Most kidney disorders are caused by patients with poorly controlled diabetes or hypertension.  As such, it is important to eat a healthy diet which is low in salt and fat (to reduce the risk of high blood pressure) and low in sugar (to reduce risk of diabetes).

Do also refer to our health articles on Diet for Hypertension and Diet for Diabetes if you also have hypertension or diabetes.

When you have kidney damage or on dialysis, the kidneys will have difficulty removing waste and fluid from your body. A good diet will help provide energy for your daily tasks, maintain a healthy weight, prevent muscle-mass loss and slow down the progression of kidney disease.

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A kidney-friendly diet refers to eating the right amount of protein, phosphorous, calcium and potassium as well as drinking appropriate amount of fluids to control the build-up of waste and fluids in your body. You need to discuss with your doctor or dietitian on how to limit the amount of:

  • sodium in foods and drinks
  • protein in your diet
  • high-phosphorus foods
  • canned foods or fruits (best to avoid)
  • liquid to prevent fluid build-up in your body which cause ankle swelling


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When you have kidney disease, you may not be getting enough minerals or vitamins in the food groups you are eating.  Vitamins which are useful for patients with kidney disorders include:

a) Vitamin B Complex. Vitamin B6, B12 and folic acid work together with iron to prevent anaemia. The other vitamin B components such as thiamine, riboflavin, pantothenic acid and niacin help your body convert foods into energy more efficiently.

b) Iron. Iron works with Vitamin B complex to prevent anaemia.

c) Vitamin D & Calcium. Vitamin D and Calcium help to maintain bone density and bone strength.


Phosphorus is a mineral which works together with calcium and vitamin D for the development and maintenance of your bones.  Excess phosphorus in the blood results in calcium being pulled out of your bones making them weak and susceptible to fractures.  The normal phosphorus level in adults should be between 2.5 to 4.5 mg/dl.

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Phosphorus is naturally found in protein rich foods such as meat, fish, poultry, dairy products, fish, legumes and nuts. Phosphorus found in animal foods is absorbed more easily by our body compared to those found in plant foods. Besides that, phosphorus is also used as additives in processed foods, canned foods and beverages. Phosphorus from food additives is completely absorbed by our body hence avoiding it can help lower your intake of phosphorus. It is usually listed on the food packaging at the ingredient labels as ‘phosphorus’ or you may look for words with ‘PHOS’.


Potassium is a mineral which is essential in maintaining regular heart beat and muscle function. Abnormal potassium levels can cause irregular heart beat or even heart attack and muscle cramps. The recommended intake for normal adults is between 3,500 to 4,500 mg per day. A potassium restricted diet is around 2,000 mg per day. 

What is a safe potassium level in the blood?

Potassium in foods

Listed below are some good practices to help reduce potassium in your diet:

  • Chopping & slicing foods into smaller pieces, soaking them in a large volume of water for a 1 – 2 hours in several changes of water and straining the vegetables to discard the water before cooking, can leach potassium into water.
  • When using canned vegetables or fruits, drain away the brine or syrup
  • Peel off the skin from fruits
  • Do not take the gravy from vegetable dishes or soup
  • Use whole spices rather than ground spices
  • Avoid herbal and traditional remedies (ginseng roots, banana stem, akar kayu and others)

Haemodialysis patients

If you are on haemodialysis, do discuss with your doctor or dietician because you may also need to:

  • add protein to your diet because hemodialysis removes protein
  • choose foods with the right amount of potassium
  • take vitamins made for people with kidney failure
  • find healthy ways to add calories to your diet because you may experience reduced appetite


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Arterio-Venous Fistula (AVF) are created for patients with end-stage (stage 5) renal failure so their veins can be used for haemodialysis. Kidneys clean and filter your blood from waste and toxins but if you have lost more than 85% of your kidney function, you will need kidney dialysis to the work. The most common causes for kidney failure are diabetes, hypertension and auto-immune disease such as lupus (SLE).

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In haemodialysis, the artificial kidney (haemodialyser) takes blood from your body, cleans the blood before returning the blood into your body. It also helps to maintain your blood pressure and balance important minerals such as sodium, potassium and calcium in your blood. The process usually takes around 4 hours and has to be repeated 3 times a week.  It may take longer depending on how heavy you are, how much kidney function and how much waste you have in your body.

Types of AVF

AVF allows the haemodialyser to get access to your blood. The surgeon will perform a minor surgery under local anaesthesia using your own vein (native AVF) or a prosthetic graft (synthetic AVF).

A successful native AVF can be used within 6-8 weeks when it is called a mature fistula. If the fistula does not mature after 2 months (called poor fistula maturation) and it can be matured via Balloon Assisted Maturation or open AVF repair procedure. Prosthetic graft fistulas take 2-3 weeks to mature.

Signs of AVF not working well

  • Infection (watch out for redness, warm feeling over the fistula area or pus)
  • Blockage (watch out for swelling of your arm and hand)
  • ‘Steal syndrome’ whereby blood is directed away from your hand (watch out for numbness or pain in the hand)

Photo of Graft Infection

Take good care of your AVF

Your AVF vein access is your lifeline and you must do your part to look after it. Wash the area around the AVF with soap and warm water every day. When blood is flowing through your AVF, you can feel a vibration over the area which means it is working well. Inform your dialysis nurse or doctor if you notice any changes so that action can be taken to save the AVF.

Download TELEME app and connect with your Vascular Surgeon or your nephrologist if you experience signs of arterio-venous fistula problem