Renal dieticians

The renal dietetic department provides a service to renal (kidney) patients in east and west Kent. We are based in Canterbury at the Kent and Canterbury Hospital and regularly visit the satellite units in Margate, Dover, Ashford, Maidstone and Medway.

Renal diets are complex and need a great deal of specialist dietary input and patient education. Regular contact with a renal dietitian provides continuity of care and, being part of the renal multi-disciplinary team, we are familiar with the diverse range of people’s needs that contribute to a person’s overall health.

All those on dialysis, many pre-dialysis patients and some transplant patients are reviewed by a dietitian. Please ask your renal nurse or renal doctor to refer you to us if you want a dietetic review.

Why you may need a dietetic review

Good kidney function is essential to remove waste products from blood. If the kidneys are not working properly, these waste products may build up, causing some of the symptoms of chronic kidney disease.
By altering your diet, you may be able to decrease the levels of several of these waste products and reduce the severity of some symptoms, helping you to feel well.

The main aims are to eat as healthy and varied a diet as possible and to keep well nourished. This is important at the pre-dialysis stage and when you are dialysing.

The need to change what you eat is based on some of your blood results and is only advised once these are different from the norm. You should not alter your diet without advice from your renal dietitian. Every person will have different dietary needs and what is fine for one individual may be harmful for another.

The renal dietitian will find out what your normal pattern of food intake is, look up your blood results to decide if changes are needed, and then suggest an appropriate diet. This diet will be individually tailored for you, taking into account your own food preferences together with medical and social factors.

Without doubt most dietary recommendations will involve some sort of restriction and have an impact on daily life. The dietitian is there to help you and make it as easy as possible.

Some patients may be malnourished and the renal dietitian will provide advice and support to help prevent / reduce this risk. Malnutrition is a strong indicator of poor clinical outcome and increases length of stay in hospital.

Waste products that affect your health

• Potassium
  This is a mineral found in the cells of the body and the kidneys normally remove any excess. Too high or too low a level of potassium is bad for the heart.

• Phosphate
  Is a substance found in many foods. The healthy kidney maintains the balance of phosphate and calcium. High phosphate levels can lead to bone disease, damage blood vessels and occasionally cause intense itchy skin.

• Salt /Sodium
  You may be advised to reduce your salt intake to help control high blood pressure and / or prevent thirst.
  

Other factors that need to be considered

• Calories / energy
  You need sufficient calories to keep healthy.
  If you are losing weight and / or have a poor appetite the dietitian will suggest ways of increasing your calorie intake.

• Protein
  Protein is vital for maintaining muscle and other body tissues.
  The dietitian will suggest ways of ensuring you have the right amount of protein in your diet.

• Vitamins
  It is common to need B and C vitamin supplements, particularly if you require a potassium restriction. Your kidney doctor will prescribe these. Do not buy over the counter vitamin supplements.

• Fluid
  The amount of fluid allowance depends on your urine output and how much fluid is removed on dialysis. Advice will be given by your doctor, nurse or dietitian.
  

Individuals have unique, individual requirements. These requirements will depend on the stage of kidney failure, blood results and – if on dialysis – what type of dialysis this is.

Recipe books

“Eating Well for Kidney Health: Expert Guidance and Delicious Recipes” by Helena Jackson, Gavin James, Claire Green. Publisher: Class Publishing. ISBN-10: 185959204X

“Eating Well with Kidney Failure: A Practical Guide and Cookbook” by Helena Jackson, Gavin James, Claire Green. Publisher: Class Publishing. ISBN-10: 9781859591161

“Truly Tasty: Over 100 Special Recipes Created by Irelands Top Chefs for Adults Living with Kidney Disease”by Valerie Twomey. Publisher: Atrium. ISBN-10: 1855942143

Useful information

• Low Potassium Diet  - advice for patients.