Taking Care of Your Kidneys

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1 Taking Care of Your Kidneys Roseville & Sacramento Medical Centers Health Education Department Nutrition Services

2 Agenda Slide The functions of the kidneys Explaining chronic kidney disease Protecting your kidneys Your diet Resources 2 November 7, 2016

3 What are the functions of the kidneys? Clean the blood Remove extra fluid Keep your body in balance Responsible for making red blood cells Controls blood pressure 3 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

4 Measurements of kidney function Creatinine: By-product of MUSCLE metabolism Normal: <1.3 Male <1.1 Female Diagram provided by the National Kidney Disease Education Program (NKDEP). GFR (Glomerular Filtration Rate) 4 November 7, 2016

5 What causes CKD? Hypertension Diabetes Chronic infection/inflammation Blockage Heredity Autoimmune disease Some drugs and toxins 5 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

6 Keep your blood pressure in control Blood pressure goal: 130/85 (if diabetes, the goal is 120/75) Take your medications Moderate alcohol Increase activity Stop smoking Lose weight if needed Low sodium diet (below 2,300mg sodium/day) 6 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

7 Control your blood sugar Prevent spilling of blood sugar into your urine Ask your doctor about your hemoglobin A1C goal Take your medications Follow nutrition guidelines Please take advantage of our many classes and resources 7 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

8 Keep current on your immunizations 8 November 7, 2016 Kaiser Permanente All Rights Reserved.

9 Avoid Nephrotoxic drugs NSAIDS- nonsteroidal anti-inflammatory Ibuprofen (Motrin, Advil) Naproxen (Aleve) Check with our doctor/pharmacist about your medications Contrast (with X-ray) 9 November 7, 2016 Kaiser Permanente All Rights Reserved.

10 A kidney protective diet: Protein Potassium Sodium Phosphorus Fluids 10 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

11 Protein Avoid overconsumption! Focus on plant sources of protein 11 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

12 How much protein do you really need? Depends on body size and stage of growth Recommended intake for adults is 0.8 gram per kilogram of ideal weight (0.365 grams per lb) Minimum is 10% of total calories Athletes may need slightly more (1.0g / kg or 0.45g / lb) For example, 5 10 man, 170 lbs needs 62 g protein/day 5 4 woman, 125 lbs needs 45 g protein/day 12 November 7, 2016

13 Protein- example of portion 1 deck of cards = 3 oz. of chicken, fish, lamb, beef, pork, etc. (This example is equal to 21 grams of protein) A 3-ounce serving of cooked meat is the same size and thickness as a deck of playing cards. (2 1/2 x 3 1/2 inches x 1/2 inch thick) 13 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

14 Protein examples Buckwheat, 1 cup 23 g Seitan (wheat gluten), 1 oz 21 g Tempeh, ½ cup 20 g Tofu, firm, ½ cup 20 g Soy nuts, roasted, ¼ cup 19 g Meatless burger, 1 patty 4-18 g Chlorella (seaweed), 1 oz 16 g TVP, dry, 1/4 cup 12 g Brewer s yeast, 1 oz 11 g Soy milk, 1 cup 10 g Hemp seeds, 1 oz 10 g Lentils, ½ cup 9 g Amaranth, 1 cup 9 g Quinoa, cooked, 1 cup 8 g Peanut butter, 2 T. 8 g Edamame, ½ cup 8 g Split peas, ½ cup 8 g Sprouted lentils, raw, 1 cup 7 g Beans, ½ cup 7 g Walnuts, 1 oz 7 g Couscous, cooked, 1 cup 6 g Hummus, ½ cup 6 g Peanuts, other nuts, 1 oz 5-6 g Sunflower seeds, 1 oz 6 g Brown rice, cooked, 1 cup 5 g Chia seeds, 1 oz 4 g Spirulina (seaweed), dry, 1 T. 4 g 14 November 7, 2016

15 What is sodium? Sodium is a mineral that can make your blood pressure go up or down. READ YOUR FOOD LABELS! Avoid foods with too much sodium. Avoid salt substitutes!!! Use fresh and dried herbs Goal <2,300mg/day DASH diet may not be wise 15 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

16 What is potassium? Potassium is a mineral that helps muscles and nerves work the right way. Elevated blood potassium levels are dangerous. Try to keep your potassium below 5.0 Medications can affect your blood potassium levels. Even if your blood potassium is within normal levels now, this may change. A list of high potassium foods is available upon request. 16 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

17 High potassium foods Some vegetables Some fruits Salt substitutes Electrolyte drinks Some low sodium foods 17 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

18 What is phosphorus? Phosphorus is a mineral that combines with calcium to keep bones and teeth strong. Extra phosphorus in your blood can cause: Bone thinning Deposits in blood vessels Avoid foods with phosphate additives: Phosphoric acid (found in colas and other sodas) Sodium triphosphate Orthophosphate 18 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

19 Phosphorus absorption Phosphate additives are 100% absorbable Up to 80% absorbable Chocolate Nuts Dairy Less than 50% absorbable Beans Whole grains Bran 19 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

20 What about fluids? It is important to keep your sodium intake low to prevent fluid retention. A normal intake of fluid is about 48 ounces or 6 cups. Contact your dietitian if your doctor wants you to restrict fluid. Check your urine color. 20 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

21 Supplements A standard multivitamin with about 100% RDA is fine Avoid additional mineral and potassium supplements unless prescribed by your physician. Check with your dietitian, physician or nephrologist for other supplements 21 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

22 Healthy eating plate HEALTHY EATING PLATE Use healthy oils (like olive and canola oil) for cooking, on salad, and at the table. Limit butter. Avoid trans fat. If you have high blood potassium, choose lower potassium foods: Asparagus, celery, green beans, green onions, leeks, lettuce, bell peppers. If you have high blood potassium, choose lower K+ fruits: apples, blueberries, grapes, fruit cocktail, pineapple. Drink according to MD recommendations. If no restriction, follow your thirst and drink as needed. Try to choose whole grains: including rice, pasta, breads. Remember potatoes are high in potassium! Choose -3 oz of high quality lean meats: including lean cuts of red meat, skinless chicken breast, turkey, fish, and egg whites. 22 November 7, Kaiser Foundation Health Plan, Inc. For internal use only. ~ KAISER PERMANENTE. th rive

23 Overall dietary goals It is still important for you to follow your current dietary goals Seek help from a registered dietitian to combine your other diets It is not necessary at this time to follow a Renal diet 23 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

24 Be careful list for healthy kidneys Blood pressure and blood sugar control Stop smoking Exercise Lose excess weight Keep all MD appointments Take all prescribed medications Be current on immunizations 24 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

25 Be careful list for healthy kidneys - continued Avoid nephrotoxic drugs Avoid Contrast (with xray) Check with doctor or dietitian before taking nutritional supplements Kaiser MD homepage at: Follow nutrition guidelines Lower sodium intake Moderate animal protein consumption Avoid phosphorus food additives Watch your potassium levels Drink enough fluids 25 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

26 Resources Health Education Center Recipes can be found at: American Heart Association American Diabetes Association 26 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

27 your doctor Order prescription refills (mailed to your home at no additional cost) Schedule routine appointments View recent lab test results Explore interactive health programs and research health topics To sign up, visit kp.org/register Have questions? Call (800) for kp.org telephone support. 27 November 7, Kaiser Foundation Health Plan, Inc. For internal use only.

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