oil by using non-stick vessels with an oil spray, or opting for olive oil instead of butter and other oils.
5. Watch the sugar.
Keeping blood sugar in check is a very important part of managing CKD, since the excess sugar affects the ability of the kidney to filter the blood. For this:
  • Eat meals at regular intervals, at approximately the same time every day.
  • Medication should also be taken around the same time every day.
  • Avoid skipping meals or snacks.
  • Get regular check-ups, as advised by the doctor, to make sure the blood glucose levels are controlled.
6. Stay hydrated.
Drink enough water and stay hydrated to help your kidneys function normally. One way to monitor your water intake is to observe the color of urine—straw-colored or pale urine is normal, but if dehydrated, the urine may be darker in color. However, some patients may also have to monitor their fluid intake and not drink too much fluid in a day.

Instead of getting overwhelmed with all the dietary restrictions, patients with CKD should ask their doctor or dietician to help them plan their meals. Making a simple chart and placing it in the kitchen or dining area, or saving a list on your phone, can help patients make the right choices for their and their kidney's health.

Besides making good dietary choices, here are some other tips to help you and your kidneys stay healthy.

1. Cut back on the alcohol and smoking
Anyone who gives up smoking will benefit from it. For those with CKD, not smoking is beneficial since smoking may cause some kidney diseases to worsen, while also increasing the risk of other diseases. An excessive amount of alcohol is also bad in CKD since it could raise blood pressure and cholesterol levels, which ultimately affect kidney function.

2. Don't skip the exercise
Regular exercise, for about 2 and a half hours every week (i.e. about 30 minutes, 5 days a week), helps to delay progression or even prevent conditions like CKD. Here are some useful exercise suggestions, though it is important to consult with your physician before starting any of these:
  • Aerobic exercises: E.g. swimming, walking and biking can be done 5-7 times a week, for 30 minutes to an hour each time.
  • Balance exercises: E.g. simple standing postures for about 5-25 seconds to improve stability and reduce the risk of falling.
  • Resistance exercises: E.g. repeated movements with weight or resistance tubing to help increase muscle strength.
  • Flexibility exercises: E.g. stretching muscles in different positions for 30 seconds each time to help reduce stiffness and improve mobility.
3. Monitor your blood pressure
This is a simple and quick test to make sure your blood pressure is in the normal and healthy range. High blood pressure can damage the blood vessels in the kidneys and increase the risk of kidney problems.

4. Watch your weight
Exercise and diet help to maintain a healthy weight, since a higher weight can often lead to high blood pressure.

5. Reduce the use of pain-relieving medications
When used over a long period of time, pain relieving medications can damage the kidneys. These medications are usually not broken down by the liver but excreted through the kidneys.

CKD = chronic kidney disease, DASH = Dietary Approaches to Stop Hypertension

1. National Kidney Foundation. Nutrition and early kidney disease (stages 1-4). Available from: https://www.kidney.org/atoz/content/nutrikidfail_stage1-4
2. National Kidney Disease Education Program (NKDEP). Diet and lifestyle changes. Available from: http://nkdep.nih.gov/living/diet-lifestyle-changes.shtml
3. National Kidney Foundation. Enjoy your own recipes using less protein. Available from: https://www.kidney.org/atoz/content/enjoy
4. National Kidney Foundation. Living well with chronic kidney disease. Available from: http://www.kidneyfund.org/kidney-health/brochures/brochure-pdf/living_well_with_ckd.pdf
5. Alberta Health Services. Exercise and chronic kidney disease. Available from: https://myhealth.alberta.ca/Alberta/Pages/Exercise-and-chronic-kidney-disease.aspx
6. National Kidney Foundation. Fight Back! A¬ superhero guide to battling chronic kidney disease. Available from: http://www.kidneyfund.org/kidney-health/brochures/brochure-pdf/super-hero-guide-battle-ckd.pdf
7. Mayo Clinic. Chronic kidney disease. Available from: http://www.mayoclinic.org/diseases-conditions/kidney-disease/basics/coping-support/con-20026778
8. NHS Choices. Chronic kidney disease. Available from: http://www.nhs.uk/Conditions/Kidney-disease-chronic/Pages/Introduction.aspx
9. The National Institute of Diabetes and Digestive and Kidney Diseases. Eating Right for Kidney Health: Tips for People with Chronic Kidney Disease. Available from: http://www.niddk.nih.gov/health-information/health-communication-programs/nkdep/a-z/eating-right/Pages/eating-right.aspx
10. The National Institute of Diabetes and Digestive and Kidney Diseases. Nutrition for Early Chronic Kidney Disease in Adults. Available from: http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/nutrition-for-early-chronic-kidney-disease-in-adults/Pages/facts.aspx