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Eating well to support kidney health

Most of us are inclined to take our hard-working kidneys for granted. However, like all other

vital organs, our kidneys benefit from daily healthy habits. Physical activity and sufficient

sleep are essential for overall health, but so are our daily food choices. Our kidneys are

responsible for eliminating waste and toxins, as well as maintaining fluid balance in our

bodies, controlling blood pressure and keeping our bones healthy.

The first week of September is Kidney Awareness Week in South Africa. It’s an important

reminder to give our kidneys a second thought and see if there are a couple of lifestyle

tweaks that could provide better support. High blood pressure, diabetes and obesity, all of

which are prevalent throughout the country, tax the kidneys hard and can lead to chronic

kidney disease (CKD) and renal failure, which may require dialysis or a kidney transplant

when the condition becomes severe.

Advances in nutrition science have led to revised nutritional guidelines for those at risk or

living with CKD. ADSA (Association for Dietetics in South Africa) spokespersons, Dr Zarina

Ebrahim, a Registered Dietitian and Lecturer at Stellenbosch University and Lynette Cilliers,

a Registered Dietitian at Groote Schuur Hospital, collaborate to champion nutritional support

and care for patients living with kidney disease. In the past, people living with CKD faced a

range of stringent dietary restrictions. Lynette says, “The liberalization of the dietary

guidelines for CKD patients is now a sparkle of sunshine in a previously doom-and-gloom


She explains: “We have moved away from outdated ‘do’ and ‘don't’ lists to a more balanced

approach of whole foods. This is important because people living with CKD must avoid

malnutrition and enjoy a good quality of life. So, we’ve gone back to the basics of healthy

balanced dietary intake, keeping it simple and natural by favouring the inclusion of foods

such as whole grains, vegetables and fruit, and limiting ultra-processed foods with additives.

This transformative approach can benefit entire households and improve the physical,

psychosocial, and financial health of a family affected by the risk factors for developing

kidney disease.”

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. She says, “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.”

What’s important to note is that the dietary guidelines for people living with CKD, are sound

advice for all. Dr Ebrahim says, “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. Choose lean sources of protein such as skinless chicken,

fish and low-fat dairy. Include plant proteins such as beans and lentils. Whole grain foods

such as wholewheat breads, brown rice and oats are good choices as they provide fibre as

well as energy. Avoid foods with added salt. Choose whole foods where possible by limiting

foods with additives such as processed and convenience foods, for example pies, pastries,

polonies, sausages like viennas, crisps, packet soups and take-aways. 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.”

Lynette and Zarina’s top tips for looking after your kidney health are:

  • Enjoy what you eat - Experiment with different recipes and ingredients to make

healthy and interesting meals.

  • 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.

  • Move. Exercise is not a punishment; it celebrates that your body is able to

move - 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.

  • Stop smoking, your kidneys don't like it.

  • Look out for specials on healthy food items, either online or instore. Plan your

meals in advance, it will make shopping and cooking much easier and more


  • 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.

  • And lastly, know your numbers - 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.

To find a dietitian in your area, visit


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