[Music] chronic kidney disease is a medical condition in which the kidney function reduces gradually from normal to less than 15 percent a renal dietitian is someone specially trained to give dietary advice based on the patient's diet daily routine appetite blood results and relevant medications discussing your diet with a renal dietitian can help to improve some of your blood results and slow down the progress of your kidney disease although we cannot stop the kidney function decreasing we can slow down the progress of kidney failure by keeping a healthy weight and maintaining a good blood pressure if you are diabetic make sure your blood sugar is well controlled you're encouraged to keep up some regular exercise according to your physical tolerance dietary wise you're encouraged to follow a no added salt diet which means you can use a small amount of salt in cooking but do not add salt to your food at the table the national recommendation of daily salt allowance is 6 grams per day which is roughly equal to 1 teaspoonful of salt you can use normal sea salt please try to avoid using salt substitutes as they are high in potassium processed foods are usually higher in salt content than in their original form that's why you are recommended to cook from scratch as often as possible you can try to flavor your food with different kinds of herbs and spices lemon juice vinegar ginger garlic mustard and pepper you can also try cooking with a small amount of stock cubes please be aware soy sauce oyster sauce and black bean sauce are all high in salt content it will be very useful to learn how to read food labels salt content of a food item is usually displayed as per 100 grams of the product or per serving size sometimes it will be displayed as a percentage of adults daily reference intake or ri sometimes foods labels may only show the sodium content per serving in order to find out the actual salt content of per portion or per 100 grams you will have to multiply the sodium in milligrams by 2.5 luckily most of the food labels show the salt in grams per portion and use the traffic light system for easy understanding when your kidneys aren't working as well as they used to they will lose their ability to remove the excessive salt in your blood your body will keep more water in your blood to dilute out the extra salt as your blood volume increases your heart will have to work harder to keep the blood going around your body this causes your blood pressure to increase due to gravity most of the excessive fluid in your body will accumulate in your feet causing a condition called edema your face and eyelids may also puff up and you may easily feel out of breath high blood pressure can cause your kidney function to go downhill quicker let's look at two different diets and compare their total salt content a bowl of cornflakes with cow's milk one rash of bacon with white bread for breakfast a packet of potato crisps for a snack a jacket potato with grated cheddar cheese and a small sachet of salt and oxtail soup for lunch fish supper and chips with one sachet of salt two tablespoonfuls of ketchup for dinner the total salt content of this diet is 14.4 grams it's more than double of the daily adult recommendation of six grams two beta books with milk and jama toast for breakfast one cup of black tea with some plain biscuits for a snack a jacket potato with cottage cheese and apple juice for lunch grilled chicken breast and chips for dinner flavored with vinegar mayonnaise lemon juice garlic or a small packet of pepper the total salt content of this diet is less than two grams depending on your condition you may be asked to reduce your fluid intake you can measure the size of the mug or cup you use at home read the volume on a drinks label and estimate your daily fluid intake remember tea coffee juice milk alcohol ice cubes soup and all the water you need for taking your medications have to be included food with high fluid content such as yogurt jelly mousse ice lolly and gravy all count as part of your fluid intake you may find following a no added salt diet helps you to comply with fluid restriction good blood sugar control can also help you to feel less thirsty you can try ice cubes chewing gum mints and artificial saliva if thirst is an issue [Music] potassium and phosphate are two other minerals that you may have heard or read about potassium is a mineral for regular heartbeat and your muscle movement any excess would normally be removed by the kidney however when you have chronic kidney disease the level of potassium can build up and can cause potential danger to your heart [Music] examples of some foods high in potassium are potato chocolate tomato and bananas phosphate is a mineral that works closely with calcium to build strong bones high phosphate levels can cause weakening of your bones and long-term damage to the blood vessels symptoms include itching joint pain and red eyes some people do not feel any high phosphate symptoms so it is important to control it before any damage is done examples of some foods high in phosphate or milk cheese and yogurt remember your doctor and dietitian will let you know if you need to restrict your potassium phosphate or fluid intake please do not restrict these items in your diet until you're advised to do so when your kidney function declines a waste product called urea will increase in your blood urea can cause taste changes and poor appetite please ask to see your dietitian if you have any concern with your appetite or weight loss for any further dietary information you can request to see your renal dietitian via your renal consultants and specialist nurses [Music] you



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