Renal-Friendly Diet


Every time I put food into my mouth, I have to be mindful that they are renal-friendly. A visit to the dietician last week has radically changed the way I eat. The visit was recommended by the urologist who wanted me to eat sensibly and reduce food that will put more stress on my impaired kidneys.

The kidneys perform several important functions to keep us healthy. They remove waste products by filtering our blood. They maintain the water balance by removing excess fluid. They maintain a healthy chemical balance in the body by removing those that are not needed.

Kidneys also produce two hormones and an enzyme. Erythropoietin stimulates the bone marrow to produce red blood cells. Calcitriol is the active form of vitamin D and helps the body absorb calcium to keep the bones healthy and strong. Renin is the enzyme that helps regulate blood pressure. I am slightly anaemic because of my renal impairment. The kidneys are not producing enough erythropoietin to stimulate a healthy growth of haemoglobin. However, that is not a cause for concern as my anaemia is mild.

A daily diet of two servings of protein is recommended. One cup of dairy milk or soya bean milk, one half cup of beans or nuts, and one matchbox-size portion of poultry, fish or meat are considered one serving. A high-protein intake produces waste in the blood. This puts a strain on the kidneys by forcing them to work harder in cleaning the blood.

I am also to go on a low-salt and low-purine diet. Food and ingredients with a good amount of salt include most sauces and preserved meats. I am one who likes a little saltiness in my food. This one regime will need a lot of self-control. I am going to miss my hams and bacons. Anchovies, prawns, roes, shellfish and sardines are among food high in purine content. I am advised to avoid high-purine food because of my higher than normal uric acid level.

However, I can eat as many servings of carbohydrates and fruits as I like. There are some vegetables that contain purine such as aparagus, dried beans, cauliflower, cabbage, lentils, mushrooms, spinach and tomatoes that I am allowed twice a week. Mushrooms are one of my favourites, especially shitake. This one needs a little discipline to adhere to.

As for fluids, I am drinking 3 liters of plain water daily which is more than sufficient. However, the dietician advised that the water intake be spread out over the entire day. I used to go on a water binge, gulping down more than 500ml of water at one go. This is another no-no as it puts a sudden strain on the kidneys which is not a good thing.

All said, this change of diet is one that I can keep to. The taboo foods will be like a luxury, one that I will recompense myself once in a long while. Although I am fond of char koay teow (fried rice noodles) and Hokkien mee (prawn noodles), I can live without them for an extended period, all for the sake of my own health. Hopefully, this will arrest, or at least decelerate, the deterioration of my kidneys.

Different Urologist, Same Diagnosis


Visits to the doctor’s clinic in the hospital were always boring affairs interspersed with long waits and depressing sights. Wuan, who had been here since last Saturday, offered to accompany me to see the urologist who first saw me for my bladder condition back in 1991 for another assessment. Her company made it more bearable.

An ultrasound scan of my kidneys was taken in the doctor’s clinic. The diagnosis: shrunken left kidney. However, there were no signs of swelling in both kidneys, which is good news in the midst of bad. A creatinine clearance test was also done to ascertain the extent of my kidney function. It was a simple test where a blood sample was taken, the serum creatinine quantified and the figure for the estimated creatinine clearance arrived at with a straightforward formula.

My estimated creatinine clearance is 47 ml/min which is categorised as moderate renal impairment. The urologist stated that I have about 60% renal function. I am to continue with my intermittent catheterisation. I was also prescribed Detrusitol for my overactive bladder.

I was previously taking Ditropan for the same problem but the side effects were interfering with my daily routine. They included drying of the eyes, mouth and skin which was further aggravated by my body’s impaired ability to regulate body temperature. That made me very uncomfortable when the weather is hot.

Eating the correct food may also help and I have to make an appointment to see the dietician for this purpose. I am scheduled for another blood test in six months. I am keeping my fingers crossed that there will be no further damage to the kidneys when I return for the follow-up appointment.

Diagnosis And Treatment


Peter took me to see the urologist this morning. This is the follow-up to my previous consultation with the doctor and to receive the results of the x-ray and ultrasound of my abdomen.

The diagnosis: I am suffering from hydronephrosis and atrophy of my left kidney. The flow of urine begins in the collection system of the kidneys. It then flows down the ureters to the bladder. Hydronephrosis is the dilation of the kidneys. This could be due to the collection system being obstructed, or when vesicoureteral reflux occurs.

Vesicoureteral reflux is the backflow of urine from the bladder into the kidneys, caused by a neurogenic bladder. I have a neurogenic bladder because of my spinal cord injury. The abnormal pressure in the kidney caused by the reflux and the stagnation of urine will damage and eventually cause the kidneys to fail.


The treatment: Continue with intermittent catheterisation. My bladder does not empty completely. I use a catheter to drain it to prevent a reflux. This I perform every three to four hours throughout the day. I am to take bladder antispasmodic medication to relax the bladder and to prevent it from involuntarily contracting. The bladder antispasmodic I was taking produced uncomfortable side effects such as drying of the eyes and mouth, blurred vision, decreased sweating and nausea.

I was also advised to prevent bladder infections by taking potassium citrate (pot cit) which will make my urine alkaline. Now, pot cit is the most awful tasting liquid I have ever taken, but that is a little discomfort I have to endure to continue maintaining my urinary system?s health.