Kidney failure: What foods to avoid?

Renal failure is an impairment of kidney function. This pathology can be acute or chronic. First of all, the'acute renal failure is characterized by a brutal alteration kidney function requiring emergency treatment. In the majority of cases it is reversible, which allows the kidneys to regain their functions, unlikechronic renal failure. Indeed, the latter is a pathology which is characterized by a progressive and irreversible reduction in renal function. Chronic kidney failure is caused in 50% of cases by diabetes or lhigh blood pressure. This pathology is considered progressive and silent because the symptoms generally appear as the disease advances. Furthermore, chronic kidney failure is divided into 5 stages depending on the filtration rate of the kidneys (The different stages of kidney failure). 

In the early stages of the disease (stage 1 and 2), glomerular filtration rate and renal function are minimally impacted. Certain preventive measures are offered to patients in order to preserve kidney function. It is from stage 3 that the flow of filtration decreases and symptoms appear such as asthenia, nausea and vomiting, abnormal urine and swelling of the limbs for example. In some cases, progression of the disease is inevitable and can reach the stage 5, the terminal stage of the disease. As a result, kidney function is seriously affected and the patient's life is at stake. Replacement treatment by dialysis or transplantation may be offered to patients.

A specific diet must be implemented in stages 3 and 4 of renal failure, then in stage 5, in order to limit renal filtration overload and avoid excess micronutrients. In each of the stages, the patient must be taken care of by a dietician-nutritionist to ensure that their daily needs are respected, and that kidney function is preserved as far as possible.

The role of diet in stage 3 and 4 is crucial to limit the overload of filtration kidneys. Therefore, it is appropriate to reduce nutrients that aggravate it such as:

• tHE proteins ; to avoid the presence of urea in the blood. In fact, proteins are eliminated by 90% in urea, in urine. During poor kidney function, proteins are less well eliminated and urea ends up accumulating in the blood system. Uremia (urea in the blood) is often a sign of kidney failure. Furthermore, studies show that reducing protein intake in people with chronic kidney failure helps slow the progression of the disease.

• tHE sodium ; to avoid its accumulation. In the case of kidney failure, sodium can no longer be properly eliminated in the urine so it accumulates in the body. Therefore, excess sodium promotes water retention in tissues and elevated blood pressure. THE salt, from its scientific name “sodium chloride”, is made up of 40% sodium and 60% chloride. A meta-analysis shows that a low-salt diet reduces blood pressure, proteinuria and albuminuria. These can reflect a dysfunction in the body such as kidney failure when they are present in large quantities in the urine. In fact, the proteinuria corresponds to an abnormal protein content in the urine. While thealbuminuria is linked to the presence of albumin, a protein in urine. However, we are careful not to have too drastic a salt restriction which can lead to reversible nephropathy.

THE stage 5 or kidney failure terminal is the last stage of the disease. Renal function is seriously impacted and, as a result, the patient's life is in danger. At this stage of the disease, the kidneys are no longer able to eliminate the excess of micronutrients and water. Therefore, the role of diet is to reduce excess intake:

• in phosphorus (hyperphosphatemia); at the beginning of muscle disorders and bony. In fact, phosphorus promotes the fixation of calcium to potassium, thus the calcium level in the blood becomes lower. This hypocalcemia causes muscle (including cramps and muscle fatigue) and bone disorders. Furthermore, the fixation of these minerals can also induce the formation of crystals (calcification) in the arteries. Therefore, people on dialysis have a greater risk of developing cardiovascular diseases.

• in potassium (hyperkalemia); which can cause heart attack, even the dead of the person receiving dialysis if the patient is not treated quickly. Clinical signs can identify hyperkalemia such as: the feeling of fatigue, muscle pain or cramps, tingling or even difficulty breathing. In some cases, taking chelators of potassium can be prescribed to support dialysis and a suitable diet.

• in sodium ; which contributes to the elevation of blood pressure, there water retention and training edema. As a reminder, high blood pressure is the main cause of chronic kidney failure with diabetes. In addition, the consumption of salt and therefore sodium should be limited, because it produces a feeling of thirst. However, water must be reduced significantly during dialysis.

• water ; which induces a weight gain between two dialysis treatments. Indeed, at the end stage of chronic kidney failure, the patient has more difficulty urinating and water is stored in the body, thus leading to weight gain. This weight gain leads to heart muscle fatigue, edema and hypotension. Of the techniques of calculations allow patients to be told the quantity of water to consume based on the urine present in the bladder (residual urine): the quantity of drink = 500 mL + diuresis volume or 750 mL in the case of anuria.

From stage 3 of the disease, the patient must be cared for by a dietitian-nutritionist to ensure that their daily needs are met and that kidney function is preserved, as far as possible.

In stages 3 and 4 of kidney failure, proteins are no longer properly eliminated by the kidneys. As a result, urea ends up accumulating in the blood system.

We recommend you :

• to restrict your consumption of meats in general (beef, grisons, veal, pork, lamb, etc.). Replace them with legumes lower in protein (split peas, lentils, kidney beans).

• to reduce dishes based on pisces. Among them, there are dried cod, tuna, squid, salmon roe, etc.

• to reduce your consumption of cheeses. Grana Padano, Mimolette, Asiago, Parmesan or Emmental are cheeses very rich in proteins. Replace them with cottage cheese, yogurt or milk and fermented yogurt which are lower in protein.

• avoid seasoning your dishes with seeds notably soybeans, lupine seeds, cucurbit seeds and even alfalfa seeds. Prefer to season these dishes with spices (white pepper, nutmeg or chili) or with fresh aromatic herbs (the thyme, tarragon, parsley, dill, etc.).

• to limit the introduction ofalgae dried or dehydrated (like spirulina and nori) in your dishes, because they are very rich in protein.

Salt and salty products contain sodium. In excess, it promotes water retention in the tissues and an increase in blood pressure.

We recommend you :

• avoid seasoning your dishes with salt generally and replace it with spices such as white pepper, nutmeg or chili pepper.

• avoid using broths, meat stocks or industrial sauces (soy sauce for example) because they are very rich in salt.

• to reduce your consumption of pisces and of meats fumes. Prefer fresh fish and meats.

• to limit your consumption of cold cuts : ham, sausage, rosette, coppa, etc.

• to limit the salty cheeses such as pecorino, mimolette, blue cheese, roquefort and feta.

• wherever possible, avoid purchasing products ultra-processed. Among them, we refer to aperitif biscuits, sandwiches, instant soups and ready meals.

• to check the food labels and pay attention to mentions "salt", "sodium chloride" and "sodium" in order to judge the salt content of these foods.

Hyperphosphatemia (excess phosphorus) can be the cause of muscle and bone disorders but also of cardiovascular diseases.

We recommend you :

• to limit the seasoning of your dishes with sounds or some germs including rice bran, wheat bran, oat bran and wheat germ.

• avoid eating large quantities of seeds such as chia seeds, poppy seeds, sunflower seeds, etc.

• to reduce your consumption ofoilseed (Brazil nuts, cashews, almonds, pistachio, peanuts) which are rich in phosphorus.

• to limit your consumption ofoffal and of game, in general.

• to avoid consuming cheeses rich in phosphorus such as Comté, Pecorino, Mimolette, Emmental as well as processed cheeses. Prefer cheeses lower in phosphorus such as: St Marcelin, Coulommiers or even crottins or logs.

• to check the food labels. Phosphorus can be hidden in food additives under different names: phosphoric acid (E338) and sodium phosphate (E339). If possible, avoid purchasing any food products that contain it.

In excess in the body, potassium can cause a heart attack or death of the patient, if the patient is not treated urgently. Therefore, potassium intake must be limited.

We recommend you :

• to avoid the use ofalgae dried or dehydrated in your dishes. Wakamé, dulse, kombu and sea beans should be avoided. 100 g of kombu covers 3 times the daily potassium needs.

• to restrict your consumption of dried fruit (apricots, dates, prunes and grapes) and prefer fresh fruits less rich in potassium such as blueberries, pears, apples, grapefruit and pineapple.

• to reduce your consumption ofoilseed : pistachios, hazelnuts, almonds, etc.

• to limit meals based on legumes (dried beans, broad beans, lentils, chickpeas).

• to exclude all salts of diet of your diet such as Herbamare® Diet and Bouillet®. These salts mainly contain potassium chloride.

• not to season your dishes with spices rich in potassium such as black pepper, paprika, turmeric and saffron. Replace them with white pepper, nutmeg and chili pepper. 

• to generally avoid products dehydrated or freeze-dried which are very rich in potassium.

• to limit your consumption of soluble coffee, soluble chicory and tea and prefer infused herbal teas.

• d’peel your fruits and vegetables before consuming them. The skin of food contains a large amount of potassium.

• to prefer cook your food in boiling water, remembering to throw away the cooking water. Potassium is a water-soluble mineral.

• d’to balance your meals with potassium. If your last meal was very rich in potassium, make sure the next meal is lower in potassium.

A substantial fluid intake contributes to weight gain between two dialysis treatments. Indeed, patients on dialysis have more difficulty urinating, so water ends up being stored in the body.

We recommend you : 

• to restrict your consumption of salty, spicy and sweet foods (including drinks and sodas). These arouse the desire to drink water.

• to subtract from your fluid restriction, your consumption of water, milk and soup. Water contained in other foods (rice, pasta, meat, etc.) is not included in fluid restriction.

• to favor the graduated containers which allow you to better control your water consumption.

• to drink small amounts of water during the day and preferably cool.

• avoid drinking water rich in minerals.

• to add juice of lemon to your water to more easily reduce the feeling of thirst.

• to suck ice cubes and D'humidify your lips.

Breakfast :

• Brewed herbal tea, unsweetened
• Bread, butter and honey
• Blueberry

Lunch :

• Hake
• Pasta salad with beans and mozzarella
• Applesauce

Snack :

• Tapioca

Dinner :

• An egg
• Basmati white rice
• Green bean
• Bread and dry goat cheese

• Perform the follow up of your illness and exams associates. The objectives are to learn to better understand your illness, to ensure that the treatments are adequate and finally that complications are absent.

• Do not make any changes to your treatment medication or do not stop it without a doctor's advice.

• Practice a physical activity regardless of your stage of illness. Daily physical activity helps reduce the progression of the disease. In addition, the National Nutrition and Health Program (PNNS) established in France encourages people to practice at least 30 minutes of physical activity per day.

• Stop it tobacco. The nicotine contained in tobacco is involved in lowering the filtration rate. In addition, researchers demonstrate that completely stopping smoking among smokers reduces the progression of the disease.

• Regularly check your blood pressure and make sure you do not show signs of hypertension (headache, fatigue, nervousness, dizziness, etc.). Otherwise, inform your doctor promptly.

• Check that your weight is constant and inform your doctor of any changes in weight. Chronic kidney failure can cause malnutrition. Therefore, it is advisable to check that your Body Mass Index (BMI) is between 18.5 and 24.9 kg/m².

• Meet the associations such as “France Rein”. Associations help you better manage your illness on a daily basis.

• Remove from your diet, carom. Indeed, this fruit contains a molecule, caramboxin, which can cause kidney failure and death in people on dialysis. In addition, the ARS (Regional Health Agency) advises against the consumption of this fruit whatever the form of consumption (in salad, juice, jam, etc.).

• Avoid certain essential oils that impair kidney function such as white sandalwood essential oil, juniper essential oil and turpentine essential oil.