Diabetes Forecast

Simplifying the Complication of Kidney Disease

By Madelyn L. Wheeler, MS, RD, CDE, FADA, CD, Associate Editor , , ,

If you have diabetic kidney disease, it may seem as if your food world is turning topsy-turvy. Strict control of blood glucose and blood pressure is always a must. In the later stages of the disease, you not only need to count carbohydrates and watch sodium in meal planning, but your health care team may advise you to limit how much phosphorus, potassium, and sometimes even calcium you consume.]

Almost all food recommendations from the government and health groups suggest eating more fruits, vegetables, whole grains, and low-fat dairy products. But certain fruits and vegetables (including bananas and potatoes) are high in potassium. Dairy products such as milk, legumes such as beans, whole-grain foods, and meat, fish, and poultry can be quite high in phosphorus.

So what's a person with kidney disease to do?

  • Watch portion size. While people with kidney disease don't need to eliminate meat, poultry, and fish, eating moderate portions is recommended. Even if foods are low in potassium or phosphorus, eating large amounts of them can be a problem.
  • Prepare food differently. Soak potatoes in water before cooking to remove some potassium. Drain and rinse canned vegetables or beans to reduce the sodium.
  • Choose fruits and vegetables that are lower in potassium: say, an apple instead of a banana.

Health groups and professionals could help make living with the combination of diabetes and kidney disease easier, too, by:

  • Standardizing educational materials. Make food amounts the same in lists provided for both diabetes and kidney disease. When providing lists for sodium, potassium, or phosphorus, giving the starch and fruit food amounts that are equivalent to 15 grams of carbohydrate would provide continuity for carb counting.
  • Including potassium and phosphorus per serving in the nutrition facts for foods and recipes. Diabetes Forecast now includes both in recipes, as does the American Diabetes Association's MyFoodAdvisor (diabetes.org/myfoodadvisor) for many of its 5,000 foods.
  • Rethinking nutrient values. For example, the number of milligrams of phosphorus per serving represents the total amount of the mineral in the food. But the body cannot absorb much of the phosphorus found in plant foods such as whole grains and legumes, so the numbers found in food lists and on nutrition facts panels may be misleadingly high.

Controlling diabetes is not an easy task. Complications of diabetes such as kidney disease make the task that much harder. Yet having better information at your fingertips can help you plan meals effectively, avoid foods that overwork the kidneys, and safeguard your health.



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