Lifestyle Changes to Manage End-stage Renal Disease (ESRD)
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Certain lifestyle changes are part of the treatment plan for ESRD.
General Guidelines
- Make Changes to Your Daily Diet
- Check With Your Doctor Before Taking Drugs or Over-the-counter Supplements
- Take Medications as Ordered to Control Blood Sugar and Blood Pressure
- Manage Emotional Issues With Support and Counseling
Make Changes to Your Daily Diet
To compensate for your reduced kidney function, you may need to make changes in your diet. A registered dietitian can help you with each of these changes. The most important nutrients for you to watch are:
Protein—Depending on your kidney function and treatment, you may need to either limit or increase protein intake. Because your kidneys are not functioning properly, protein can build up in your blood. Eating less protein decreases strain on your kidneys. However, your body still needs protein. Your doctor will recommend a daily protein level and ask a dietitian to help you plan meals. If you begin hemodialysis or have a transplant , your protein needs will change.
Foods rich in protein include meats, poultry, and fish, as well as eggs, dairy products, soy products, and legumes (beans).
Fat and Cholesterol—A diet that is high in saturated and trans fat and cholesterol contributes to the formation of plaque in the arteries, which leads to heart disease. Choose a more healthful diet —foods that are low in cholesterol, saturated fat, and trans fat.
Sodium—Sodium (found in salt) contributes to fluid retention. Over the long-term, retaining excess fluid can increase your blood pressure and cause discomfort during dialysis . Try to decrease the salt from both foods and fluids.
Potassium—Because your kidneys are not functioning properly, potassium may accumulate in your blood. High levels of potassium in the blood can be dangerous to your heart. Try to decrease the potassium in your diet .
Phosphorus (phosphates)—Because your kidneys are not functioning properly, phosphorous can also accumulate in your blood. Excess amounts of phosphorus interfere with bone metabolism and can weaken your bones. Phosphorous is found in many foods, making it difficult to limit it in your diet. Instead, your doctor or dietitian may recommend that you take a phosphate binder, such as calcium carbonate, with your meals. Phosphate binders are included with medications .
Fluids—Excess fluid makes your heart work harder and can raise your blood pressure. Your doctor or dietitian will help you determine how much fluid you can have each day.
Check with Your Doctor Before Taking Over-the-Counter Drugs or Supplements
Over-the-counter (OTC) and herbal products may contain substances that can change your blood chemistry and be harmful to your kidneys. Therefore, before you take any OTC drugs or dietary supplements, check with your doctor.
Take Medications as Ordered to Control Blood Sugar and Blood Pressure
If you have diabetes or hypertension , your doctor may order medications to control your condition. Always take these medications as directed. Do not stop taking them without consulting with your doctor.
References:
National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://www2.niddk.nih.gov/ .
National Kidney Foundation website. Available at: http://www.kidney.org/ .
Last reviewed April 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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