In South Africa, the first week of September marks Kidney Awareness Week, a crucial reminder to prioritise the health of our kidneys and consider making lifestyle adjustments for better support.
The prevalence of high blood pressure, diabetes, and obesity in the country puts a significant strain on the kidneys and increases the risk of chronic kidney disease (CKD) and renal failure, which may eventually require dialysis or a kidney transplant.
The estimated number of people with chronic kidney disease (CKD) globally is approximately 844 million.
According to the South African Medical Journal, 10% of the world's population has some kind of CKD, which means that 5 million South Africans over the age of 20 are likely to be affected.
Recognising the importance of nutrition in kidney care, experts from the Association for Dietetics in South Africa (ADSA) have revised nutritional guidelines to provide better support for individuals at risk of or living with CKD.
Dr Zarina Ebrahim, a Registered Dietitian and Lecturer at Stellenbosch University, and Lynette Cilliers, a Registered Dietitian at Groote Schuur Hospital, have joined forces to champion nutritional care for kidney disease patients.
In the past, individuals with CKD faced strict dietary restrictions. However, there has been a shift towards a more balanced approach that focuses on whole foods, vegetables and fruit, and limiting ultra-processed foods with additives, explained Cilliers.
“We have moved away from outdated ‘do’ and ‘don’t’ lists to a more balanced approach to whole foods. This is important because people living with CKD must avoid malnutrition and enjoy a good quality of life.”
Cilliers further adds, “This transformative approach not only benefits those with CKD but can also improve the overall health of households and alleviate the physical, psychosocial, and financial burdens associated with kidney disease risk factors.”
While these dietary guidelines are beneficial for anyone looking to protect their kidney health or those at risk, Dr Ebrahim stresses the importance of personalised nutrition guidelines for individuals living with CKD.
These guidelines consider the stage of the disease, current health assessments, and treatments. Dr Ebrahim states, “The aim for CKD patients is to reduce the burden on the kidneys through nutrition, which means paying attention to the protein, potassium, phosphate, and sodium content of the foods they eat.”
While these dietary guidelines are good for anyone aiming to protect their kidney health and those at risk, Dr Ebrahim notes that those living with CKD must have individualised nutrition guidelines that take into account the stage of disease, their current health assessments and treatments.
The aim for CKD patients is to reduce the burden on the kidneys through nutrition, which means paying attention to the protein, potassium, phosphate and sodium content of the foods they eat.
Working with a dietitian on your health team helps to determine healthy eating plans that reflect your food preferences, family life and household budget, as well as your health needs, said Dr Ebrahim.
“Overall, you want to maintain a healthy weight. Your nutrition focus should be on eating a variety of healthy foods to provide you with the right balance of energy and protein.”
Based on expert recommendations, here are the foods and beverages to avoid:
Choose lean sources of protein such as skinless chicken, fish and low-fat dairy. Include plant proteins such as beans and lentils.
Wholegrain foods such as wholewheat bread, brown rice and oats are good choices as they provide fibre as well as energy.
Avoid foods with added salt
Limiting foods with additives such as processed and convenience foods, for example, pies, pastries, polonies, sausages like viennas, crisps, packet soups and takeaways.
“Additives contain potassium and phosphate salts which are absorbed much quicker in your bloodstream than from natural food.
“This is problematic when your kidney function is deteriorating since the kidney struggles to excrete these minerals. You can flavour your meals with herbs and spices rather than salt. Make sure that you limit or completely avoid alcohol.”
Top tips for looking after your kidney health are from dietary experts:
Enjoy what you eat
Experiment with different recipes and ingredients to make healthy and interesting meals.
Make it fun. You don't have to hit a gym, dancing in your living room or gardening is also movement.
Choose your liquids wisely
Consider how much sugar or additives are in your drink of choice. Are you hydrating appropriately for your body's needs? Clean, safe water should be your first choice.
Look out for specials on healthy food items
Plan your meals, it will make shopping and cooking much easier and more economical. Pack in healthy meals for work, rather than buying take-outs.
Manage your stress
Physical and emotional stress influences our overall health and sleep and has a knock-on effect on how we choose foods.
Go for check-ups
Get regular check-ups on your blood sugar levels, blood pressure and weight. Early diagnosis and management of high blood pressure or diabetes can prevent the progression of kidney disease.
It's not the ‘sometimes’ decisions that change the course of your health and wellness, it is the small everyday commitments that alter our lives. Making healthy food choices ‘most days’ is how you change your dietary patterns, said the experts.