Dear Reader,

Alice is glad you asked this question because diet is one of the most important aspects for treating kidney, or renal, insufficiency. When a person has renal insufficiency, it means that some of the nephron function in the kidneys has been lost, and the fluid, protein, and electrolytes are not filtered as efficiently through the kidneys. In order to delay renal insufficiency and prevent it from worsening, it is important to limit the amount of electrolytes (i.e., sodium, potassium, phosphorus, and calcium), fluids, and protein that one ingests. Depending on the degree of your renal insufficiency, various protein restrictions would be necessary. At this point, a diet could be planned that would balance your intake of phosphorus, potassium, and calcium. If you have fluid retention, decreased urinary output, and/or hypertension, it could be necessary for you to have a sodium and fluid restriction as well. In this case, you should talk to your doctor about how much to restrict these nutrients.

When we eat large amounts of protein, extra stress is placed upon the kidneys because they excrete waste products derived from protein. Since someone in your situation needs to eat a reduced amount of protein, the protein you eat should come from sources that are easily assimilated into body tissue. This type of protein is termed High Biological Value (HBV for short). The highest HBV protein is from an egg — other sources with slightly lower HBV protein include fish, beef, and poultry. In renal insufficiency, about 70 - 80 percent of your protein should come from these sources.

Diabetes is the main cause of kidney insufficiency, which can eventually result in kidney failure. The reason for this is that increased blood sugar damages the capillaries and nerves that support kidney function. In addition to your low protein diabetic diet, you should also be sure that you are testing your blood sugar daily, exercising, and following your doctor's instructions.

Your doctor and Registered Dietitian can formulate an eating plan designed to meet your specific needs. If you are a Columbia student, this service is free for you at the Health Service. You can call to make an appointment. If not, you can call the American Dietetic Association for a referral to a Registered Dietitian in your area at 800.366.1655.

For more information on diabetes, you can try the following resources:

Hotlines

• American Diabetes Association
  800.232.3472
  

• American Association of Diabetes Educators
  800.366.1655
  

• National Diabetes Information Clearinghouse
  301.654.3327

Websites

• The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH)
  

• The American Dietetic Association

Alice

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