March is designated not only as National Nutrition Month, but also National Kidney Month. Food can be considered medicine and likewise, food choices decrease the progression and symptoms of kidney disease.

People with diabetes, cardiovascular disease and hypertension are at risk for developing kidney disease which can be quite debilitating with time and can even lead to dialysis when the kidneys’ can no longer filter the blood well enough.

As we move about and breathe, our body makes waste products, which have to be removed from the blood. The kidney is made of many tiny filters that let some fluid and waste out and keeps blood cells and protein from passing though. The final product becomes urine. The kidneys control how much fluid, sodium, potassium and phosphate stay in the body which helps control acid levels, blood volume, blood pressure and muscle (including the heart muscle) contractions.

The kidneys also make and regulate hormones that control blood pressure, work with bone marrow to make red blood cells, and decide how much calcium and phosphorus gets absorbed into the blood, which affects bone health. Symptoms of worsened kidney function are bone and mineral disorders with possible fractures, fatigue, anemia, leg cramps and restless legs, itching, loss of appetite and malnutrition.

High blood pressure and diabetes are two conditions that lead to kidney damage so it is important to control these to save the kidneys.

Lifestyle. Take the medicines you’ve been prescribed to control your blood pressure, cholesterol and blood sugar levels. Be more physically active. Lose weight if you are overweight. Take steps to quit smoking if you use tobacco. Limit your alcohol intake.

Nutrition. A balanced meal plan that helps you maintain a healthy weight and is low in salt can help you control your blood pressure. If you have diabetes, your meal plan is also important in controlling your blood sugar.

Calories. Eating the right amount of calories may be step one. Over eating without regard for portion size and/or food choices can lead to obesity and the excess fat makes blood sugars, cholesterol and blood pressure harder to control. Choose fresh and frozen fruits and vegetables, whole grains, low-fat dairy, beans, lentils, nuts and lean meats and fish in meal plans. Steer far clear of candy, sugar sodas, cakes, pastries and chips.

Protein. Protein is important for body maintenance and health but having too much can also be a problem. A diet very high in protein can make the kidneys work harder and may cause more damage. The amount of protein you should have depends on your body size, activity level and health concerns.

Carbohydrate. The amount you need depends on your body size and activity level. Avoiding excesses helps control blood sugar, weight and triglycerides (a fat in the blood that can also negatively affect your kidney and heart health). Healthy sources of carbohydrates include fruits, vegetables, beans, whole grains and dairy. Unhealthy sources of carbohydrates include sugar, honey, hard candies, sugary drinks, cakes, etc.

Fat. Because of the close ties between heart disease, diabetes and kidney disease, choosing healthy fats and limiting the bad ones is important. Choose unsaturated oils like olive, canola or vegetable. In moderation include foods like avocado, nuts and seeds. Remove skin from chicken, remove visible fat from meats and avoid breakfast meats, lard, shortening, and butter.

Sodium. This is a mineral found in most foods naturally. Most Americans get closer to 4,000 to 7,000 mg daily compared to the 1,500 to 2,000 mg recommended for people with kidney disease and hypertension. Too much sodium causes thirst and increases swelling and blood pressure. This leads to kidney damage and causes the heart to work harder.

Start with plain frozen or fresh vegetables or reduced sodium canned ones. Don’t add salt during cooking or while eating. Experiment with herbs and spices for flavor. Use lemon, vinegar or spice blends like Ms. Dash, for example. Most people become accustomed to the new taste of foods when they cut back on salt.

Avoid processed meats like ham, bacon, sausage, luncheon meats and hotdogs. Avoid canned soups and frozen food items with more than 300 mg per serving. Avoid olives and pickled foods and limit condiments like soy sauce, barbeque sauce and ketchup. Hot sauce is high in sodium but a very small amount, may help give flavor with less sodium. Munch on fresh fruits and vegetables rather than crackers and other salty snacks.

With so many important jobs to do, the kidneys deserve tender loving care. If you have diabetes or hypertension, controlling these diseases is extremely important for kidney health. The National Institute of Diabetes and Digestive and Kidney Diseases is a great Internet resource for more information.

Laurel Mackenzie, RDN, LDN, CDE is the dietician for Vidant Beaufort Hospital.