Diet in Chronic Kidney Disease: Simple Food Guide for Patients on Dialysis and Not on Dialysis (International Guidelines)
Kidney disease mein diet bahut important hoti hai. Jo aap khate ho, usse:
Kidney damage slow ho sakta hai
Swelling aur BP control hota hai
Potassium–phosphorus balance hota hai
Body strong rehti hai
International guidelines kehte hain ki har patient ke liye alag-alag diet plan hona chahiye, labs aur stage ke hisaab se.
Goals depend karte hain ki patient:
Dialysis par hai ya nahi
CKD Stage 1–5 but NOT on dialysis
Ya maintenance dialysis (hemodialysis / peritoneal dialysis) par hai
1. Core Principles – Har CKD Patient ke Liye Common Rules
Sab patients ke liye 5 basic baatein zaroori hoti hain:s
1️⃣ Enough calories (energy)
2️⃣ Sahi amount mein protein
3️⃣ Kam namak (salt)
4️⃣ Potassium & phosphorus labs ke hisaab se
5️⃣ Fluids doctor ke advice ke mutabik
Diet adjust hoti hai based on:
eGFR
Potassium, phosphate, bicarbonate levels
Albumin
Urine output
Dialysis type
Weight & nutrition status
2. Protein Intake – Sabse Bada Difference Yahin Hai
CKD Not on Dialysis (Stage 3–5)
Protein thoda kam rakha jata hai:
0.55–0.8 g/kg/day
Aadhe se zyada high-quality protein hona chahiye
Iska purpose:
Toxins kam banana
Kidney damage slow karna
Phosphate control karna
Avoid karein:
High-protein fad diets
Gym/body-building supplements
CKD on Dialysis
Dialysis ke time protein body se nikal jata hai.
Isliye need zyada hoti hai:
Hemodialysis: 1.0–1.2 g/kg/day
Peritoneal dialysis: 1.2–1.3 g/kg/day
Goal:
Weakness na aaye
Albumin maintain rahe
Muscles strong rahein
3. Energy (Calories) Requirement
Dono groups ko chahiye:
25–35 kcal/kg/day
Bahut kam calories → weakness & muscle loss
Bahut zyada → weight gain & sugar problems
Peritoneal dialysis wale patients glucose absorption ko bhi count karte hain.
4. Salt (Sodium) Restriction
Daily namak:
2 gram sodium se kam (≈ 1 teaspoon salt)
Faayde:
BP control
Swelling kam
Dialysis ke beech weight kam badhta
Heart protection
Avoid:
Pickles
Papad
Canned food
Instant soup
Processed meat
5. Potassium Management
Sabko automatically potassium kam karna zaroori nahi hota.
Diet lab reports ke hisaab se hoti hai.
Restrict tab karte hain jab:
Potassium high ho
Advanced CKD ho
Certain BP medicines le rahe ho
High-potassium foods:
Banana
Coconut water
Orange
Potato
Tomato paste
Dry fruits
Vegetables ko kaat ke, bhigo ke, boil karke pani fenk dena potassium kam karta hai.
6. Phosphorus Control
High phosphorus se:
Bone weak hoti hai
PTH badhta hai
Blood vessels mein calcium jam sakta hai
Goal:
Phosphate normal range mein rahe.
Limit:
Cola drinks
Processed cheese
Bakery items
Organ meat
Prefer:
Fresh homemade food
Rice
Chapati
Limited meat portions
Dialysis patients ko aksar phosphate binders chahiye hote hain.
7. Fluids Kitne Piyein?
Not on Dialysis
Usually normal fluids allowed hote hain jab tak:
Swelling
Low sodium
Heart failure na ho
Dialysis Patients
General rule:
Kal jitna urine nikla + 500 ml
Monitor karein:
Weight jump
BP
Saans ka phoolna
Pairon mein sujan
8. Acid–Base Balance
Acidosis hone se:
Muscle tootne lagti hai
Bone weak hoti hai
CKD fast badhta hai
Doctors chahte hain:
Bicarbonate ≥22 mmol/L
Zarurat par sodium bicarbonate tablets
Balanced diet
9. Vitamins & Supplements
Kabhi-kabhi zaroorat hoti hai:
Kidney vitamin capsules
Iron
Vitamin D
Calcium
Zinc
Herbal medicines ya “kidney detox” products bina pooche na lein.
10. Dialysis Type ke Hisab se Diet
Hemodialysis
Salt & water strict
Dialysis ke baad protein meal
Potassium labs ke hisab se
Peritoneal Dialysis
Protein zyada
Weight gain ka risk
Sugar absorption hota hai
Kuch patients mein potassium liberal hota hai
11. Food List – Simple Table
Prefer | Limit |
Egg whites | Nuts |
White rice | Brown rice |
Apple, pear | Banana |
Bottle gourd | Spinach excess |
Fresh meat | Processed meat |
Homemade food | Packaged food |
12. Common Patient Mistakes
Dialysis se pehle protein bahut kam kar dena Dialysis shuru hone ke baad protein na khana Roz coconut water peena Rock salt freely use karna Herbal powders lena Labels na padhna
13. Key Points Yaad Rakhein
Dialysis ke baad protein zyada chahiye Salt sabko control karna hai Potassium-phosphorus reports pe depend karta hai Diet stage ke saath change hoti hai Har patient ki diet alag hoti hai
Final Word
International guidelines kehte hain:
Ek fixed “renal diet” sabke liye nahi hota.
Best results tab aate hain jab:
Diet kidney stage ke hisab se ho
Blood reports dekhe jaayein
Nephrologist & dietitian supervise karein
Sahi diet se:
Kidney damage slow hota hai Hospital visits kam hote hain Dialysis better tolerate hota hai Muscles strong rehti hain Heart safe rehta hai