Have you been told to “watch your phosphorus,” “avoid salt,” or “not to eat those bananas”? A renal diet is one of the most complicated therapeutic diets for patients. This is why the guidance of a renal dietitian is helpful for people with chronic kidney disease (CKD). The American Kidney Fund (AKF) explains how a renal dietitian—who specializes in nutritional care for your kidneys—can help you plan your diet and monitor your health.*

Why is having a renal dietitian important?

No matter what stage of CKD you’re at, a renal dietitian can teach you to feel confident in the food choices you make. The goal of a renal dietitian is not to be the “food police,” but to help teach and empower you to make a healthy, well-balanced diet a part of your lifestyle. Following renal diet recommendations on specific nutrients—such as protein, carbohydrates, fat, vitamins, and minerals—plays an important role in preventing kidney disease from worsening.  

What should I expect when I first meet with a renal dietitian?

Your first appointment with a renal dietitian will include the following:

• An interview to get to know you and your food habits
• A review of all your nutrition-related bloodwork, like phosphorus, potassium, and calcium, if possible
• The creation of a manageable strategy for dietary changes, based on your body type, lifestyle, and bloodwork 

Be sure to bring a family member, friend, or romantic partner along with you to the appointment if they will be helping with grocery shopping and/or cooking. 

How will diet recommendations change as CKD progresses?

Your stage of CKD can affect your bloodwork and fluid status, which will help your renal dietitian determine the appropriate dietary recommendations for you. During the early stages of CKD, many patients do not have to restrict their phosphorus, protein, potassium, and fluids. 

Any dietary recommendations you’re given will likely focus on ways to prevent your CKD from worsening. Often, this includes a heart-healthy diet and/or low-carbohydrate diet if you have diabetes. As the disease progresses and your kidneys become unable to filter excess waste, you may need to restrict certain nutrients to prevent them from building up in your body. 

What should I expect from a renal dietitian when on dialysis?  

If you have kidney failure and require dialysis, you should expect to see your rental dietitian at least monthly. He or she will monitor your:

• weight, 
• appetite, 
• blood pressure, and 
• all nutrition-related bloodwork.

From this, your renal dietician will provide you with personalized nutrition counseling and education. Your renal dietitian and nephrologist will work together to determine if you need medications, renal multivitamins, and/or protein supplements to help improve your bloodwork or nutritional status. 

A renal dietitian will provide fluid recommendations based on:

• the amount you urinate, 
• your body size, and 
• dialysis treatment orders.

Your renal dietitian can educate you on your specific fluid allowance, what counts as a fluid, and tips on dealing with thirst.

If you are overweight and are told to lose weight before transplant surgery, your renal dietitian is a great source to turn to. Renal dietitians specialize in the kidneys, but they can also help with weight loss and other areas of health you may have concerns or questions about. 

Will I still need a renal dietitian post-transplant? 

It is important to continue to see a renal dietitian post-transplant to ensure your new kidney stays healthy. After your surgery, you may need adjustments to your diet. Increasing protein intake or adjusting nutrients based on how your body tolerates anti-rejection medicines is common.

If you require immunosuppressive medicines post-transplant, a renal dietitian can also teach you about food safety to help avoid infections and minimize bacteria that can get into your body from your food.  

Blattman, E. (2020, June 23). Meet your treatment team: Renal dietitian. American Kidney Fund. https://www.kidneyfund.org/kidney-today/meet-your-treatment-team-renal-dietitian.html