RCB’s Cameron Green says he has special diet to control his chronic kidney disease: What to eat, what not?

WHAT IS CHRONIC KIDNEY DISEASE?

It involves a gradual loss of kidney function, which involves filtering waste and excess fluids from your blood, which are then removed in your urine. “CKD is irreversible but it can be managed, treated, controlled and retarded through medication, diet, exercise and follow-ups with nephrologists. Unless it is a congenital or a developmental problem, as in Green’s case, it is caused by hypertension and diabetes,” says Dr Deepak Kumar Chithralli, senior consultant, nephrologist and transplant physician, Manipal Hospital.

WHAT IS A KIDNEY-FRIENDLY DIET?

The idea is not to overload the kidney which anyway has leftover waste that it cannot excrete. “One has to watch one’s intake of protein, fats, sodium, potassium and even fluids to make sure that their end products do not accumulate in the body. In the early stages, there is not much need for intervention, except cutting down on salt and potassium-rich foods. It is in the later stages that you have to lower your intake further,” adds Dr Chithrali. Dietary modification can bring down creatinine levels, a spike in which indicates kidney disease.

WHAT ARE DIETARY NORMS?

If your condition is between Stage 1 and 3, when creatinine levels have not spiked beyond 1.4 mg/dL, then your protein intake should be 0.8 g per kg of ideal body weight. “The height-weight ratio holds the key here. For example, if you are 160 cm tall but weigh 80 kg instead of 60 kg, your protein allowance will be 0.8 g multiplied by 60 kg or your ideal body weight. Besides, you have to spread your consumption across meals instead of cramming it in one. Energy should be 25 to 30 kcal per kg of ideal body weight. Your consumption of sodium should be less than 3 g per day, phosphorus no more than 1000 mg per day and potassium less than 3,000 mg per day,” says Krishna.

In layman’s terms, she recommends restricting organ meat, processed meat, sausages and having more plant proteins instead. “Since you have to limit sodium, potassium and phosphorus intake, you must limit use of potato, banana, cluster beans, French beans, avocado, drumstick, spinach, leafy vegetables, ragi, jowar and bajra. Safe choices of vegetables are fibre- rich bottle gourd, zucchini, cucumber and pumpkin. Have non citrus fruits,” says Krishna. Carbohydrates should be complex like wholegrains.

To make a low-salt diet palatable, use spices and condiments such as garlic, onion, lemon juice, bay leaf, tamarind pulp, vinegar, cinnamon, cloves, nutmeg, black pepper and cumin. But avoid salt substitutes as they contain high amounts of potassium.

However, if a patient has to go for dialysis in an advanced stage, then the protein requirement is higher at 1.2 per kg of ideal body weight, again spread across meals, adds Mishra.

CAN YOU BUILD MUSCLE MASS?

Green has built muscle mass while keeping to minimum salt and protein, increasing salt volume slightly while performing on the field. You need lean proteins, such as whole eggs and skinless chicken and turkey.

“You can add muscle mass by consuming egg whites, cottage cheese, 100 to 150 ml of milk and curd and legumes after leaching (soak the legumes in water and then discard the slurry as they lose 50 to 60 per cent of sodium and potassium). If all fails, then there is an oral nutrition supplement that you must take in consultation with a doctor and nutritionist,” says Dr Chithrali. Stage 4 and 5 of CKD mean further reducing the above permissible limits besides reducing water intake to just 1.5 litres a day.

This diet has other benefits too, like controlling your blood sugar and blood pressure.