Nutrition plays effective role in slowing chronic kidney disease

Chronic kidney disease (CKD) has emerged as a major global health challenge, affecting nearly 850 million people worldwide.

While medical treatment is essential, dietary intervention remains one of the most effective ways to slow disease progression and improve quality of life.

Currently, malnutrition is common among CKD patients, with studies reporting rates ranging from 18 to 75 per cent, significantly increasing the risk of illness and death. As kidney disease advances, nutritional needs change, often leaving patients confused by shifting, scattered dietary advice.

Current dietary guidelines emphasise that blanket nutrient restriction is unnecessary, unless blood levels are abnormally high. Experts stress that diet-related communication with patients and families should be frequent, simple and practical.

Protein intake is a key area of focus. Low-protein diets are often recommended to reduce stress on the kidneys and slow CKD progression. In India, the average diet already provides relatively low protein (0.6-0.8 g/kg/day).

Avoiding protein-rich foods such as pulses and milk, without proper substitutes can lead to protein-energy malnutrition.

Vegetarians can usually continue their usual diet without severe protein restriction.

Increasingly, a shift toward plant based diets is encouraged, as they benefit heart health, improve gut microbiota, and help manage acid-base balance and bone health.

As kidney function declines, patients often develop abnormal lipid levels. The American Heart Association recommends that total fat should provide 25-35 per cent of daily calories, with limits on saturated and trans fats.

In India, a balanced mix of oils such as groundnut, sesame, rice bran, mustard or soybean oil is advised.

Adequate energy intake is equally important. The 2020 KDOQI guidelines suggest 25-35 kcal per kg of ideal body weight daily, adjusted for age, activity, disease stage and other conditions.

Fibre intake of 25-30 gm per day is encouraged, as it aids digestion and prevents constipation.

Potassium and phosphorus restrictions are now advised only when blood levels are high.

Patients should choose low-potassium fruits and vegetables if hyperkalaemia occurs, and limit foods high in inorganic phosphorus, such as colas, processed meats and instant foods.

Salt restriction remains a cornerstone of CKD care, with WHO recommending less than 5 grams per day.

Fluid intake generally remains normal in early CKD but must be individualised later. Ultimately, experts emphasise that every CKD patient should consult a dietician to develop a personalised, stage-specific diet plan for better kidney health.

— As told to Amritsar Tribune’s Manmeet Singh Gill