The Mediterranean Kidney Diet, the DASH diet, the Nordic diet, and the vegan and vegetarian diet have all been linked to improved kidney function. Following these dietary guidelines has been linked to a lower risk of developing chronic kidney disease. In addition, the course of CKD is generally slowed when patients adopt certain dietary behaviors.

1. New Approaches to the Kidney Diet
By The Lifesciences Magazine
Kidney Diet:
More than 15% of American adults, or around 37 million individuals, have
chronic renal disease, according to the Centers for Disease Control and
Prevention. Limiting sodium, phosphorus, and potassium was a primary
emphasis of CKD dietary recommendations until recently. Because of this,
many plant foods, such as fruits, vegetables, and whole grains, were
traditionally off-limits to those with CKD despite being rich sources of these
nutrients.
Focusing on total Kidney Diet quality — which includes more plant foods —
is, however, recommended by newer research and guidelines, such as the
National Kidney Foundation’s 2020 Kidney Disease Outcomes Quality
Initiative (KDOQI) Clinical Practice Guideline for Nutrition in CKD,
developed in partnership with the Academy. It is possible that this method,
in conjunction with a personalized nutrition intervention, may be more
successful in halting CKD’s development than following predetermined
dietary limits alone.

2. The Mediterranean Kidney Diet, the DASH diet, the Nordic diet, and the
vegan and vegetarian diet have all been linked to improved kidney function.
Following these dietary guidelines has been linked to a lower risk of
developing chronic kidney disease. In addition, the course of CKD is
generally slowed when patients adopt certain dietary behaviors.
Here Are Some New Approaches
to the Kidney Diet ;
1. Protein from Plants Vs. Protein from
Animals
Adults with CKD stages 3 through 5 who are “metabolically stable” and not
on dialysis are encouraged to restrict their protein intake and be closely
monitored, according the KDOQI recommendations and the Academy’s
Evidence Analysis Library. Although both recommendations declare that
there is inadequate evidence to suggest either animal or plant protein as
superior, they do so based on the best knowledge available as of April
2017. (or through August 2018 for any of the consensus opinion
statements).
“While there was insufficient data to support a strong recommendation at
that time, additional evidence favoring plant-based proteins has been
published since,” says Annamarie Rodriguez, RDN, LD, FAND, who has
worked as a nephrology dietitian for nearly 25 years and served on the
boards of several renal-related groups and held positions in the Academy
and affiliate groups. She also maintains a private practice while working
full-time for an infusion firm.
Whether or whether plant proteins are the primary source of protein in the
Kidney Diet, there is sufficient evidence to support the advantages of
include more plant foods and plant proteins for patients or clients with CKD
or at risk for CKD.
2.Plant foods’ effects on chronic kidney
disease

3. Potential advantages of a plant-based Kidney Diet and plant-based protein
consumption for people with CKD include reduced inflammation, decreased
uremic toxins, decreased metabolic acidosis, an improved gut microbiome
due to an increase in fiber intake, and a decreased bioavailability of certain
nutrients, including phosphorus and potassium.
3.Inflammation
Inflammation and inflammatory co-morbidities are more common in people
with CKD. Type 2 diabetes affects 40 percent of those with CKD, whereas
cardiovascular disease affects 65 percent and hypertension affects 50
percent to 75 percent. People with CKD have a higher risk of dying from
cardiovascular disease than the general population.
Comorbidities and inflammation are reduced in those who follow plant-
based Kidney Diets like the Mediterranean, DASH, vegan, and vegetarian.
A 2019 research indicated heart-protective advantages from consuming at
least 800 grams, or roughly five servings, of fruits and vegetables daily. In
addition, according to Rodriguez, there are a plethora of epidemiological
research that point to the preventive and anti-inflammatory advantages of
greater fruit and vegetable diet.

4. When considering the comorbid diseases and inflammatory response
mechanisms that are activated by CKD, “the phytochemicals and
antioxidants in fruits and vegetables are extremely critical to what our
patients require,” adds Rodriguez. “The healthier and more natural
approach is to load up on fruits and veggies.”
4.A Condition Known as Metabolic Acidosis
Because of the kidney’s diminished capacity to filter and remove acids via
urine, metabolic acidosis, or an excess of acids in the blood, may be both a
cause and an effect of CKD. An excessive amount of acid in the body’s
fluids may cause or exacerbate a variety of health problems, including
brittle bones, insulin resistance, squandering of muscle protein and energy,
and the progression of kidney disease.
According to Rodriguez, the oxidation of organic sulfur in amino acids like
methionine and cysteine results in sulfate, which promotes acid formation.
Natural alkaline precursors like citrate and malate may be found in plant-
based Kidney Diets including fruits, vegetables, and legumes, and can be
transformed into serum bicarbonate, which can serve as a buffer.
Rodriguez contends that a diet rich in alkaline foods may be just as
beneficial as oral alkali medicines while also delivering the advantages of

5. fiber, antioxidants, and phytonutrients, which are typically absent from the
conventional or historical CKD diet.
Metabolic acidosis may be treated and prevented with a Kidney Diet rich in
fruits and vegetables, according to reviews published in 2013 and 2015.
Researchers discovered that increasing fruit and vegetable consumption
was just as beneficial as oral sodium bicarbonate in treating metabolic
acidosis in persons with CKD stages 2, 3, and 4.
Rodriguez suggests that even if patients or clients aren’t ready to
completely cut out animal-based proteins, they may still benefit from finding
methods to add in more plant foods like fruits and vegetables.
5.Potassium and phosphorus’s bioavailability
Once upon a time, the cornerstone of the CKD Kidney Diet for persons in
stages 3–5 of CKD and on dialysis was a strict prohibition of foods rich in
phosphorus and potassium. Consequently, consumers cut down on their
intake of plant-based diets. However, there is evidence that the phosphorus
and potassium in plant diets are less accessible than those found in animal
products.
Animal proteins, including meat, chicken, and fish, may have phosphorus
and potassium additions, in a more accessible form, according to a
research published in 2018. Professionals are encouraged to think about
bioavailability of phosphorus sources as recommended by the revised
KDOQI standards.
“When I speak to dietitians about getting CKD patients to eat more plant-
based proteins, their main concerns are potassium and phosphorus,” adds
Rodriguez. She adds that certain plant meals include phosphorus, but that
this phosphorus is in the form of phytic acid, which is poorly absorbed by
humans since we lack the enzyme phytase.
She suggests that the increased fiber content in plant Kidney Diets may
limit the absorption of both phosphorus and potassium. Additionally,
recently discovered potassium binders may assist patients and clients
maintain blood potassium levels within range while simultaneously
consuming more plant foods.
Rodriguez says she constantly tells her patients and clients that processing
methods like sprouting, fermenting, and boiling may make phosphorus
more accessible. Rodriguez urges registered dietitian nutritionists educate
patients or clients about inorganic sources of phosphorus, which commonly
are present in highly processed meals and drinks such as soda. The

6. human body absorbs almost all of the phosphorus that is artificially (or
inorganically) given to the Kidney Diet.
6.Learnings from RDN
Despite the astonishing prevalence of CKD and the promising potential of
medical nutrition treatment to delay the development of the illness, only
around 10% of persons with non-dialysis CKD are projected to ever visit an
RDN. Barriers to MNT may include a lack of physician knowledge and
referrals, plus RDN availability. Whatever the reason, RDNs may wish to
consider advocating for the significance of Kidney Diet for CKD whenever
feasible.
Individuals may delay or forego medical nutrition treatment due to concerns
about the financial commitment involved in consulting a dietician. Private
practice registered dietitian nutritionists (RDNs) can help patients with
chronic kidney disease (CKD) who are not on dialysis or who have had a
kidney transplant within the past 36 months and were referred by their
doctors by becoming Medicare providers, which pays for a limited number
of appointments.
There is a common misperception among patients and clients that a Kidney
Diet rich in fresh produce and healthy grains may worsen their ailment.
Provide the most recent research and details on the many positive effects
of a plant-based Kidney Diet in counseling sessions with patients and

7. clients. You should stress the significance of slow, steady improvements if
your patients or customers are not yet prepared to make drastic ones.
Rodriguez argues that “even minor objectives, even baby steps,” may have
a big effect on health outcomes. Just switching to plant-based alternatives
for a few of weekly meals may have a significant impact.
To Know More About Different Types of Diets : Click Here