Renal Diet Cookbook for Beginners: 75 Simple Recipes to Help Manage Chronic Kidney Disease
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Interior and Cover Designer: Stephanie Mautone
Art Producer: Meg Baggott
Editor: Rachelle Cihonski
Production Editor: Jenna Dutton
Production Manager: Jose Olivera
Photography ©2021 Darren Muir. Food styling by Yolanda Muir
ISBN: Print 978-1-64876-632-9
eBook 978-1-64876-136-2
R0
To my husband, Tenny, and my parents, Cindy and Steve, for inspiring, encouraging, and supporting me in all my endeavors.
Contents
Introduction
1 Understanding the Renal Diet
2 Cooking Basics
3 Beverages and Breakfast
Cinnamon Hazelnut Latte
Chai Tea Latte
Blueberry Cranberry Smoothie
Acai Berry Smoothie Bowls
Oatmeal Breakfast Cookies
PB&J Overnight Oats
Chocolate Coconut Pancakes
Egg-Stuffed Avocado
Loaded Veggie Egg Cups with Toast
Plant-Powered Breakfast Wraps
Tofu Breakfast Muffins
Turkey Sausage Breakfast Casserole
4 Salads, Vegetables, and Sides
Crisp Cucumber Salad
Jicama Cabbage Slaw
Crunchy Couscous Salad
Tempeh Salad with Spicy Peanut Dressing
Marinated Mustard Green Beans
Cauliflower Mash
Sesame Asparagus Spears
Roasted Napa Cabbage
Rice Pilaf
Vegan Sweet Potato Chili "Cheese" Fries
Roasted Veggie Ginger Soup
Mushroom Soup
5 Vegetarian and Seafood Entrees
Slow Cooker Kabocha Barley Risotto
Chickpea Shawarma Wraps
Roasted Vegetable and Tofu Fried Rice
Vegetarian Garam Masala Burritos
“Cheezy” Pasta with Broccoli
Tangy Kale Orzo with Tempeh Sausage
Spicy Black Bean Power Bowls
Vegetarian Enchiladas
Pressure Cooker Lentil Sloppy Joes with Coleslaw
Tofu Spring Rolls
Feta, Onion, and Pepper Pizza
Shrimp Quesadillas
Baked Crab Cakes with Corn and Roasted Broccoli
Zesty Tuna Salad Sandwiches with Carrot Sticks
Sheet Pan Teriyaki Salmon with Roasted Vegetables
6 Poultry and Meat Entrees
Rotisserie Chicken Noodle Soup
Chicken and Veggie Soba Noodles
Jerk Chicken with Rice and Vegetables
Sweet Soy Chicken Stir-Fry
Turkey Flatbread Pizza
Spicy Turkey Burgers
Turkey Nuggets with Roasted Vegetables
Turkey-Stuffed Bell Peppers
Lemon-Rosemary Pork with Cauliflower Mash
Baked Apple Pork Chops with Wild Rice and Green Beans
Spiced Lamb Meatballs with Roasted Vegetables
Sweet and Sour Beef Meatballs
Taco-Seasoned Roast Beef Wraps
Chili with Flatbread Crackers
Beef Shish Kebabs with Grilled Corn
7 Sweets and Snacks
Cucumber Pineapple Cooler
Raspberry Pear Sorbet
Dark Chocolate Chickpea Balls
Tangy Lemon Energy Bites
Carrot Cake Cookies
Cinnamon Apple Chia Seed Pudding
PB Chocolate Fudge
Open-Faced Turkey Crackers
Garlic and Herb Flatbread Crackers with Cilantro-Lime Yogurt Dip
Barbecue Roasted Chickpeas
8 Staples and Seasonings
Taco Seasoning
Curry Garlic Seasoning
Italian Seasoning Blend
Barbecue Rub Seasoning Blend
Roasted Tomatillo Salsa
Low-Sodium Dijon Mustard
Mango Teriyaki Sauce
Peanut Apple Sauce
Enchilada Sauce
Unsweetened Almond Milk
Salt-Free Pizza Dough
Measurement Conversions
Resources
References
Acknowledgments
About the Author
Introduction
Welcome to Renal Diet Cookbook for Beginners! My name is Edith Yang; I’m a registered dietitian who is board certified in renal nutrition. Chronic kidney disease (CKD) affects millions of people around the globe and most don’t even know it. By picking up and reading this book, you are one step ahead of the game. My specialty is working with those who have CKD and helping them slow the progression of their kidney disease by making simple dietary and lifestyle changes. Though CKD may be scary and send you down a never-ending spiral of confusion and worry, you should rest assured knowing that CKD is a manageable health condition. My motto is “Healthy alternatives, infinite possibilities!” There is no one-size-fits-all approach to nutrition—my goal is to educate you on a kidney-friendly diet and provide you with the basic tools you need to make conscious and educate
d choices, and create a palatable, delicious, and nutritious diet to fit your lifestyle, needs, and tastes.
I’ve had many clients come to me at various stages of CKD, feeling very confused by all the information on the internet. Most of my clients don’t even understand what is going on or why this is happening to them, and tell me that they are afraid to eat or are avoiding many foods. All of them are afraid of dialysis and want to avoid it. I’ve had much success providing medical nutrition therapy to help my clients delay the progression of the disease and improve their quality of life. Many of my clients have seen improvements in their kidney function with proper nutrition and lifestyle changes. Their success inspired me to write this book, so I could help those affected by CKD and their caregivers navigate through the confusing and conflicting information about the disease.
I believe that knowledge is power and that everyone should have access to and make informed choices about their health and wellness. There is a lot of outdated misinformation on the internet regarding the renal diet. This book will help clear up that information, help you understand the condition, and provide you with up-to-date and evidenced-based nutrition information. We will go through what CKD is, how it happens, and how you can manage it so that you can continue to live a fulfilling life and slow its progression.
The renal diet doesn’t have to be boring and unpalatable. There are a plethora of recipes in this book that the whole family can enjoy. Most of the recipes are designed so that even the most beginner chefs can prepare them. The recipes have tips so that you can customize them to your specific tastes or preferences, and are modified to fit those with other comorbidities such as diabetes and hypertension.
The first step to taking control is educating yourself and you are doing just that!
Please note: This book is written for those with CKD not yet on dialysis. The nutritional needs for those on dialysis are different. Furthermore, every person is different, and everyone has different nutrients they will need to monitor with CKD. You may be at the same stage of CKD as someone but have completely different dietary needs depending on your body and your overall condition. Your nutrition needs may also change as your CKD progresses or changes. The general guidelines in this book are not intended to treat, diagnose, or give specific medical advice. All of the content in this book was created by a board-certified registered dietitian and strives to provide only accurate, scientific-based information. However, your specific health needs may or may not apply. It is best to speak with your medical provider and/or registered dietitian regarding your specific nutrient needs or before starting any dietary protocol.
Tangy Lemon Energy Bites
1
Understanding the Renal Diet
Diet and nutrition are crucial components of living with chronic kidney disease. What and how much we eat plays a large role in helping manage CKD. Following a kidney-friendly diet is extremely important and can help slow the advancement of your kidney disease. Depending on how well your kidneys are working or what stage of CKD you are in will determine what nutrients you will need to watch out for. It may seem complex and daunting, but this book will be your guide to help you manage CKD.
What Is Chronic Kidney Disease?
In 2019, it was estimated that more than 37 million adults in the United States have chronic kidney disease (CKD). Most people are unaware they have kidney disease until it progresses to the later stages and they start to show symptoms. But before we get into what CKD is and how it develops, let me first explain what the kidneys are and what they do.
The kidneys are bean-shaped, fist-size organs located symmetrically on either side of the spine. Each kidney weighs 4 to 6 ounces and contains more than half a million nephrons (filtering units). The kidneys have many important jobs, such as removing extra fluids and waste products, maintaining electrolyte balance, controlling blood pressure, helping make red blood cells, and keeping our bones healthy. Our kidneys work 24 hours a day to keep our bodies healthy and in balance. CKD occurs when the nephrons are damaged and can no longer do their job. As a result, toxins and fluids build up and cause more damage to the body.
The Causes of CKD
Diabetes and hypertension are the most common causes of CKD. Other factors that put people at risk for CKD are heart disease, family history of kidney disease, obesity, autoimmune diseases, overuse of painkillers, genetic disorders, kidney stones, and urinary tract infections. It’s important to note that as we age, there is a normal decrease in our kidney function. After 30 years of age, our kidney function declines about 10 percent with each passing decade. This makes it even more important to monitor your kidney function and do what you can to slow its progression.
DIABETES
Diabetes is the number one cause of CKD in the US. If you have CKD caused by diabetes, it is commonly referred to as diabetic kidney disease (DKD) or diabetic nephropathy. Diabetes leads to CKD in various ways but generally it is due to high blood sugar. If your blood sugar is not under control and you have consistently high blood sugar levels, damage to the blood vessels in the nephrons of the kidneys occurs.
If you have diabetes, take control of your blood sugar and speak with your healthcare practitioner (HCP) and dietitian about what goals are best for you.
HYPERTENSION/HIGH BLOOD PRESSURE
The second leading cause of CKD is hypertension (HTN) or high blood pressure; these cases account for about 30 percent of all cases of end-stage kidney disease in the United States. HTN occurs when the pressure of blood against the walls of your blood vessels gets too high. Over time, high blood pressure damages your blood vessels and reduces blood flow to your organs, including the kidneys. HTN damages your nephrons and they become unable to properly filter out extra waste, toxins, and fluids.
Normal adult blood pressure is less than 120/80. Blood pressure goals for those with CKD should be as close to normal as possible. However, every person is different, so be sure to ask your HCP what goals are appropriate for you.
CARING FOR SOMEONE WITH CKD
Caring for someone with CKD can be a very complex, challenging, and stressful task. However, being a caregiver for someone with CKD is especially important, because many who are going through this are lost and overwhelmed. Having a good support system is crucial for the success and management of the disease.
The information and recipes in this book are designed to fit the needs of the person with CKD but they are also designed to fit the palates of everyone, including you. You may need to modify the way you currently cook and prepare foods, but know that the recipes are designed to be nutritious and benefit everyone while still being delicious. As caregivers and family members, you should keep an open mind and know that you can modify and adjust the taste profiles of the recipes after cooking by adding your own seasonings, spices, and sauces.
Living with kidney disease or caring for someone with it requires patience, courage, and positivity. Thank you for being a part of someone's life and helping them work through this disease.
Diagnosing CKD
As I mentioned earlier, most people don’t realize they have kidney disease until it’s very advanced. At the later stages of CKD, you may start to show symptoms such as water retention (edema), fatigue, itching, decreased appetite, sleep disturbances, anemia, and an increased sensitivity to medications. The best way to find out if you do have kidney disease is to have your healthcare practitioner run simple blood and urine tests. I recommend all adults with or without CKD to check in with their HCP at least once a year for a routine physical and to get blood work done.
In general, your HCP will want to evaluate your estimated glomerular filtration rate (eGFR), creatinine, and urine to assess and stage your CKD. The eGFR estimates how well your kidney’s nephrons are filtering. You can think of the eGFR in terms of a percentage. If your eGFR is 87, your kidneys are working at 87 percent of their capacity. Most healthy adults have an eGFR of 90 mL/min/1.73m2 or higher. The National Kidney Foundation defines CKD as having kidney damage o
r a decreased GFR for more than three months.
The First Steps
When you first find out you have CKD, your primary doctor or other HCP may talk to you about what caused your kidney disease. They will likely refer you to a nephrologist, but if not, you should ask for a referral. A nephrologist is a doctor who specializes in treating kidney disease, and can provide you with more detailed information on what you need to do to and guide you on the proper steps to help manage your condition.
Another specialist you should be referred to or request to see is a registered dietitian. A registered dietitian (RD/RDN) is someone who is trained in food and nutrition and how these things impact the body. They are able to provide you with medical nutrition therapy, which is important if you have CKD. A nutritionist or health coach is not the same thing as a dietitian. RD/RDNs must have a bachelors degree, take courses from an accredited program, undergo extensive training and complete more than 900 hours of supervised practice through an internship. In addition, they must take and pass a national exam that is overseen by the Commission on Dietetic Registration.
There are some registered dietitians, such as myself, who specialize in kidney nutrition. They are referred to as a CSR (board certified specialist in renal nutrition). You can refer to the Resources to find a CKD dietitian near you. As you will learn throughout this book, diet and nutrition are critical in helping you manage your kidney disease. When you meet with a dietitian, they will go over your complete medical history, review your labs, medications, and any other pertinent health or lifestyle information and develop a plan personalized just for you. Though this book will provide a basic guideline for you, it is important to know that individual needs can vary and seeking out professional help is recommended.
The Five Stages
CKD is typically a progressive disease. Your kidney function declines over time. Knowing what stage you are in is one of the first steps toward managing the disease. There are five different stages of CKD and your diet and nutrition needs may vary at each stage.
STAGE
GFR (ML/MIN/1.73M2)