The following points are considered, along with your test results and lifestyle:

Protein in the diet

The waste products from protein such as urea

The calories needed from fat and carbohydrate. Too much and weight is put on. Not enough and the body may start to break down muscle for energy needs

Amounts of minerals and salt eaten: both sodium salt (table salt) and potassium salt (salt substitutes)

The management of calcium, phosphate and vitamin D taken in the diet, to prevent bone disease

Fluid intake, so the body has enough, without suffering from fluid overload

This becomes more important when urine output is reduced in the later stages of chronic kidney disease

Protein

People of different ages and sizes need different amounts.

Children and pregnant or lactating mothers need extra for growth, maintenance and repair

During recovery after surgery, severe illness, times of poor diet, more protein is needed. Nutritional supplements can help

Suitable foods high in protein include: meat, fish, poultry, eggs, cheese, milk, milk products, nuts and pulses legumes (after discussion with the dietician)

• The pros and cons of dietary protein restriction to alleviate symptoms of uraemia (high urea levels in the blood), before dialysis starts should be discussed with your doctor and renal dietitian. Monitoring of your nutritional intake is essential when a protein restricted diet is prescribed to prevent under nutrition. Sometimes a spontaneous reduction in protein intake will occur and needs to be corrected

The fats (lipids)

High lipid levels in the bloodstream (hyperlipidemia) are common in kidney patients

The risks of stroke and heart disease are increased

Lipid levels in the blood can be controlled with medication

Prevention of obesity helps, as do exercising, being more active, eating