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Date issued: May 2023

Review date: May 2025

REF: C-527/SW/SALT/Living well for your kidneys

PDF:  Living well for your Kidneys final May 2023.pdf [pdf] 335KB

Living well for your kidneys

Most people can live a largely normal life with chronic kidney disease (CKD)

Although it is not possible to repair the damage that has already happened to your kidneys, you can help protect and slow down damage to your kidneys by making changes to your diet and lifestyle.

By adopting healthy changes, you will improve your overall health and may also reduce your risk of developing other conditions, such as heart disease.

How can I slow down the damage to my kidneys?

• Eat healthily and keep well hydrated

• Reduce your alcohol intake

• Maintain or aim to achieve a healthy weight

• Keep active

• Give up smoking

These changes will also help control your blood pressure and blood sugar levels (if you have diabetes), which in turn will help protect your kidneys.

What are the kidneys for?

• Remove waste and water from the blood

• Balances chemicals in the body

• Releases hormones

• Controls blood pressure

• Helps to produce red blood cells

• Produces vitamin D to keep bones strong

Your kidney function is measured using a blood test known as eGFR. 

Hypertension

High blood pressure can damage your kidneys. Some causes of high blood pressure are:

• Obesity

• Smoking and alcohol

• Unhealthy diet, high in processed and salty foods

• Stress

Simple life changes may have a profound impact on blood pressure and help protect your kidneys.

Aim for a blood pressure below 140/80

Healthy Eating

Do I need to follow a “renal diet”?

No, most people with kidney disease will not need a special diet.  This is usually only needed if you have advanced kidney disease or you are on dialysis.

Healthy kidneys normally control the level of substances such as potassium and phosphate in the blood. Some people with CKD are not able to control the balance of these levels and will need restrict certain foods from their diet which contain potassium and phosphate. Your blood potassium and phosphate levels will be checked regularly, and you will be advised by a healthcare professional if you need to follow a low potassium or low phosphate diet.  If so, you should be offered a consultation with a renal specialist dietitian who will provide you with personalised advice.

Low potassium or low phosphate diet

There is no benefit to following a low potassium or low phosphate diet if you do not need to

Otherwise, you can enjoy a healthy, balanced diet as follows:

• Eat a variety of foods

• Eat less salt

• Eat less processed foods

• Drink plenty of fluids

• Drink alcohol in moderation

Eat a wide variety of foods

Ensure you include foods from each of the five different food groups every day, as shown below. By doing this, you will get the wide range of nutrients your body needs to stay healthy.

Every day, you should aim to:

• Have at least 5 portions of fruit and vegetables

• Base meal’s on starchy carbohydrates such as bread, rice, pasta, choose wholegrain varieties as much as possible

• Have 2-3 portions of dairy or dairy alternatives

• Have 2 portions of meat, fish, eggs or vegetarian protein, aim to have more vegetable proteins

• Eat very small amounts of fats and oils

• Have foods that are high in fat and sugar less often and in small amounts

 

Varied diet

If you eat a varied diet, you should not need to take vitamin and mineral supplements.  Multivitamin and mineral supplements as well as some herbal remedies can be harmful if you have kidney disease, so it is important to check with a healthcare professional before taking these. Cod liver oil should also be avoided due to its high vitamin A content.

 

Eat less salt and fewer salty foods

A high salt diet can be damaging to your kidneys, it increases your blood pressure, which in turn puts strain on your kidneys. In addition, a high salt intake increases protein in the urine which can further kidney damage.

• Cook from scratch, using fresh ingredients rather than ready-made and processed foods

• Avoid adding salt during cooking and at the table, try other flavourings such as pepper, garlic, vinegar or lemon

• Your taste buds will need time to adapt, try reducing the amount of salt you use gradually over a few weeks

• Avoid using low sodium alternatives such as LoSalt, these are very high in potassium 

Shopping and label reading

• Foods that are normally high in salt:

  • Processed meat and fish – ham, sausages, cured meat, smoked fish, bacon

  • Convenience foods, ready meals, soups, pizza, pastries

  • Snack foods, instant noodles, crisps, salted nuts, crackers

  • Condiments, ketchup, soy sauce, brown sauce, gravy granules, stock cubes

• Fresh meat, fish, fruit and vegetables, pasta, rice and grains, generally contain no added salt, so there is no need to check food labels on these products

• Check food labels on pre-packed, tinned and frozen foods e.g., breakfast cereals, prepared salads, dips and cook-in sauces 

Salt content per 100g

	Salt content per 100g
LOW	0.3g or less	Can be eaten regularly
MEDIUM	Between 0.3g and 1.5g	An OK choice
HIGH	More than 1.5g	Avoid or only eat occasionally

Limit processed foods

Many convenience or pre-prepared food and drink products are heavily processed and may typically contain several industrial substances such as preservatives and artificial colours/flavours. They are usually low in nutrients such as fibre and vitamins, and high in sugar, salt, refined carbohydrates and saturated and trans fats.

Research shows that people who eat a lot of these foods are at higher risk of CKD, as well as heart disease.

Examples of highly processed foods include:

• Sugary drinks

• Prepacked sliced meats, “snack” meats and sausages

• Processed cheese

• Crisps and savoury snacks

• Instant soups and noodles

• Sweets and biscuits 

Keep these foods for treats only, and try swapping to less processed or unprocessed foods:

• Cook from scratch as much as possible

• Choose fresh meat over sausages, bacon, breaded/battered chicken and fish

• Avoid using ham and other sliced meats in sandwiches.  Use leftover roast chicken, beef or pork instead

• Use tinned tomatoes or passata rather than ready-made tomato sauces

• Make your own soups using zero-salt or reduced salt stock cubes – soup can be made in bulk and frozen into portions for convenience

• Use dried or frozen herbs and spices rather than pre-prepared spice mixes and marinades

• Try making homemade snacks e.g. flapjacks, popcorn rather than shop bought biscuits and crisps

• Check ingredients lists on food labels for additives – aim to avoid those which contain preservatives, stabilisers, emulsifiers and artificial colours and flavourings

Drink plenty of fluids

Kidneys require a good fluid intake to work well.  It is recommended that most people should drink 6-8 cups of fluid per day, however you may need more if you are unwell with sickness and/or diarrhoea. This can include any sugar free fluid.

Your healthcare team will advise you if you need to follow a fluid restriction.

Drink alcohol in moderation

The alcohol recommendation is the same for people with kidney disease as it is for the general population: aim to drink less than 14 units per week.

• 1 unit of alcohol is equivalent to:

• One measure of spirits

• Half a pint of average strength (4%) lagerHalf a 175ml glass of average strength (12%) wine 

If you regularly drink 14 units or more per week, it is better to spread this out evenly over three or more days and avoid binge drinking. It is a good idea to have at least two alcohol free days per week.

Although it is not usually necessary to cut out alcohol completely, it is a good idea to check with your doctor if it is safe for you to drink alcohol, especially if you take a lot of medications.

Maintain or aim to achieve a healthy weight

If you are overweight, weight loss can help to reduce the risk of damage to the kidneys and will help to keep your blood pressure under control. If you have diabetes, losing weight will help with your blood glucose control.  A healthy weight is a Body Mass Index (BMI) between 20 and 25, however if your BMI is much higher than this a weight loss of just 5 – 10% of your body weight will have positive health benefits.

Here are some tips to help you get started with your weight loss:

• Aim to lose weight slowly, 1 – 2lb (0.5 – 1.0kg per week is recommended as a safe rate of weight loss

• Choose foods that are lower in fat and sugar

• Try to eat regular meals each day and keep to a consistent meal pattern

• If you are hungry between meals choose healthy snacks e.g. fruit, yoghurt, handful of unsalted nuts

• Avoid fad diets, “dieting” will often lead to rapid weight loss in the short term, however it is often difficult to maintain this

• Make gradual changes and be realistic, often 2 – 3 changes and achieve these before adding in further changes

• Watch your portion sizes, using a smaller plate may help

• Be more physically active, regular exercise will help you burn calories and maintain any weight loss you achieve

• Get help and support from friends and familywww.oneyouplymouth.co.uk/eat-well

Help and support with weight loss:

www.oneyouplymouth.co.uk/eat-well

www.nhs.uk/live-well/healthy-weight/managing-your-weight

Keep active

Regular physical activity is good for anyone with kidney disease, however, severe. Not only will it boost your energy, help you sleep, strengthen your bones and improve your mood, it may also reduce your risk of problems such as heart disease.

If you have mild to moderate kidney disease, your ability to exercise should not be reduced. You should be able to exercise as often and as vigorously as someone the same age as you with healthy kidneys.

How?  Continuous activities can be more beneficial for people with kidney disease as they involve steady, whole-body movements. These include:

• Walking

• Jogging

• Swimming

• Cycling

• Dancing 

You should aim for at least 150 minutes of moderate exercise spread out through the week, or 75 minutes of more vigorous activity per week. This can be broken into 10 minute chunks throughout the day.

If you are not used to exercising you should build up to this level slowly over time to avoid the risk of injury. It is important to choose an activity that you enjoy doing as you are more likely to keep it up.

If you have not exercised for a while or you would like to try more vigorous activities, check with your doctor before you start.

Give up smoking

As well as being damaging to the lungs, smoking increases blood pressure and promotes fatty deposits in the arteries. Research shows that smokers are four times more likely to develop kidney failure compared to non-smokers.

Compared to non-smokers, smokers have an increased risk of:

• protein in urine

• diabetic related kidney damage

• progression to end stage renal failure

Website:  www.oneyouplymouth.co.uk/stop-smoking

Tel: 01752 437 177

Medications

Avoid anti-inflammatory medications e.g., Ibuprofen and Voltarol.

Avoid any herbal, homeopathic or Chinese medicines.

Tips for remembering to take your tablets:

• Keep a spare packet in your bag/pocket, or use a pillbox

• Do not forget to order your repeat prescription from your GP in time

• Make taking your tablets part of your daily routine e.g. take them when you clean your teeth, or with meals

• Keep track by using a dailycalendar

Monitoring your health

Your CKD nurses and Renal consultant will check your renal bloods regularly.  You can always ask what your blood results are.

“Patients Know Best”

Patients Know Best (PKB) is an online platform which will allow you access to your blood results and medical information.

Visit the website www.patientsknowbest.com/renal to register. Once you have registered, email the renal secretaries on  plh-tr.renaladmin@nhs.net who will add your data onto your PKB account.

Plymouth Renal Dietitians

A Renal dietitian can support you to manage your chronic kidney disease with changes to your food, drink and lifestyle. The advice they give will take into account your individual condition, the treatment you are receiving, your blood test results, and your personal preferences.

Our team:

• Sandra Wood

• Katy PoynerJ

• acinth Clarke 

You can contact the renal dietitians directly on 01752 439961 (please leave a message on our answerphone) if you would like any further help and support with your diet.  You can also ask your Renal nurse or consultant to refer you.