I am empowered because I use and enforce my right to be a decision-maker as it relates to my health and treatment options.
My Needs
I am empowered because I have access to resources and information that help me identify my needs and figure out how my care should address my needs.
My Voice
I am empowered by the education that patient organizations like NephCure provides. This allows my voice to be amplified and to become a part of a more significant change in health outcomes.
My Values
I am empowered because I know health equity means having access to the medical care I deserve. Healthcare should NOT be a privilege for some. All people should receive the same access to care so that we can have healthier individuals and communities.
My Expertise
I am empowered because my expertise in living with a rare disease is valuable. I know my journey is powerful and has meaning.
A kidney-healthy diet is a specific way of eating that helps support your kidney function, and is especially important if you have rare kidney disease (RKD). This diet limits certain things like salt, potassium, and phosphorus which can be hard for the kidneys to process.
But it’s not just about what you eat— it’s also important to think about how you cook your food. Preparing kidney-friendly meals using safe, non-toxic cookware is another way to ensure your meals stay healthy. Certain cookware, like non-stick pans, can release harmful chemicals when exposed to heat due to the materials it’s made with. The guide below will help you to identify how the quality and safety of food can be impacted by the cookware you’re using.
Remember to always consult your doctor or specialist before starting a kidney-healthy diet or choosing cookware to ensure it’s the right option for you.
Safe and Non-toxic Cookware Options:
Click on each arrow to learn more
Stainless Steel
Stainless steel cookware is widely regarded as safe and non-toxic for everyday use. Stainless steel non-toxic cookware is a durable, corrosion-resistant alloy that’s practical for a wide range of cooking tasks. By preheating your stainless steel pan and using a bit of oil you can help prevent food from sticking. It’s also an affordable option that offers long-lasting performance.
Safety and Toxicity:
Material Composition
Stainless steel is primarily composed of iron, chromium, and nickel. These elements are generally considered safe for cooking. The chromium and nickel enhance durability and resistance to corrosion, while the steel provides strength.
Non-Reactivity
Stainless steel cookware is non-reactive, meaning it does not interact with acidic or alkaline foods. This prevents leaching of metals into food, making it a safe choice for a variety of cooking applications.
Safe Usage Tips:
Choose High-Quality Cookware
Opt for stainless steel cookware from reputable brands that use high-quality alloys. This reduces the risk of issues such as leaching or rusting.
Avoid Overheating
Extremely high temperatures can cause discoloration or damage to the cookware. Use appropriate heat settings to maintain the integrity of the cookware.
Regular Cleaning
Follow manufacturer guidelines for cleaning and avoid using abrasive materials that can damage the surface.
Tempered Glass
Glass cookware is both non-toxic and nonreactive, meaning it won’t alter the taste or safety of your food. It’s transparent, allowing you to monitor your cooking progress, and it’s easy to clean. Glass non-toxic cookware is oven-safe but should be handled carefully to avoid breaking.
Safety Features:
Durability
Tempered glass is designed to be more durable and resistant to thermal shock compared to regular glass. This means it can handle sudden changes in temperature, such as going from the oven to a countertop, without breaking.
Non-Reactive
Tempered glass is non-reactive, which means it won’t leach chemicals into food or react with acidic ingredients. This makes it a safe choice for cooking and baking.
No Coatings
Unlike some cookware, tempered glass does not have coatings that could wear off or interact with food. This ensures that no harmful substances are introduced during cooking.
Safe Usage Tips:
Avoid Thermal Shock
Do not expose tempered glass cookware to sudden temperature changes, such as placing a hot dish directly into cold water. This can cause it to crack or break.
Check for Damage
Regularly inspect your tempered glass cookware for any cracks, chips, or signs of wear. Damaged cookware should be replaced to prevent potential hazards.
Copper
Copper cookware is generally safe for cooking, but there are some considerations regarding its potential toxicity, especially under certain conditions:
Safety and Toxicity:
Copper Leaching
Cooking in unlined copper cookware can cause copper to leach into food, particularly with acidic foods like tomatoes or citrus. While small amounts of copper are essential for health, excessive copper intake can lead to copper toxicity, which may cause symptoms such as nausea, abdominal pain, and headaches.
Lined Copper Cookware
Many copper pans are lined with a non-reactive metal, such as stainless steel or tin, which prevents copper from coming into direct contact with food. Lined copper cookware is generally considered safe as long as the lining is intact.
Wear and Tear
Over time, the lining in copper cookware can wear down or become damaged. When this happens, the underlying copper may become exposed, potentially leading to copper leaching.
Safe Usage Tips:
Use Lined Cookware
Opt for copper cookware that has a lining of stainless steel or tin to prevent copper from leaching into food.
Regular Inspection
Check for damage to the lining. If you notice scratches, dents, or peeling, consider replacing the cookware or having it professionally re-lined.
Avoid Acidic Foods
If using unlined copper cookware, avoid cooking highly acidic foods to minimize the risk of copper leaching.
Aluminum
Aluminum cookware is generally safe, but there are considerations regarding its potential toxicity, especially under certain conditions. It is lightweight and affordable, but often requires a nonstick coating or anodizing to reduce reactivity.
Potential Risks:
Uncoated Aluminum
Cooking acidic foods in uncoated aluminum can cause the metal to leach into your food. While the amount is usually small, excessive aluminum intake has been debated for its possible links to health issues like neurotoxicity and Alzheimer’s disease.
Nonstick or Anodized Aluminum
Modern aluminum cookware is often anodized or coated with a nonstick surface, which reduces the risk of aluminum leaching. Anodized aluminum creates a non-reactive surface, making it safer for cooking.
Safe Usage Tips:
Avoid Acidic Foods
If using uncoated aluminum, steer clear of cooking acidic foods to minimize aluminum leaching.
Regular Replacement
Replace cookware with damaged coatings or significant wear to ensure safety and performance.
Carbon Steel
Carbon steel cookware is not considered toxic when used properly. It shares many similarities with cast iron, including its chemical composition and the way it develops a natural nonstick surface.
Safety and Toxicity:
Seasoning
Like cast iron, carbon steel cookware develops a protective seasoning layer when it’s seasoned properly. This layer helps to create a nonstick surface and prevent rust. When properly sea
Chemical Composition
Carbon steel is primarily made of iron and carbon, with no harmful chemicals that would pose a risk when used as cookware. It is a safe material for cooking.
Maintenance
Proper care and maintenance are crucial. If the seasoning is damaged or the cookware is not dried thoroughly after washing, it can rust. Rusty carbon steel cookware should be cleaned and re-seasoned rather than used, as consuming rust particles can be harmful.
Safe Usage Tips:
Season Regularly
Maintain a good seasoning layer to prevent rust and ensure the cookware remains non-reactive and safe.
Avoid Cooking Acidic Foods
While carbon steel is generally safe, cooking highly acidic foods frequently can break down the seasoning layer over time.
Proper Cleaning
Avoid harsh cleaning methods or soaking your cookware, as this can damage the seasoning and lead to rust. Clean with warm water and a soft brush, and dry immediately.
Stoneware
Stoneware cookware is generally considered safe and non-toxic for everyday cooking. It is ideal for baking, offers even heat distribution but requires careful handling to avoid cracking.
Safety and Toxicity:
Material Composition
Stoneware is made from clay that is fired at high temperatures to create a durable and non-porous surface. It does not contain harmful chemicals or metals, making it safe for cooking.
Glazes
Stoneware cookware is often coated with a glaze to enhance durability and aesthetics. Most modern glazes are lead-free and food-safe. However, older or imported stoneware might have lead-based glazes. To ensure safety, check for labels or certifications indicating that the glaze is free of harmful substances.
Non-Reactivity
Stoneware is non-reactive, meaning it won’t leach chemicals or react with acidic or alkaline foods, which makes it a safe choice for a variety of dishes.
Safe Usage Tips:
Verify Glaze Safety
Ensure that your stoneware is labeled as lead-free or has been tested for harmful substances, especially if it’s an older piece or from an unfamiliar source.
Avoid Sudden Temperature Changes
Stoneware can crack or break if exposed to extreme temperature changes, so avoid transferring it directly from the refrigerator to a hot oven.
Regular Inspection
Check for any signs of damage or deterioration in the glaze, as cracks or chips can compromise the safety of the cookware.
Ceramic Coated
Ceramic-coated cookware is generally considered non-toxic. It is typically made from a base material (like aluminum or stainless steel) that is coated with a layer of ceramic.
Safety and Toxicity:
Non-Reactive Surface
Ceramic coatings are made from inorganic materials that do not react with food. This means they won’t leach chemicals into your meals, even when cooking acidic foods like tomatoes or citrus.
Free from Harmful Chemicals
High-quality ceramic-coated cookware is typically free from potentially harmful chemicals like PTFE (Teflon) and PFOA, which are found in some non-stick coatings. This absence reduces concerns about chemical exposure.
High Heat Resistance
Ceramic coatings can often withstand higher temperatures than traditional non-stick coatings without breaking down or releasing toxic fumes.
Safe Usage Tips:
Durability
While ceramic coatings are generally safe, they can wear down over time. Scratches, chips, or cracks in the coating can compromise the non-stick surface and potentially introduce particles into your food.
Proper Use and Care
To ensure your ceramic-coated cookware remains safe, avoid using metal utensils, which can scratch the surface, and refrain from using abrasive cleaners. Always follow the manufacturer’s guidelines for heat settings to prevent damage.
Ceramic
Ceramic cookware is naturally nonstick, making it easy to clean without the need for chemical coatings. It’s free from harmful metals and toxins, ensuring that nothing leaches into your food. Ceramic is also oven-safe and can be used for various cooking methods.
Safety and Toxicity:
Made to Last
100% ceramic cookware is handcrafted from clay and other ceramic materials which results in a very high quality product that is made to last a lifetime. The surface is also non-scratch and resistant to chips from minor bumps or bangs. Without the need to consistently replace these products it reduces consumer waste and consumer cost over time.
Non Reactive
Ceramic is non-reactive, which means it won’t leach chemicals or metals into food or react with acidic ingredients. This makes it a safe choice for cooking and baking.
Thermal Properties
Ceramic is a thermal insulator which means that it retain heat very well. White it may take more time for the pan to heat up to temperature it will retain that temperature longer than other materials which means that it is optimal for taking food from the stove to the table without food cooling down. Ceramic can also withstand high temperatures and be used under the broiler, on the grill, and in the dishwasher.
Safe Usage Tips:
Avoid Thermal Shock
Do not expose ceramic cookware to sudden temperature changes, such as placing a hot dish directly into cold water. This can cause it to crack or break. Thermal breakage is rare but if it does happen some companies back their products with a thermal shock warranty!
Storing
Store your cookware with a soft towel or our specially designed cookware protectors between pieces to prevent any chipping or damage.
Cleaning
This cookware is safe to use in the dishwasher and easily hand washable with hot, soapy water and a scour pad or brush. If using in the dishwasher be mindful to stack the cookware safely to avoid unnecessary damage.
Cast Iron
Cast iron is one of the safest metals for non-toxic cookware, though it can leach small amounts of iron into food. For most people, this is beneficial, especially those who are iron deficient. Check with your nephrologist to confirm whether you should be monitoring iron intake. It is versatile and great for high-heat cooking. Cast iron non-toxic cookware is incredibly durable and, when properly seasoned, can develop a natural nonstick surface over time.
Safety and Toxicity:
Non-Toxic Cooking Surface
When properly seasoned, cast iron forms a natural non-stick surface using vegetable oils. This means there is no need for synthetic coatings that might degrade over time or leach harmful substances into your food.
Heat Stability
Cast iron can withstand very high temperatures without releasing any toxins. It also distributes heat evenly, ensuring that your food is cooked thoroughly and without burning or sticking.
Well-Seasoning Reduces Iron Leaching
If iron leaching is a concern, a well-seasoned cast iron pan can reduce the amount of iron that leaches into food, Seasoning creates a protective barrier that prevents direct contact between the raw iron and food, reducing the risk of any metallic taste or excessive iron leaching. The seasoning improves over time, making the cookware even more stable and reliable.
Safe Usage Tips
Cooking Acidic Foods
Note that highly acidic foods (e.g., tomatoes, citrus, vinegar) can strip the seasoning and react with the iron, causing iron and a metallic taste to leach into your food. While some iron leaching from cast iron is generally considered safe and may be beneficial for those with iron deficiencies, excessive iron intake can be harmful. Consult with your nephrologist to confirm whether you need to monitor iron intake.
Avoid Sudden Temperature Changes
Cast iron is prone to cracking from thermal shock when exposed to sudden temperature changes (e.g., putting a hot pan under cold water).
Rust Prevention
Cast iron is prone to rusting if not properly cared for. After washing, always dry the pan thoroughly and apply a thin coat of oil before storing. Avoid soaking the pan or leaving it wet.
Seasoning is the process of creating a non-stick, protective layer with a layer of oil on cast iron cookware to enhance its cooking performance and durability.
How to Season Cast Iron:
Clean the Cookware: Start with clean, dry cast iron. If necessary, scrub it with a mild detergent and dry thoroughly.
Apply Oil: Rub a thin, even layer of a high-smoke-point oil (like vegetable oil, flaxseed oil, or canola oil) over the entire surface of the cookware, including the exterior and handle.
Heat the Cookware: Place the oiled cookware in an oven preheated to a high temperature (around 400-450°F or 200-230°C). Bake it upside down on the middle rack with a baking sheet or aluminum foil on the lower rack to catch any drips. Bake for 1 hour to allow the oil to polymerize and form the seasoning layer.
Cool Down: Let the cookware cool in the oven to room temperature before removing it.
When Should You Replace Your Non-Toxic Cookware?
Cast iron pans are beloved for their durability and versatility, but even the most well-maintained cookware can eventually reach the end of its life. While some issues can be repaired, certain defects in cast iron cookware signal that it’s time for a replacement.
Cracks:
Cracks are one of the most serious problems with cast iron pans. Frequent use at high temperatures can cause cracks to form, which can expand and become hazardous over time. Not only do cracks weaken the pan, but they can also harbor bacteria, making it difficult to clean thoroughly. To avoid the risks of a cracked pan, it’s best to replace it once you notice any fractures.
Chips and Holes:
Chipping can occur when food burns and sticks to the pan or when the pan is accidentally bumped against other cookware. Holes can also develop over time due to improper care. Both chips and holes can worsen, compromising the pan’s integrity. If you notice significant chipping or holes, it’s time to invest in new cookware.
Warping:
Warping happens when a cast iron pan is exposed to extreme or rapid heat changes, causing the metal to bend. A warped pan won’t sit flat, leading to uneven heating and increased risk of tipping. While minor warping might not be an immediate concern, severe warping can make cooking difficult and dangerous.
Rust:
Rust is a common issue with cast iron, often caused by moisture penetrating the pan’s surface. While some believe that rust can be scoured off and the pan re-seasoned, it’s hard to determine how deep the rust has gone. Cooking with a rusty pan can allow rust and iron particles to leach into your food, which can pose health risks. If rust has progressed to the point of corrosion, it’s safer to discard the pan.
Health Risks of Rusty Pans:
Using a rusty cast iron pan can lead to excess iron consumption, which may cause stomach issues, ulcers, and other abdominal problems. Since the body cannot eliminate excess iron, prolonged use of a rusty pan can increase the risk of diseases like heart disease or liver cirrhosis in some individuals. To protect your health, it’s best to replace a rusted pan rather than take the risk.
Ceramic-coated cookware is popular for its nonstick properties and ease of use. However, over time, these pans can lose their effectiveness. Here are the key signs that it’s time to replace your ceramic-coated pans:
Food Sticks to the Surface:
The main appeal of ceramic-coated pans is their nonstick surface. If food starts sticking, it’s a clear sign that the nonstick coating is wearing off. As this coating deteriorates, the surface becomes more porous, making cooking difficult.
Scratches and Chips on the Surface:
Visible scratches and chips indicate that the ceramic coating is compromised. Once damaged, the pan’s performance and safety can be affected, as food may stick or even absorb particles from the scratched surface.
The Pan Warps or Distorts:
Ceramic-coated pans are often made from lightweight materials that can warp over time. If your pan is no longer flat, cooking becomes uneven, and the risk of spills increases. A warped pan should be replaced to ensure safe and effective cooking.
The Color Fades:
Fading color is a sign that the ceramic coating is wearing off. As the vibrant color diminishes, the surface becomes more porous and less nonstick, indicating it’s time for a replacement.
The Pan Is Hard to Clean:
If your ceramic pan is becoming harder to clean, it’s likely that the nonstick coating is deteriorating. Food particles can get trapped, making it difficult to maintain hygiene. A pan that’s tough to clean is a strong sign it’s time for a new one.
The Handles Are Loose:
Loose or broken handles are another indicator that your pan may be too old. If the handles can’t be tightened or repaired, it’s safer to replace the pan.
What Is the Life Span of Copper Pans?
Copper pans can last for years, even decades, with proper care. The longevity of your copper cookware largely depends on how often you use it, how well you maintain it, and the type of copper pan you own.
Types of Copper Cookware:
Lined Copper Cookware: These pans have a lining of non-reactive, food-safe metals like tin or stainless steel, making them safer for cooking. The lining protects your food from direct contact with copper, preventing copper poisoning.
Unlined Copper Cookware: These pans have copper on both the inner and outer surfaces. While they can be used occasionally without much risk, frequent use can lead to copper toxicity, as copper may leach into your food.
Factors Affecting Copper Pan Longevity:
Exposure to Oxygen and Acidic Foods: Copper reacts with acidic foods, potentially damaging the lining over time. To prolong your pan’s life, avoid cooking acidic dishes frequently and be gentle when using utensils to prevent scratches that expose the copper.
Maintenance: Regular cleaning and polishing can prevent your copper pans from oxidizing and turning green. Lined copper pans may need re-tinning every few years, which a coppersmith can do by melting tin and applying it to the pan’s interior.
When to Replace Your Copper Pans:
Damaged Copper Coating: If your pan’s copper lining is scratched or broken, it can pose a health risk, as copper can leach into your food. Re-tinning is an option, but it can be costly. If re-tinning isn’t feasible, it’s best to replace the pan.
Warping: Warped pans affect cooking quality, leading to uneven heating. If your pan wobbles on a flat surface, it’s a sign that it’s warped and should be replaced.
Broken Handle:
A broken or loose handle can be dangerous, especially when lifting a hot, heavy pan. If the handle can’t be repaired, it’s time to get a new pan.
How Long Do Stainless Steel Pans Last?
Stainless steel pans are known for their durability and longevity, but their lifespan can vary based on several factors. High-quality stainless steel pans, when properly cared for, can last for decades, while lower-quality pans or those that aren’t well-maintained might only last a few years.
Factors Affecting Longevity:
Grade of Steel: The grade of stainless steel, determined by the percentage of chromium and nickel, impacts durability, corrosion resistance, and finish. Higher-grade stainless steel generally lasts longer.
Thickness: Thicker stainless steel pans are more durable, retain heat better, and are less likely to warp. Thinner pans tend to have shorter lifespans.
Pan Construction: Fully clad pans, with layers of steel and a core of heat-conductive material like aluminum, are more durable than impact-bonded pans, which have multilayered exteriors.
Exposed Layers: Pans with exposed layers or unsealed rims are more prone to rust and layer separation, reducing their lifespan.
Brand: The manufacturer’s reputation matters. Well-known brands often offer higher-quality, longer-lasting pans, though they may come at a higher price.
When to Replace Your Stainless Steel Pans:
Warping: If a pan warps, it won’t sit flat or heat evenly, making it less safe and effective to use.
Loose Handles: Handles that can’t be tightened pose a safety risk, as they may pop off during use. If this happens, it’s time to replace the pan.
Scratches and Pitting: These imperfections can expose the core layers, leading to metal leaching into food, which is unsafe for cooking.
Rust and Discoloration: Rust can cause health issues if it gets into your food, so it’s best to replace pans that are rusting.
Separated Layers:
If the pan’s layers start separating, especially around the rim, it’s a sign that the pan is no longer safe to use and should be replaced.
Ceramic cookware is popular for its durability, non-reactive properties, and its versatility. It is nontoxic, and made to last a lifetime. However, it’s not immune to damage, with the main concern being thermal shock or accidental breakage. Replace your ceramic cookware if you notice:
Hairline Fractures:
Small cracks or fractures are indicative of thermal shock or thermal breakage. Although this is a rare occurrence it can happened from time to time especially if there product experiences rapid temperature change. Check to see if the company has a warranty for thermal breakage to replace your product. A quality company that stands behind their products should have a warranty program.
Chips:
Chipping caused by accidental bumps or bangs in the kitchen can happen with a 100% ceramic product. Most of the time these chips are cosmetic and don’t affect the performance of the cookware. However, some will find it necessary to replace their product for aesthetic reasons.
Hot Spots:
If you notice that the product is heating unevenly or that there are hot spots that form on the products, this may be a defect and be eligible to be replaced.
Tempered glass cookware is popular for its durability, non-reactive properties, and the ability to see food as it cooks. It is nontoxic, is durable and can last for years. However, it’s not immune to damage, with the main concern being that the glass could shatter. Replace your tempered glass cookware if you notice:
Cracks or Chips
Cracks or chips in tempered glass cookware are a major safety concern. Even small cracks can weaken the structure, making the cookware more prone to shattering, especially under heat.
Cloudiness or Scratches:
Over time, the surface of tempered glass can become scratched, cloudy, or etched. While this might not immediately affect functionality, it can weaken the glass and make it more susceptible to breakage.
Loose Handles or Lids:
Handles and lids that are loose or damaged pose a safety hazard, especially when dealing with hot, heavy cookware. If the handles or lid knobs cannot be securely tightened or repaired, replacement is necessary.
Sudden changes in cooking performance:
If you notice that your tempered glass cookware no longer heats evenly or if it develops hot spots, it might be a sign of internal stress within the glass, which can lead to breakage.
Scratches and Wear:
Deep scratches or worn areas, especially if they expose the underlying metal, can lead to aluminum leaching. If the coating is damaged, it’s time to replace the cookware.
Warping:
If your aluminum cookware warps and no longer sits flat, it can affect cooking performance and even heat distribution. Warped cookware should be replaced.
Discoloration:
Significant or persistent discoloration, particularly if the cookware is difficult to clean, might indicate degradation of the surface and potential safety issues.
Loose or Broken Handles:
Handles that are loose or damaged can pose a safety risk. If they can’t be repaired securely, replace the cookware.
Severe Rusting:
If the cookware develops extensive rust that cannot be effectively cleaned or re-seasoned, it may be time to replace it. Severe rust can affect cooking performance and safety.
Deep Pitting or Cracks:
Significant pitting or cracks in the surface can compromise the cookware’s integrity and lead to uneven heating or food contamination. Replace cookware with severe damage.
Warping:
If the carbon steel cookware warps and no longer sits flat on the heat source, it can affect cooking efficiency and pose a safety risk. Warped cookware should be replaced.
Loss of Seasoning:
If the seasoning is severely worn and cannot be restored, the cookware may become reactive and prone to rust. If repeated seasoning attempts fail, it’s time to replace it.
Cracks or Chips:
If you notice significant cracks or chips in the stoneware, it’s time to replace it. These can compromise the cookware’s integrity and make it more prone to breaking or harboring bacteria.
Severe Staining or Discoloration:
Persistent stains or discoloration that cannot be cleaned may indicate deterioration of the surface. If these affect cooking performance or cleanliness, consider replacing the piece.
Flaking Glaze:
If the glaze starts to flake or peel, it may affect the safety of the cookware. Replace stoneware with damaged glaze to avoid potential health risks.
Warping:
Although rare, if stoneware warps or becomes uneven, it can impact cooking efficiency and safety. Replace warped cookware to ensure even cooking and prevent accidents.
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Phosphorus is a mineral that helps build strong, healthy bones and keeps muscles working correctly. When food containing phosphorus is consumed and digested, the small intestines absorb it and it becomes stored in the bones. Kidney disease may cause the kidneys to be unable to remove excess phosphorus from the blood.
High phosphorus levels cause bones to weaken and lead to dangerous calcium deposits in blood vessels, eyes, lungs, and heart. Levels of phosphorus in the blood should be monitored by a healthcare provider.
The normal level of phosphorus should range from 2.4 to 4.1. Low phosphorus diets limit total consumption to 800-1,000 mg daily. Check with your physician to receive the daily limit that is right for you.
Hyperphosphatemia is the medical term that describes an electrolyte disturbance in which there is an abnormally-elevated level of phosphate in the blood.
Examples of Foods That May Have Added Phosphorus:
Frozen uncooked meats and poultry
Frozen baked goods
Chicken nuggets
Cereals, cereal bars
Baking mixes
Instant puddings
Sauces
Steps You Can Take to Keep Phosphorus at Safe Levels:
Know what foods are lower in phosphorus.
Pay close attention to serving size.
Eat smaller portions of foods that are high in protein.
Eat fresh fruits and vegetables.
Ask your physician about using phosphate binders at meal time.
Avoid prepackaged foods that contain added phosphorus. Look for phosphorus, or for words with PHOS, on ingredient labels, like the one below.
One Serving:
Fruit is one small piece, 1/2 cup fresh, canned or cooked fruit, or 1/2 cup juice. Vegetables is 1/2 cup fresh or cooked vegetables, 1 cup raw leafy vegetables, or 1/2 cup juice. Meat is 1-3 ounces cooked. Bread is one slice. Eggs is 1 egg or 1/4 cup egg substitute. Rice, noodles, and pasta is 1/3 cup cooked.
Potassium is a nutrient that helps keep the body’s heart, nerves, and muscles working correctly. Kidney disease may cause the kidneys to be unable to remove excess potassium from the blood creating the potential for muscle weakness, nausea, weak pulse, and even heart attack.
Levels of potassium in the blood should be monitored by a healthcare provider. The normal level of potassium should range from 3.5 to 5.0. Low potassium diets limit the total consumption to 1,500 to 2,500 mg daily. Check with your physician to receive the daily limit right for you.
Hyperkalemia is the medical term that describes a potassium level in your blood that’s higher than normal.
Foods with High Potassium Content
Fruits
Apricots
Bananas
Cantaloupes
Dates
Nectarines
Kiwi
Prunes/prune juice
Oranges/orange juice
Raisins/dried fruit
Vegetables
Acorn & butternut squash
Avocado
Baked beans
Broccoli (cooked)
Brussels sprouts (cooked)
Chard
Chile peppers
Mushrooms (cooked)
Potatoes
Pumpkin
Spinach (cooked)
Split peas, lentils, beans
Sweet potatoes
Vegetable juice
Tomatoes/tomato juice/tomato sauce
Protein & Other Foods
Milk
Yogurt
Nuts & seeds
Ham
Bacon
Fish
Sardines
Bran
Chocolate
Granola
Molasses
Peanut butter
Steps You Can Take to Keep Potassium at Safe Levels:
1. Talk with a renal dietitian about creating an eating plan. 2. Limit foods that are high in potassium. 3. Limit milk and dairy products. 4. Choose fresh fruits and vegetables. 5. Avoid salt substitutes and seasonings with potassium. 6. Read labels on packaged foods and avoid potassium chloride. 7. Pay close attention to serving size. 8. Keep a food journal.
Eat these foods:
White rice
White bread & pasta
Cooked rice & cereal
Unenriched rice milk
Fresh white meat
Instead of these foods:
Brown & wild rice
Whole wheat bread & pasta
Bran cereal
Cow’s milk
Dark or packaged meat
Foods with Lower Potassium Content
Fruits
Apples/apple juice/applesauce
Berries
Cranberry juice
Grapes/grape juice
Grapefruit/grapefruit juice
Tangerines
Honeydew
Lemons & limes
Mangoes
Papayas
Pears
Peaches
Plums
Pineapple
Watermelon
Protein & Other Foods
Chicken (white meat)
Turkey (white meat)
Canned tuna
Eggs
Rice
Noodles
Pasta
Bread (not whole grain)
Vegetables
Bell peppers
Bamboo shoots (canned)
Broccoli (fresh)
Cabbage
Carrots
Cucumber
Eggplant
Green beans
Kale
Lettuce
Mushrooms (fresh)
Okra
Summer squash (cooked)
One Serving:
• Fruit is one small piece, 1/2 cup fresh, canned or cooked fruit, or 1/2 cup juice. • Vegetables is 1/2 cup fresh or cooked vegetables, 1 cup raw leafy vegetables, or 1/2 cup juice. • Meat is 1-3 ounces cooked. • Bread is one slice. • Eggs is 1 egg or 1/4 cup egg substitute. • Rice, noodles, and pasta is 1/3 cup cooked.
Sodium is a mineral found in most foods that helps balance how much fluid your body keeps. It also helps regulate nerve impulses and muscle contractions. Kidney disease may cause the kidneys to be unable to remove excess sodium from the body causing it to build up in the blood. Because sodium attracts and holds water, blood volume increases.
This can cause:
High blood pressure
Swelling
Thirst
Heart disease
Stroke
Levels of sodium in the blood should be monitored by a healthcare provider. The normal level of sodium should range from 135 to 145 mEq/L. Low sodium diets limit total consumption to 1,500 to 2,000 mg daily. Check with your physician to receive the daily limit that’s right for you.
Hypernatremia is the medical term that describes a sodium level in your blood that’s higher than normal.
Salty Misconceptions
The biggest contributor to sodium consumption is not the salt shaker. Approximately 75% of the sodium you eat comes from sodium added to processed foods and restaurant foods. This makes it difficult to choose foods with less sodium and to limit how much sodium you are eating because it is already added to your food before you purchase it.
Kidney patients should NOT eliminate salt completely from their diet. Sodium is an essential nutrient that controls blood pressure and ensures nerves and muscles work properly, so you need the proper amount.
Sea salt does NOT contain LESS sodium than table salt. Sea salt typically contains the same percentage of sodium as table salt.
High levels of sodium are not only found in food. Some over-the-counter medications contain high levels of sodium. Be sure to read drug labels carefully.
Tips for Reading a Food Label
Pay close attention to single serving size.
Limit snacks to 140-150mg per serving.
Limit meals to 400-500mg.
Avoid items that have over 8% of your daily value.
Compare food labels of various brands.
Avoid products that list salt or sodium containing compoiound in the first 5 ingredients:
Monosodium glutamate (MSG)
Sodium bicarbonate (baking soda)
Baking powder
Disodium phosphate
Sodium citrate
Sodium nitrate
Cooking Tips:
1. Take time to plan ahead. 2. Shop the outer portion of the grocery store. 3. Use fresh meats and produce. Avoid processed food. 4. Use spices that don’t list “salt” in their title (example: choose garlic powder instead of garlic salt). 5. Cook from scratch and use spices, herbs, lemon, garlic, ginger, vinegar, and pepper to season food. 6. Keep a food journal.
Symptoms of rare kidney diseases are often invisible or not obvious. It is important to talk to your doctor to know the symptoms to look out for and questions to ask your doctor so that simple tests can be done to determine if you are at risk or have kidney disease.
Protein in the urine (proteinuria), which can be foamy
High cholesterol
Blood in the urine (hematuria)
Fatigue
Weight gain due to extra fluid building up in the body
Dark or ‘cola’ colored urine after a viral infection (cold, respiratory illness, sore throat)
Joint pain or pain in and around the kidneys
High blood pressure
Consider asking these questions at your next doctor’s appointment:
What is my IgAN risk assessment score and how does that impact my treatment goals?
Do I have protein in my urine?
Do I have blood in my urine?
What other labs should I be concerned about?
How many patients do you treat with IgAN?
Which FDA-approved therapies should we use to treat my IgAN?
Am I a good fit for a clinical trial?
What lifestyle changes can I make such as diet, exercise, habits to improve my health?
My IgAN symptoms or side effects from my current medications (nausea, brain fog, fatigue, swelling, pain) are affecting my quality of life. What changes can we make to ensure I am able to function better?
When talking to a child with RKD, it’s important to approach the conversation with sensitivity, openness, and age-appropriate language. Here are some tips for communicating with your child
1) Find a quiet and comfortable environment where you can have a conversation without distractions. This helps your child feel secure and allows them to focus on the discussion
2) Use simple age appropriate language. Explain things in a way that they can understand. Avoid using medical terms unless your child is familiar with those terms.
3) Be truthful about your child’s condition and validate that what they are experiencing is difficult. Avoid providing false reassurances, but emphasize that you and the medical team are there to support and help them.
4) Encourage your child to ask questions and express their feelings. Be patient and ready to answer their questions honestly. This helps build trust and understanding
5) Depending on your child’s age, visual aids such as experiments, drawings, or age-appropriate books can help explain their condition and its treatment.
6) When appropriate, involve your child in discussions about their treatment plan or any decisions that affect them. This can help them feel more in control and empowered.
7) Let the child know that you are there to support them throughout their journey. Reassure them that they are not alone in facing their challenges.
8) Acknowledge and validate the child’s emotions. It’s normal for them to feel a range of emotions, including fear, sadness, or frustration. Encourage them to express their feelings and offer emotional support.
9) While it’s important to be honest, maintain a positive and hopeful tone. Focus on the aspects of their treatment and care that can improve their well-being.
10) Regularly check in with the child to see how they are feeling and if they have any new questions or concerns. This ongoing communication helps build trust and keeps the lines of communication open.
Remember that each child is unique, so it’s important to be flexible and adapt your approach based on their individual needs, personality, and developmental stage. Building a trusting and open relationship is crucial for the child’s well-being and coping with the challenges of living with a rare disease.
When you have a child with Nephrotic Syndrome, there are many considerations when it comes to school. Many children with Nephrotic Syndrome don’t qualify for an Individualized Education Plan (IEP), but could benefit from a few accommodations in school and a 504 Health Plan may be able to help. Part of a civil rights law, a 504 plan is developed at the school level to customize a student’s school and learning environment to meet their specific needs.
A 504 Plan can be a good tool that helps your child receive the instruction they need inside the classroom, while protecting their health at the same time.
What is a 504 Plan?
A 504 Plan refers to Section 504 of the Rehabilitation Act and the Americans with Disabilities Act. This specifies that no one with a disability can be excluded from participating in federally funded programs or activities, including elementary, secondary, or post-secondary schooling.
The goal of a 504 Plan is to remove barriers and allow students with health concerns to participate effectively in public education or in schools that receive public funding. This plan can be helpful for students with minor or severe health concerns. It removes barriers by listing accommodations designed for a student to help them learn in a classroom environment and participate in school just as they would if they didn’t have a disability. These accommodations are specific to each student and each 54 Plan is uniquely suited to the student’s particular needs.
Children who benefit from a 504 Plan are those who are able to learn at a typical level if they are provided appropriate accommodations. Thus, a child with intellectual disabilities will likely need an IEP, while a child with Nephrotic Syndrome would be better served by a 504 Plan.
According to the US Department of Education, a child with a disability is defined as a child who:
Has a physical or mental impairment that substantially limits a major life activity;
Has a record of such an impairment;
Is regarded as having such an impairment.”
Eligibility for a 504 Plan does not define specific medical conditions. Instead, it is intentionally left as a broad statement of possible physical and mental impairments so that each school can determine eligibility on an individual basis.
“Major life activities” include a variety of functions required in daily life, from seeing or hearing to concentrating, communicating, and learning. The Department of Education also includes “major bodily functions” as part of life activities, so children with respiratory, bowel or bladder, immune, and other physical conditions are protected under the law.
How to Establish a 504 Plan
Sometimes the 504 Plan is proposed by the school for a child that they see could use a little extra help. Parents can also request a 504 Plan if they see a need or if a diagnosis or life event occurs that may impact their child’s safety at school or their learning abilities.
School districts will often have a coordinator who handles both IEP and 504 plans. It’s also common for a team to be established to develop the plan. This may include the student’s teacher, principal, and counselor. Parents should also take part in creating a 504 Plan and attend all meetings.
A school should develop a written and signed 504 Plan to ensure all responsible parties are informed and protected. It’s important that all teachers at the school have a copy and understand the accommodations set forth in the 504 Plan.
Within the 504 Plan, the parent and the school will list specific accommodations or modifications that will make it possible for the student to succeed in school. Unlike an IEP, a 504 will not include academic goals, benchmarks, or measurements.
Accommodations may include items such as: – Requiring teachers and aides to receive training about your child’s condition (educational pamphlet about Nephrotic Syndrome) – Supervision regarding dietary and fluid restrictions/requirements – Keeping the classroom free of as many germs as possible by wiping down surfaces, providing access to non-shared school supplies, allowing the child to sit away from children who are coughing, etc. (sample letter to send home to parents) – Providing a child with extra time or modified testing and homework – Protection against missed school for illness and or doctor appointments – Ability to visit the school nurse for medications and/or monitoring – Home instruction if your child misses too much school
504 Plan vs. Individualized Education Plan
There is some confusion regarding the similarities between a 504 Plan and an Individualized Education Plan (IEP). While both are intended to help children with disabilities learn with adaptations to meet their needs, they take a different approach.
A 504 Plan is intended for children with a wide range of disabilities who are, nevertheless, able to participate and succeed in a general education classroom. An IEP, on the other hand, is intended for children who are not able to learn at the same pace as their peers and who require special education services. Some children with Nephrotic Syndrome do qualify for an IEP.
If you feel like your child could benefit from a written 504 Plan or an IEP, contact your school and set up a meeting!
Kidney Model or Image with picture of Filtering Units
Age appropriate scissors
Explanation
The kidney’s function is to clean our blood. The kidneys have millions of filtering units called glomeruli that act kind of like a coffee filter. The kidney filters gather waste products and eliminate them in the form of urine but do not allow the good products like blood, immunoglobulins and protein (albumin) to pass through. Instead they send them back into the bloodstream. (Show diagram or model) The purpose of this experiment is to give patients a visual demonstration of how their kidney’s are not functioning properly.
Part 1: Normal Kidney
Have a child take beads and put them into the jug of water (blood). The beads represent the good protein (albumin).
Then take a normal coffee filter and place it over a clear container.
Place a couple drops of yellow food coloring onto the center of the filter paper.
Pour the water and beads over the filter.
Ask: What do you see?
Explanation: The water should turn yellow, as the toxins are removed in the urine, but there should be no good products like protein leaking out. Once the kidney filters out the toxins, it returns the good products back into the blood where they are needed.
Part 2: Kidney affected by Nephrotic Syndrome
Ask: In NS the filters (glomeruli) lose their shape. Now when blood passes through what happens?
Take another coffee filter and get them to cut holes (big enough for the beads to pass through).
Place the filter over a clear container.
Place a couple drops of yellow food coloring onto the center of the filter paper.
Pour the water and beads over the filter.
Ask: What happened? Did the filter with holes work properly?
Explanation: This is what happens in the kidneys of a person when they have NS. The protein leaks from the blood into the urine because the kidneys cannot filter it properly. When we don’t have enough protein in our blood we become swollen, and the protein can cause foamy urine.
Phosphorus is a mineral that helps build strong, healthy bones and keeps muscles working correctly. When food containing phosphorus is consumed and digested, the small intestines absorb it and it becomes stored in the bones. Kidney disease may cause the kidneys t be unable to remove excess phosphorus from the blood. High phosphorus levels cause bones to weaken and lead to dangerous calcium deposits in blood vessels, eyes, lungs and heart. Levels of phosphorus in the blood should be monitored by a healthcare provider. The normal level of phosphorus should range form 2.4 to 4.1. Low phosphorus diets limit total consumption to 800-1,000 mg daily. Check with your physician to receive the daily limit that is right for you.
Hyperphosphatemia is the medical term that describes an electrolyte disturbance in which there is an abnormally-elevated level of phosphate in the blood.
Steps you can take to keep phosphorus at safe levels:
Know what foods are lower in phosphorus.
Pay close attention to serving size.
Eat smaller portions of foods that are high in protein.
Eat fresh fruits and vegetables.
Ask you physician about using phosphate binders at meal time.
Avoid prepackaged foods that contain added phosphorus. Look for phosphorus, or for words with PHOS, on ingredient labels, the the one below.
Lower Phosphorus Foods
Fresh Fruits
All fruits are low in phosphorus
Fresh Vegetables
All vegetables are low in phosphorus
Carbohydrates
Breads (white),
Crackers (not wheat)
Pasta
Popcorn
Corn and Rice cereal
Rice (white)
Meat
Fresh meat (check for
added PHOS)
Hot Dog
Sausage
Egg
Beverages
Fruit Juices
Light colored soda
Tea
Coffee (no dairy)
Home-brewed Iced Tea
Examples of Foods That May Have Added Phosphorus:
Frozen uncooked meats
and poultry
Frozen baked goods
Chicken nuggets
Cereals, cereal bars
Baking mixes
Instant puddings
Sauces
One Serving =
Fruit 1/2 cup fresh, canned or cooked fruit, or 1/2 cup juice.
Vegetables or cooked vegetables, 1 cup raw leafy vegetables, or 1/2 cup juice.
Potassium is a nutrient that helps keep the body’s heart, nerves and muscles working correctly. Kidney disease may cause the kidneys to be unable to remove excess potassium from the blood creating the potential for muscle weakness, nausea, weak pulse and even heart attack.
Levels of potassium in the blood should be monitored by a healthcare provider. The normal level of potassium should range from 3.5 to 5.0.
Low potassium diets limit the total consumption to 1, 500 to 2, 500 mg daily. Check with your physician to receive the daily limit right for you.
Hyperkaliemia is the medical term that describes a potassium level in your blood that’s higher than normal.
Steps you can take to keep potassium at safe levels:
Talk with a renal dietitian about creating an eating plan
Limit foods that are high in potassium
Limit milk and dairy products
Choose fresh fruits and vegetables
Avoid salt substitutes and seasonings with potassium
Read labels on packaged foods and avoid potassium chloride
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