Living With CKD (and the Blessings)

As someone who lives with chronic kidney disease (brought on by the sarcoidosis, apparently), I find that it can be tricky to get on a balanced diet - and one that doesn't suck! I'm pretty sure I've said this at least 20 times or more, but I wish doctors knew more about nutrition than they seem to. 

With CKD, there are so many foods, beverages, and herbs that I have to avoid or carefully limit. It's still so wild to me that a lot of the things that are part of a healthy diet for a "normal" person are not good at all for me and other CKD patients. Just when I get to the age and have "developed a palate", I can't enjoy all the green and leafy veggies or some of the most plentiful fruits. Here are a list of ordinarily healthy things that I need to limit (with reasons listed in parentheses):

• Dairy - I pretty much limit it to my coffee & tea... (phosphorous, protein and potassium)
• Avocados - I didn't fall in love with them until a few years ago. (potassium)
• Dried fruit - I used to drink a tea made with dried fruit. Delicious! (potassium)
• Collard greens - A Southern or "soul food" staple! (limit due to potassium)
• Spinach - limited for the same as greens
• Beef jerky - best snack in the history of ever! (sodium)
• Raisins - best snack after jerky- and dates which are a recent fave (potassium)
• Bran cereal - another "really?" one... (potassium, phosphorous and sodium)
• Sweet potatoes - there goes my low-cal sweet potato pie! (potassium)
• Tomatoes & tomato products - just shoot me! (potassium)
• Anything canned or ready-to-eat - not a huge problem since I like to cook my own food. (sodium)
• Anything pickled - even those with "less sodium" (sodium)
• Orange juice - and I do love me some good, cold O.J. (potassium)
• Whole wheat bread - like, really?!?!? (phosphorous and potassium) and the same goes for...
• ... Brown rice - I actually stocked up one before I knew better 

As if that isn't awful enough, potatoes are on the no-no list because of potassium, potassium, potassium... Oh, and I have to limit protein intake. What the heck, right?

Of course, there are other options - especially when it comes to fruit, and I have come to like having a lot of berries in the freezer. The thing is berries are generally more expensive when looking for snacking produce. On the plus side, frozen is almost as good as fresh and are more affordable.

Here is what is on my general shopping list:

• Pineapple juice and pineapple chunks. I get Dole because it tends to be the best as far as taste and ingredients. I use the juice to make smoothies or to make the less tasty beverages easier to go down. Keep reading...
• Cabbage - both red and green. I eat these as "steaks" or simply sautéed and seasoned. Since I cannot chew so well currently, I either juice the green ones and simmer the red ones for the liquid. And this is where that pineapple juice comes in! It's amazing that just a little bit of pineapple juice can make cabbage juice bearable. If I add a little more pineapple juice, the cabbage juice (or water) is actually pleasant.
• Apples. I don't really love apples and have to be in the mood for them, But, again, if I add them to salads or juice them, they help add flavor.
• Fish. Salmon is my go-to fish, but it's hard to find good salmon. Halibut and cod are my other favorites, but salmon is easier to eat without teeth so, for now...
• Shrimp. This is probably my favorite food that's allowed. However, it can be expensive. I try to buy when it is on sale. As I write this, I have some vac-sealed in the freezer that I found on deep sale about 2 months ago. I can't wait til I can chew! (I try to find the best kind of shrimp, which can be tricky when shopping on a budget.)
• Broccoli was a top fave when I was healthier. I will still eat it (raw with a bit of dip or lightly steamed). It's one of those things that is healthy because it might lower creatinine levels, but it also has a lot of potassium.
• Pasta is a favorite - even more so now because it is soft. I eat this either in casseroles (with tuna and/or cheese) or as spaghetti. If I make my own sauce, I can control the sodium and other "bad stuff" better.
• Pinto beans are a HUGE favorite. I can eat them so many ways - in soups, stews, with rice, with ground beef (or... ground turkey ~sigh~), or with cornbread. I always use dried beans, and I soak them overnight (to get rid of some of the potassium) before cooking them. They are so filling and comforting to eat. (I have a goal to start adding chickpeas and lentils into my diet.)
• Tofu - I'm back and forth on this. Sometimes, I find it's great to have around. It surely does bulk up some stews and soups where I'm low on ground beef. Since it basically takes on whatever flavor you give it, it's pretty ideal. It's usually affordable, so there's that.
• Turkey - I am only just recently adding this to my diet. I find that it's soooo much cheaper than ground beef. The trick is to add a little bit of olive oil and seasonings - and don't think too hard about it being turkey and not beef! What I cannot do is turkey bacon. That stuff is just a dry, crumbly mess in the mouth. Yicky!

In addition to pineapple, apple, and grape juice (and cabbage water/juice), I do drink a lot of water, and I am learning to take my coffee and black tea with a lot less cream and/or sugar. I actually enjoy a good cup of Tetley's with just a little bit of milk or cream (not creamer, but cream).  My cold beverage favorites are cold herbal teas or pineapple juice - but I use the pineapple to make the other things less bland.

By the way, here are some things I do for a better diet:

• Cabbage Juice - (I prefer to juice green cabbage because it's usually sweeter than red cabbage.) To avoid pulling out the loud juicer, I use a blender. I wash the cabbage really well, then put the first batch in the blender with a little water. I strain out the juice and use that juice (and a little more water) until I have blended all the cabbage. I strain the pulp really well to get all the juice, then I freeze the pulp to add to smoothies. (I add fruit juice for flavor.)
• Cabbage Water (or pot liquor) - (I prefer this for red cabbage because it's kind of ick(er) when just juiced.) I boil some water and put the cabbage in just long enough to leech the flavor. I find that it tastes better when it's not overcooked. Plus, I can eat the cabbage later. (My mother would just cook the cabbage and save the "pot liquor".)
• Coffee with less cream & sugar - I personally have a hard time drinking black coffee, but I can take it with a little cream. The Luzianne brand red bag coffee is the best one I have found if I have to drink it black. For other brands/brews, for drinking without sugar and just a little bit of plain cream (or half n half)  I like to add a bit of cacao powder. Somehow that makes the coffee more palatable. 
• Alternative to white or brown sugar - I love to add brown sugar to coffee and cereal, but I have found that panela is lower calorie and has some of that brown sugar richness. (I use a powdered panela.)
• Water - I didn't always appreciate plain water, but in Anchorage, the tap water tasted amazing. For the past four or more years, I am very conscious of my water intake. The guideline from my kidney doc is to drink enough so that my urine in a pale yellow - not clear. Drinking too much water depletes minerals and stuff. I find that I prefer my water to be room temp - not cold. My SIL is the opposite (and I always keep some in the fridge just for when she visits!). I also try to remember to add a pinch of Celtic salt to my first glass of water each day. If you find it difficult to drink enough water, try using a straw or experiment with the temperature of the water. 

I hope that this helps someone. I'm sure that it will help you understand how CKD can affect someone's life (and diet).

Peace

--Free