Symptom 1: Changes in Urination

Kidneys make urine, so when the kidneys are failing, the urine may change. How?

§  You may have to get up at night to urinate.

§  Urine may be foamy or bubbly.

§  You may urinate more often, or in greater amounts than usual, with pale urine.

§  You may urinate less often, or in smaller amounts than usual, with dark-colored urine.

§  Your urine may contain blood.

§  You may feel pressure or have difficulty urinating.

What patients said:

"When you go to use the restroom, you couldn't get it all out. And it would still feel just like tightness down there, there was so much pressure."

"My urine is what I had started noticing. Then I was frequently going to the bathroom, and when I got there, nothing's happening. You think, 'Hey, I've got to go to the john,' and you get there: 2, 3 drops."

"I was passing blood in my urine. It was so dark it looked like grape Kool-Aid. And when I went to the hospital they thought I was lying about what color it was."

Symptom 2: Swelling

Failing kidneys don't remove extra fluid, which builds up in your body causing swelling in the legs, ankles, feet, face, and/or hands.

What patients said:

"I remember a lot of swelling in my ankles. My ankles were so big I couldn't get my shoes on."

"My sister, her hair started to fall out, she was losing weight, but her face was really puffy, you know, and everything like that, before she found out what was going on with her."

"Going to work one morning, my left ankle was swollen, real swollen, and I was very exhausted just walking to the bus stop. And I knew then that I had to see a doctor."

Symptom 3: Fatigue

Healthy kidneys make a hormone called erythropoietin (a-rith'-ro-po'-uh-tin), or EPO, that tells your body to make oxygen-carrying red blood cells. As the kidneys fail, they make less EPO. With fewer red blood cells to carry oxygen, your muscles and brain tire very quickly. This is anemia, and it can be treated.

What patients said:

"I was constantly exhausted and didn't have any pep or anything."

"I would sleep a lot. I'd come home from work and get right in that bed."

"It's just like when you're extremely tired all the time. Fatigued, and you're just drained, even if you didn't do anything, just totally drained."

Symptom 4: Skin Rash/Itching

Kidneys remove wastes from the bloodstream. When the kidneys fail, the build-up of wastes in your blood can cause severe itching.

What patients said:

"It's not really a skin itch or anything, it's just right down to the bone. I had to get a brush and dig. My back was just bloody from scratching it so much."

"My skin had broke out, I was itching and scratching a lot."

Symptom 5: Metallic Taste in Mouth/Ammonia Breath

A build-up of wastes in the blood (called uremia) can make food taste different and cause bad breath. You may also notice that you stop liking to eat meat, or that you are losing weight because you just don't feel like eating.

What patients said:

"Foul taste in your mouth. Almost like you're drinking iron."

"You don't have the appetite you used to have."

"Before I started dialysis, I must have lost around about 10 pounds."

Symptom 6: Nausea and Vomiting

A severe build-up of wastes in the blood (uremia) can also cause nausea and vomiting. Loss of appetite can lead to weight loss.

What patients said:

"I had a lot of itching, and I was nauseated, throwing up all the time. I couldn't keep anything down in my stomach."

"When I got the nausea, I couldn't eat and I had a hard time taking my blood pressure pills."

Symptom 7: Shortness of Breath

Trouble catching your breath can be related to the kidneys in two ways. First, extra fluid in the body can build up in the lungs. And second, anemia (a shortage of oxygen-carrying red blood cells) can leave your body oxygen-starved and short of breath.

What patients said:

"At the times when I get the shortness of breath, it's alarming to me. It just fears me. I think maybe I might fall or something so I usually go sit down for awhile."

"I couldn't sleep at night. I couldn't catch my breath, like I was drowning or something. And, the bloating, can't breathe, can't walk anywhere. It was bad."

"You go up a set of stairs and you're out of breath, or you do work and you get tired and you have to stop."

Symptom 8: Feeling Cold

Anemia can make you feel cold all the time, even in a warm room.

What patients said:

"I notice sometimes I get really cold, I get chills."

"Sometimes I get really, really cold. It could be hot, and I'd be cold."

Symptom 9: Dizziness and Trouble Concentrating

Anemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to memory problems, trouble with concentration, and dizziness.

What patients said:

"I know I mentioned to my wife that my memory—I couldn't remember what I did last week, or maybe what I had 2 days ago. I couldn't really concentrate, because I like to work crossword puzzles and read a lot."

"I was always tired and dizzy."

"It got to the point, like, I used to be at work, and all of the sudden I'd start getting dizzy. So I was thinking maybe it was my blood pressure or else diabetes was going bad. That's what was on my mind."

Symptom 10: Leg/Flank Pain

The most common causes of CKD do not cause any pain. And, much of the pain that is near the kidneys is not caused by a kidney problem. But some people who have CKD do have pain.

Some people with kidney problems may have pain in the upper back (where the kidneys are) or on the same side as the affected kidney.

§  Polycystic kidney disease (PKD), which causes large, fluid-filled cysts on the kidneys and sometimes the liver, can cause pain.

§  Kidney infections and kidney stones can cause severe pain, often in spasms.

§  Bladder infections can cause burning when you urinate.

§  People who have medullary sponge kidney say it is painful.

What patients said:

"About 2 years ago, I was constantly going to the bathroom all the time, my back was always hurting and I was wondering why...and they diagnosed that kidney problem."

"And then you're having to get up all time through the night, and then you have the side ache, a backache, and you can't move."

"At night, I would get a pain in my side. It was worse than labor pain. And I'd be crying and my husband would get up, everybody, rubbing my legs."

Top 15 Healthy Foods for People with Kidney Disease

By DaVita® renal dietitian, Sara Colman, RD, CSR, CDE

Researchers are discovering more and more links between chronic diseases, inflammation and “super foods” that may prevent or protect against undesirable fatty acid oxidation, a condition that occurs when the oxygen in your body reacts with fats in your blood and your cells. Oxidation is a normal process for energy production and many chemical reactions in the body, but excessive oxidation of fats and cholesterol creates molecules known as free radicals that can damage your proteins, cell membranes and genes. Heart disease, cancer, Alzheimer’s disease, Parkinson’s disease and other chronic and degenerative conditions have been linked to oxidative damage.

However, foods that contain antioxidants can help neutralize free radicals and protect the body. Many of the foods that protect against oxidation are included in the kidney diet and make excellent choices fordialysis patients or people with chronic kidney disease (CKD). Eating healthy foods, working with a renal dietitian and following a renal diet made up of kidney-friendly foods is important for people with kidney disease because they experience more inflammation and have a higher risk for cardiovascular disease.

1. Red bell peppers

§  1/2 cup serving red bell pepper = 1 mg sodium, 88 mg potassium, 10 mg phosphorus

Red bell peppers are low in potassium and high in flavor, but that’s not the only reason they’re perfect for the kidney diet. These tasty vegetables are also an excellent source of vitamin C and vitamin A, as well as vitamin B6, folic acid and fiber. Red bell peppers are good for you because they contain lycopene, an antioxidant that protects against certain cancers.

Eat red bell peppers raw with dip as a snack or appetizer, or mix them into tuna or chicken salad. You can also roast peppers and use them as a topping on sandwiches or lettuce salads, chop them for an omelet, add them to kabobs on the grill or stuff peppers with ground turkey or beef and bake them for a main dish.

2. Cabbage

§  1/2 cup serving green cabbage = 6 mg sodium, 60 mg potassium, 9 mg phosphorus

A cruciferous vegetable, cabbage is packed full of phytochemicals, chemical compounds in fruit or vegetables that break up free radicals before they can do damage. Many phytochemicals are also known to protect against and fight cancer, as well as foster cardiovascular health.

High in vitamin K, vitamin C and fiber, cabbage is also a good source of vitamin B6 and folic acid. Low in potassium and low in cost, it’s an affordable addition to the kidney diet.

Raw cabbage makes a great addition to the dialysis diet as coleslaw or topping for fish tacos. You can steam, microwave or boil it, add butter or cream cheese plus pepper or caraway seeds and serve it as a side dish.Cabbage Rolls Made with Turkey are a great appetizer, and if you’re feeling fancy, you can stuff a cabbage with ground meat and bake it for a flavorful meal bursting with nutrients.

3. Cauliflower

§  1/2 cup serving boiled cauliflower = 9 mg sodium, 88 mg potassium, 20 mg phosphorus

Another cruciferous vegetable, cauliflower is high in vitamin C and a good source of folate and fiber. It’s also packed full of indoles, glucosinolates and thiocyanates—compounds that help the liver neutralize toxic substances that could damage cell membranes and DNA.

Serve it raw as crudités with dip, add it to a salad, or steam or boil it and season with spices such as turmeric, curry powder, pepper and herb seasonings. You can also make a nondairy white sauce, pour it over the cauliflower and bake until tender. You can pair cauliflower with pasta or even mash cauliflower as a dialysis diet replacement for mashed potatoes.

4. Garlic

§  1 clove garlic = 1 mg sodium, 12 mg potassium, 4 mg phosphorus

Garlic helps prevent plaque from forming on your teeth, lowers cholesterol and reduces inflammation.    

Buy it fresh, bottled, minced or powdered, and add it to meat, vegetable or pasta dishes. You can also roast a head of garlic and spread on bread. Garlic provides a delicious flavor and garlic powder is a great substitute for garlic salt in the dialysis diet.

5. Onions

§  1/2 cup serving onion = 3 mg sodium, 116 mg potassium, 3 mg phosphorus

Onion, a member of the Allium family and a basic flavoring in many cooked dishes, contains sulfur compounds which give it its pungent smell. But in addition to making some people cry, onions are also rich in flavonoids, especially quercetin, a powerful antioxidant that works to reduce heart disease and protects against many cancers. Onions are low in potassium and a good source of chromium, a mineral that helps withcarbohydrate, fat and protein metabolism.

Try using a variety of onions including white, brown, red and others. Eat onions raw on burgers, sandwiches and in salads, cook them and use as a caramelized topping or fry them into onion rings. Include onions in recipes such as Italian Beef with Peppers and Onions.

6. Apples

§  1 medium apple with skin = 0 sodium, 158 mg potassium, 10 mg phosphorus

Apples have been known to reduce cholesterol, prevent constipation, protect against heart disease and reduce the risk of cancer. High in fiber and anti-inflammatory compounds, an apple a day may really keep the doctor away. Good news for people with kidney disease who already have their share of doctor visits.

This kidney diet winner can be paired with the previous good-for-you food, onions, to make a unique Apple Onion Omelet. With versatile apples you can eat them raw, make baked apples, stew apples, make them into apple sauce, or drink them as apple juice or apple cider.

7. Cranberries

§  1/2 cup serving cranberry juice cocktail = 3 mg sodium, 22 mg potassium, 3 mg phosphorus

§  1/4 cup serving cranberry sauce = 35 mg sodium, 17 mg potassium, 6 mg phosphorus

§  1/2 cup serving dried cranberries = 2 mg sodium, 24 mg potassium and 5 mg phosphorus

These tangy, tasty berries are known to protect against bladder infections by preventing bacteria from sticking to the bladder wall. In a similar way, cranberries also protect the stomach from ulcer-causing bacteria and protect the lining of the gastrointestinal (GI) tract, promoting GI health. Cranberries have also been shown to protect against cancer and heart disease.

Cranberry juice and cranberry sauce are the most frequently consumed cranberry products. You can also add dried cranberries to salads or have them as a snack.

8. Blueberries

§  1/2 cup serving fresh blueberries = 4 mg sodium, 65 mg potassium, 7 mg phosphorus

Blueberries are high in antioxidant phytonutrients called anthocyanidins, which give them their blue color, and they are bursting with natural compounds that reduce inflammation. Blueberries are a good source of vitamin C; manganese, a compound that keeps your bones healthy; and fiber. They may also help protect the brain from some of the effects of aging. Antioxidants in blueberries and other berries have been shown to help slow bone breakdown in rats made to be low in estrogen.

Buy blueberries fresh, frozen or dried, and try them in cereal or , topped with whipped topping, in a fruit smoothie. You can also drink blueberry juice.

9. Raspberries

§  1/2 cup serving raspberries = 0 mg sodium, 93 mg potassium, 7 mg phosphorus

Raspberries contain a phytonutrient called ellagic acid which helps neutralize free radicals in the body to prevent cell damage. They also contain flavonoids called anthocyanins, antioxidants which give them their red color. An excellent source of manganese, vitamin C, fiber and folate, a B vitamin, raspberries may have properties that inhibit cancer cell growth and tumor formation.

Add raspberries to cereal, or puree and sweeten them to make a dessert sauce or add them to vinaigrette dressing.

10. Strawberries

§  1/2 cup serving (5 medium) fresh strawberries = 1 mg sodium, 120 mg potassium, 13 mg phosphorus

Strawberries are rich in two types of phenols: anthocyanins and ellagitannins. Anthocyananins are what give strawberries their red color and are powerful antioxidants that help protect body cell structures and prevent oxidative damage. Strawberries are an excellent source of vitamin C and manganese and a very good source of fiber. They are known to provide heart protection, as well as anti-cancer and anti-inflammatory components.

Eat strawberries with cereal, smoothies and salad,or slice and serve them fresh or top them with whipped topping. If you’d like a more elaborate dessert, you can make strawberry pudding or sorbet, or puree and sweeten them to serve as a dessert.

11. Cherries

§  1/2 cup serving fresh sweet cherries = 0 mg sodium, 160 mg potassium, 15 mg phosphorus

Cherries have been shown to reduce inflammation when eaten daily. They are also packed with antioxidants and phytochemicals that protect the heart.

Eat fresh cherries as a snack or make a cherry sauce to serve with lamb or pork. Cherry juice is another way to consume this tasty food.

12. Red grapes

§  1/2 cup serving red grapes = 1 mg sodium, 88 mg potassium, 4 mg phosphorus

Red grapes contain several flavonoids that give them their reddish color. Flavonoids help protect against heart disease by preventing oxidation and reducing the formation of blood clots. Resveratrol, a flavonoid found in grapes, may also stimulate production of nitric oxide which helps relax muscle cells in the blood vessels to increase blood flow. These flavonoids also provide protection against cancer and prevent inflammation.

Buy grapes with red or purple skin since their anthocyanin content is higher. Freeze them to eat as a snack or to quench thirst for those on a fluid restriction for the dialysis diet. Add grapes to a fruit salad or chicken salad. Try a unique kidney diet recipe for Turkey Kabobs that feature grapes. You can also drink them as grape juice.

13. Egg whites

§  2 egg whites = 7 grams protein, 110 mg sodium, 108 mg potassium, 10 mg phosphorus

Egg whites are pure protein and provide the highest quality of protein with all the essential amino acids. For the kidney diet, egg whites provide protein with less phosphorus than other protein sources such as egg yolk or meats.

Buy powdered, fresh or pasteurized egg whites. Make an omelet or egg white sandwich, add pasteurized egg whites to smoothies or shakes, make deviled egg snacks,or add whites of hard-boiled eggs to tuna salad or garden salad to add extra protein.

14. Fish

§  3 ounces wild salmon = 50 mg sodium, 368 mg potassium, 274 mg phosphorus

Fish provides high-quality protein and contains anti-inflammatory fats called omega-3s. The healthy fats in fish can help fight diseases such as heart disease and cancer. Omega-3s also help lower low-density lipoprotein or LDL cholesterol, which is bad cholesterol, and raise high-density lipoprotein or HDL cholesterol, which is good cholesterol.

The American Heart Association1 and American Diabetes Association2recommend eating fish at least two times a week. Fish highest in omega-3s include albacore tuna, herring, mackerel, rainbow trout and salmon.

1American Heart Association: Fish and Omega-3 Fatty Acids

2American Diabetes Association: Seafood – A Smart Choice for Diabetes

15. Olive oil

§  1 tablespoon olive oil = less than 1 mg sodium, less than 1 mg potassium, 0 mg phosphorus

Olive oil is a great source of oleic acid, an anti-inflammatory fatty acid. The monounsaturated fat in olive oil protects against oxidation. Olive oil is rich in polyphenols and antioxidant compounds that prevent inflammation and oxidation.

Studies show that populations that use large amounts of olive oil instead of other oils have lower rates of heart disease and cancer.

Buy virgin or extra virgin olive oil because they are higher in antioxidants. Use olive oil to make salad dressing, in cooking, for dipping bread or for marinating vegetables.

Talk to your renal dietitian about incorporating these top 15 foods for a kidney diet into your healthy eating plan. Keep in mind that these foods are healthy for everyone—including family members and friends who do not have kidney disease or are not on dialysis. When you stock your kitchen with delicious, healthy, kidney-friend foods that’s one big step to helping you do well on your kidney diet.