Kidney (Renal) Dietitian’s service
Renal dietitians, more commonly known as kidney dietitians support the dietary needs of people with chronic kidney disease (CKD).
What do we do?
We are specialist dietitians who assess the nutritional requirements of people with kidney problems, taking into account their complex needs. We enable people to optimise their nutritional status and quality of life while managing the complications associated with chronic kidney disease (CKD).
We support people to make appropriate changes to food and drink choices. These changes are based on their medical condition, current treatment, blood results, weight, medications and personal circumstances including food choices and lifestyle factors. For more information about kidney dietitians follow this link How can a renal dietitian help me? | Kidney Care UK
Who do we see?
We are based at Gloucestershire Royal Hospital but provide a countywide service to patients in Gloucestershire. We also work as part of the kidney (renal) multi-disciplinary team which includes kidney consultants and specialist nurses.
We work in both inpatient and outpatient settings, you may see a kidney dietitian if you are admitted to the renal ward, attend a renal outpatient clinic or receive dialysis. We specifically see kidney patients with:
- High potassium levels (greater than 5.5 mmol/L)
- High phosphate levels (greater than 1.8 mmol/L)
- Stage 4 & 5 kidney disease
- Poor appetite or weight loss
- Fluid overload
- On dialysis
Not everyone with chronic kidney disease will see a kidney dietitian. For those with stage 1-4 kidney disease, dietary changes such as a no added salt diet, controlling diabetes and being a healthy weight can be beneficial to preserve your kidney function.
We have put together a list of resources below that can help you.
Patients with chronic kidney disease Stage 1-4
Most people with kidney problems will benefit from a healthy diet. Watch the National Kidney Federation (NKF) webinar series: Healthy eating for your kidneys for more information.
There are many organisations that offer support and information to kidney patients. The Gloucestershire Kidney Patient Association (GKPA) is a local charity that offers support for all patients with kidney disease and includes those in the early stages of kidney disease, pre-dialysis, dialysis and transplant patients as well. They also offer support to family members and friends. Take a look around their website to find out more about the GKPA, and how they can help you.
Kidney care UK is the leading kidney patient support charity providing advice, support and financial assistance to thousands every year. There is useful dietary information here too. Check out their website for more information.
The National Kidney Federation also provides free support to people with kidney disease. You can also access a copy of their kidney-friendly recipe book - Taste! Healthy Eating for a Modern Lifestyle – which cost £7.50 from NKF website.
No added salt diet
Eating too much salt is linked with high blood pressure and heart disease, which can damage your kidneys. Everyone should aim to lower their salt intake. For further information go to the Action on Salt website.
Most of the salt we get from our diet is already added to the food we buy therefore checking labels and choosing lower-salt products is an important way of reducing your salt intake. Check out the Food switch APP as this can be a useful tool in helping you keep to a no added salt diet.
If you find cutting down on salt difficult, your taste buds adapt surprisingly quickly to dietary changes. Within a month you won’t be able to tell the difference.
Diabetes
Diabetes is the most common cause of chronic kidney disease, responsible for around a third of people needing kidney replacement therapy (dialysis or pre-emptive kidney transplant). If you need help in managing your diabetes there is the support that you can access, see below:
- Ask your kidney consultant to refer you to the Gloucestershire Hospitals NHS Foundation Trust diabetes service or community diabetes service as appropriate.
- Book an appointment to see your GP or diabetes practice nurse
- Visit the Diabetes UK website
If you have impaired glucose tolerance, ask your GP to refer you to the NHS diabetes prevention programme known as the Healthier You programme, click on the link for more information - NHS England » NHS Diabetes Prevention Programme (NHS DPP)
Weight Management
It is particularly important to try and maintain a healthy weight when you have kidney disease. If you are overweight, weight loss can help reduce the risk of damage to the kidneys and will help to control your blood pressure.
Healthy lifestyles Gloucestershire offers a great individualised approach to help you achieve a healthy weight right now AND enjoy a new healthy diet for the future. You can self-refer or ask your GP for a referral. Support includes one-to-one time with your own coach, a FREE 12-week personalised programme, FREE weight checkpoints at Weigh & Go drop-in sessions, FREE Weight Watchers and Slimming World sessions (GP referral), FREE recipes and tips and access to an online community through their Best-You app
Patient Webinars are also a useful resource.
If you have a BMI greater than 40 with a medical condition that would benefit from weight loss e.g. sleep apnoea, type 2 diabetes, cardiac issues, or a BMI >50 without any medical conditions, you may be eligible for the Specialist Weight Management service (gloshospitals.nhs.uk). Speak to your consultant or GP about a referral.
Being active
Get active! It is important to keep active when you have kidney problems. Exercise has lots of benefits, and any small change to your activity levels can help. Kidney BEAM is a free online exercise resource specially designed for people with kidney problems. Check it out today and get moving.
For an easy-to-use guide to exercise at home use the Fall-proof strength and balance plan, find out more here and follow-on Facebook @fallproofme for free exercises to do at home.
Other resources
Gout:
Gout is caused by a build-up of uric acid in the body which happens when your kidneys are not removing it properly, or when your body makes too much. For diet and lifestyle advice to help manage gout visit the Versus Arthritis website - Gout | Causes, symptoms, treatments | Versus Arthritis
Kidney stones:
A kidney stone is a hard mass that forms from crystals in the urine. In most people, natural chemicals in the urine stop stones from forming. If you have kidney stones, certain changes to your diet may help reduce the risk of forming stones in the future. For more information go to Kidney stones | Kidney Care UK. You might be referred to a kidney dietitian by your urologist or kidney doctor if more in depth dietary advice is needed.
Information for those on low potassium/low phosphate diets:
If your kidney function has dropped to stage 4 or 5 you can experience a high potassium or high phosphate level. These are both minerals that can rise in the bloodstream when the kidneys aren’t working properly. If you have been advised to follow a low potassium and/or low phosphate diet by your kidney dietitian, the following information offers some suggestions to help you.
The Kidney Kitchen | Kidney Care UK is a great resource for those on a low potassium and/or low phosphate diet. They have a wide range of dietary information available to help you manage your chronic kidney disease. It also includes information and support on cooking skills, recipe books, diet myth busters and cooking on a budget.
There are two low-potassium and low-phosphate recipe books that you may find useful:
- Kidney Care UK – Kidney kitchen
- Food for thought – £1.00 from NKF
Only follow this advice if your kidney dietitian has told you that you need to follow a low potassium or low phosphate diet.
The Nephrology (renal) page can be found here