Effective management of CKD often requires patients to change their eating habits and choices in order to slow CKD progression and avoid further kidney damage to their kidneys. That’s why CKD-savvy Registered Dietitians like Jamie Felt, RD, LDN are important members of the multidisciplinary Care Navigation team at the heart of Healthmap’s Kidney Population Health Management program.
We reached out to Jamie for insights into the relationship between food and kidney health and key tips for eating right while managing CKD.
What are some foods to eat and avoid for someone with chronic kidney disease?
JAMIE: In general, we steer patients towards a whole food, plant-based approach with a higher intake of fruits, vegetables, whole grains, nuts, seeds, beans, lentils and legumes, and soy products. Some specific foods and beverages may need to be limited, depending upon the patient’s CKD stage, their comorbidities, and other considerations.
Reduced overall sodium (salt) intake is important for patients with chronic kidney disease, high blood pressure, and congestive heart failure. That typically means cutting back on common sources of high-sodium foods, such as prepackaged meals, processed meats, canned soups, and salty snacks. There are many ways to add flavor without using salt, such as adding spices, herbs, citrus, vinegar, and vegetables to dishes.
Some patients may have to lower their protein intake to slow the progression of their CKD. How much will depend on their CKD stage and whether they are on dialysis. Dietitians often recommend that patients limit their intake of red meats as well as processed meats and substitute protein from plants, low-fat dairy, and leaner cuts of animal meats. Another tactic is to include a meatless meal once or twice a week.
As chronic kidney disease advances to the later stages, fluid intake and foods that are high in potassium and phosphorus may specifically need to be limited. It’s important for patients to understand that their dietary intake may need to change over time.
How can patients ensure that they are getting the proper nutrients and vitamins while maintaining kidney health?
JAMIE: Having an overall balanced nutrient approach to meal planning is important. Dietitians often refer to the USDA My Plate Method1, which recommends eating a variety of foods within daily food group targets. A kidney-friendly intake pattern should include a variety of colorful fruits and vegetables, a variety of lean dairy or plant-based dairy products, making at least half of daily grain intake as whole grains, and varying the protein intake of lean animal and plant-based proteins. The Diabetic Plate Method2 also has some variances in overall carbohydrate intake for patients with diabetes.
Do medications impact dietary restrictions or guidelines for CKD patients?
JAMIE: Certain medications may contribute to nutrient imbalances by causing gastrointestinal side effects that affect the patient’s appetite. We also recommend that patients discuss any herbal, vitamin, or mineral supplements with their doctor or pharmacist to be sure they won’t adversely interact with any of their prescription medications.
Can patients keep their personal dietary preferences when developing a kidney-friendly meal plan? (e.g., following vegan or kosher dietary guidelines)
JAMIE: Yes, when preparing a nutrition plan, we always consider the individual’s food preferences, daily eating habits, and cultural or religious beliefs, along with the necessary dietary restrictions. We can offer suggestions for healthier food choices and recommend alternative eating patterns that will suit the patient’s preferences.
How can a Registered Dietitian work with other healthcare providers to ensure that a patient’s diet and overall health are optimized for managing CKD?
JAMIE: There are several ways dietitians can contribute to CKD management. One is by helping to manage the patient’s comorbidities, for example, by optimizing nutrition to improve blood pressure control, achieve and maintain a healthy weight, and improve diabetes management. In addition, dietitians are also experienced in motivational interviewing, which can give other providers good insight into the patient’s overall health.
How do Healthmap’s dietitians help patients achieve their health goals?
JAMIE: Healthmap dietitians help our members set realistic nutritional goals. We allow our members the ability to verbalize and plan their changes and provide members an opportunity to set their own food choices and behavioral or lifestyle goals. We also provide members the option to self-monitor their changes and are here to provide support if they need it.
Jamie Felt, RD, LDN has 22 years of experience working as a clinical dietitian and has focused on renal dietetics for the past 12 years. Jamie finds working at Healthmap Solutions very rewarding, knowing she is making a difference in patients’ lives by improving their nutritional status and empowering them to make beneficial lifestyle changes to slow the progression of chronic kidney disease. Outside of work, Jamie enjoys spending time with her family and pets, being outdoors, gardening, kayaking, biking, swimming, and beachgoing.