Renal Diet Myth Busters

There are many myths and misconceptions regarding kidney health and nutrition. Navigating through all the different information can be confusing and overwhelming, but we are here to help! Here are some common myths to provide you with the information you need to create a healthy, balanced diet plan that works.

Myth: There is only one renal diet that everyone on dialysis needs to follow.

Fact: Everyone is unique and that includes their dietary needs that depend on some of the following:

• Stage of kidney disease.
• Lab results.
• Medications.
• Comorbidities like diabetes or high blood pressure.
• Lifestyle activities like exercising.

Working with your healthcare team and renal dietitian is the best way to create a diet plan that is right for you.

Myth: Whole grains, nuts, seeds, and beans have too much phosphorus.

Fact: Whole grains, nuts, seeds, and beans contain phosphorus, but your body only absorbs 50% of phosphorus from non-processed, plant-based foods! You absorb 80-100% of phosphorus from protein-rich foods like meat, fish, and dairy or processed foods with phosphorus additives. Avoid phosphorus additives like: Sodium hexametaphosphate, Dicalcium phosphate, Trisodium phosphate, Sodium tripolyphosphate, and Phosphoric acid.

Myth: People with kidney disease need a low-potassium diet.

Fact: Contrary to the popular belief that everyone with kidney disease needs a low-potassium diet, people with kidney disease can be at risk of having too much or too little potassium, which affects your heart rhythm.

• High potassium/hyperkalemia: Blood potassium levels are too high. You’ll need to eat less or low-potassium foods if you have high potassium. Your doctor may prescribe or adjust medications to help your body release extra potassium.
• Low potassium/hypokalemia: Blood potassium levels are too low. You may need to eat more potassium or high-potassium foods if you have low potassium. Your doctor may prescribe or adjust medications to help you maintain potassium.

Sudden or severe hyperkalemia and hypokalemia are life-threatening conditions that require immediate medical care.

Myth: I need to limit fruits and vegetables because of potassium.

Fact: Even those who need to limit potassium need plenty of fruits and vegetables. Less potassium is absorbed from plant foods than from meat-based or overly-processed foods. Fiber may also improve bowel regularity to increase overall potassium excretion and improve acidosis, which is a condition where body fluids contain too much acid. Acidosis can cause kidney disease to progress more quickly, increased bone loss or osteoporosis, and muscle loss.

Myth: Salt substitutes are safer than salt.

Fact: Too much sodium can cause high blood pressure, discomfort during dialysis, and fluid build up around the heart and lungs. Salt substitute contain potassium chloride. This could be dangerous, especially if you need to limit how much potassium you eat. If you choose low-sodium or salt-free seasoning blends, look at the label and choose one without potassium chloride. Check with your dietitian to see if it is okay to use.

Myth: I don’t put salt in my food, so I don’t need to worry about sodium.

Fact: Sodium is found in many foods besides the salt shaker. High sodium foods include breads, pizza, sandwiches, soups, tacos, condiments, snack foods, deli and cured meats (bacon, hot dogs, sausages, etc.) Make simple changes while grocery shopping like trying unsalted or reduced sodium foods and choosing fresh foods.

Myth: Eating more salt will help with cramping during and after dialysis treatments.

Fact: Common causes of dialysis muscle cramps include rapid or excessive fluid removal, low blood pressure during dialysis, and electrolyte imbalances. Cramping can be caused by high weight gain in between dialysis treatments, overly aggressive fluid removal, missing or not completing dialysis treatments, and eating too much salt. Tips for managing cramping include longer or more frequent treatments, managing fluid gains in between treatments by limiting sodium to 2000 mg or less a day and following your fluid restriction of 32-48 oz/day, and completing all treatments as prescribed.