Feeding habit that will help a kidney patient

New York, NY (April 17, 2013) – Poor eating habits, smoking and obesity are associated with increased risk for kidney disease, according to new research published today online in the National Kidney Foundation's American Journal of Kidney Disease.

Researchers led by Alex Chang, MD, MS of Johns Hopkins University found that people with normal kidney function whose diet quality was poor—high in red and processed meats, sugar-sweetened beverages and sodium, and low in fruit, legumes, nuts, whole grains and low-fat dairy—were more likely to develop kidney disease. Only 1% of individuals with no unhealthy lifestyle-related factors developed protein in their urine, an early indicator of kidney damage. That is compared with 13% of participants with three unhealthy lifestyle factors such as obesity, poor diet and smoking.

Obese people - those with body mass index (BMI) over 30 -- were twice as likely to develop kidney disease. An unhealthy diet independently impacted risk for chronic kidney disease even after adjusting for weight and other lifestyle-related factors.

Researchers also noted an association between those who currently smoke and the development of chronic kidney disease. Those who smoked were about 60% more likely to develop kidney disease.

In the first study to examine kidney disease risk factors in healthy young people, researchers used longitudinal data spanning 15 years on over 2,300 black and white adults, aged 28-40 from the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

"Unlike family history of kidney disease, diet, smoking, and obesity are modifiable lifestyle factors that we can all control. By eating well, quitting smoking, and maintaining a normal weight, people can protect their kidneys and prevent future damage," says Dr. Chang.

Overall, those who developed kidney disease were more likely to be African American, living with diabetes or high blood pressure, have a family history of kidney disease, and consumed more soft drinks, red meat, and fast food than those who did not develop kidney disease.

"In the United States, 26 million adults are living with chronic kidney disease. We need to shift the focus from managing chronic kidney disease to preventing it in the first place. Using this study as evidence, we can encourage changes in individual lifestyle choices and behaviors, and ultimately prevent people from developing kidney disease," says Dr. Beth Piraino, National Kidney Foundation President.

Risk Reduction Tips from the National Kidney Foundation:

• Cut the sodium: Americans today consume 50% more than the recommended daily quantity of sodium -- 2,300 mg of sodium, about one teaspoon of salt, should be the daily limit.
• Reduce red meat: High protein diets, especially those containing large quantities of animal protein, may harm the kidneys. Red meat is also high in saturated fat—another no-no.
• Stop the soda: Sugar-sweetened beverages, such as sodas are high calorie and contain no nutritious value. Colas also have phosphorus additives which can harm the kidneys.
• Pass on processed foods: Crackers, potato chips, deli meats, cheese spreads, and instant potato mix are all examples of processed foods that are high in sodium and phosphorus additives - both which can have negative effects on the kidneys.
• Slow down with sugar: An overdose of sugar can lead to diabetes and obesity, which are linked to kidney disease.

Curl from national kidney foundation

How to Prevent Kidney Disease

By Robert C. Stanton, M.D.
Chief, Nephrology Section, Joslin Clinic

Diabetes, particularly type 2 diabetes, has become so common that diabetic kidney disease (nephropathy) has leaped ahead of high blood pressure as the leading cause of kidney failure in much of the world.

Kidney failure is a serious matter: The kidneys’ job is to filter waste products and excess fluids from the blood circulating through our bodies. If the kidneys fail, survival depends on either dialysis (being hooked up to a machine to do the kidneys’ blood-filtering) or a kidney transplant.

High blood glucose levels can damage blood vessels all over the body, including the tiny blood vessels that do the kidneys’ filtering. When those tiny vessels are damaged, they can’t do the job correctly. High blood pressure can result and make the problem worse, damaging more blood vessels and speeding up the progression of kidney disease. Both kidneys are affected.

Though 20-40 percent of those with diabetes develop kidney disease, it can be slowed significantly if diagnosed early and treated.

Prescription for Kidney Health

Five principles should be followed by everyone with diabetes to help prevent and treat kidney problems:

• Tight control of blood glucose levels (A1C less than 7 percent)
• Tight control of blood pressure: aim for lower than 130/80
• Control of lipids: LDL (“bad”) cholesterol should be less than 100 mg/dl, HDL (“good”) cholesterol should be above 50 mg/dl and triglycerides should be less than 150 mg/dl
• No cigarette smoking
• Blood pressure-lowering drugs, such as ACE inhibitors or angiotensin receptor blockers (ARBs), are effective in protecting the kidney from damage if you have signs of diabetic kidney disease

The Earlier You Know, the Better

There are no symptoms in the early stages of diabetic kidney disease. Symptoms of kidney failure—fatigue, nausea and fluid retention—usually don’t occur until the late stages of kidney disease because the kidney can still adequately filter the blood even after extensive damage.

Usually the first sign that the kidneys’ filtration system is damaged is an excess amount of protein in the urine, known as microalbuminuria. This is not just an early sign of kidney disease, but a well-established risk factor for cardiovascular disease, such as heart attack and stroke.

Two tests—one using urine and the other blood—must be performed annually for early detection. The urine sample is used to screen for microalbuminuria. The standard urine dipstick used in doctors’ offices does not measure this—a special machine is required instead.

The blood sample is used to measure the level of creatinine, a substance normally present in the blood, which increases if your kidneys are not functioning properly. The blood sample results are then plugged into a formula that estimates your kidneys’ filtering capacity. The most commonly used formula is called the MDRD equation.

One cannot overemphasize how important it is to measure your blood creatinine and to use the MDRD equation to estimate total kidney filtering. The creatinine value alone can be misleading, as it must be interpreted within the context of age and gender. Patients often have more advanced kidney disease than their blood creatinine value alone suggests.

For this reason, the National Kidney Foundation strongly urges all physicians to use the MDRD equation; however, not all (besides kidney specialists) routinely use it. An accurate estimate of your kidney function is essential for your doctor to decide what, if anything, needs to be done.

With aggressive treatment and yearly testing, we can greatly slow the decline in kidney function and reduce the number of people developing kidney failure. 

This article appeared in the Special Diabetes Insert in the  November 21, 2005 issue of TIME Magazine.

How your kidneys functions

Did you­ know that kidney stone plagued even the ancient Egyptians [source: NKUDIC]? Or that 26 million Americans have chronic kidney disease [source:National Kidney Foundation]? Hundreds of thousan­ds of people suffer from renal failure each year and undergo dialysis or await a kidney transplant.

But what do your kidneys do? Why are they so important? Don't they just produce urine? In this article, we'll take a close look at our kidneys and find out exactly what they do.

Your kidneys are two bean-shaped organs, each about the size of your fist. They are located in the middle of your back, just below your rib cage, on either side of your spine. Your kidneys weigh about 0.5 percent of your total body weight. Although the kidneys are small organs by weight, they receive a huge amount -- 20 percent -- of the blood pumped by the heart. The large blood supply to your kidneys enables them to do the following tasks:

• Regulate the composition of your blood: Keep the concentrations of various ions and other important substances constant; Keep the volume of water in your body constant; Remove wastes from your body (urea, ammonia, drugs, toxic substances); Keep the acid/base concentration of your blood constant
• Help regulate your blood pressure
• Stimulate the making of red blood cells
• Maintain your body's calcium levels

Your kidneys receive the blood from the renal artery, process it, return the processed blood to the body through the renal vein and­ remove the wastes and other unwanted substances in the urine. Urine flows from the kidneys through the ureters to the bladder. In the bladder, the urine is stored until it is excreted from the body through the urethra.

Now let's take a look inside your kidneys.

adapted from ki

Frequently-Asked Questions about Chronic Kidney Disease (CKD)

When people are told they have chronic kidney disease (CKD), the first questions they often have are "How long will I live?" and "How well will I live?" This section answers these and other questions about CKD, while also presenting thoughts from patients.

1. How long can I live with chronic kidney disease?
2. How good will my life be with CKD?
3. Can I still have a good life if I need dialysis?
4. I'm tired all the time. Is there a treatment for fatigue?
5. How can I keep my kidneys working as long as possible?
6. Should I keep working?
7. What questions should I ask my doctor?
8. Where can I find out more information about chronic kidney disease?

Q: How long can I live with chronic kidney disease?

A: Many people think that if their kidneys fail, they will die. Right away. This used to be true—50 years ago. Back then, there were not enough dialysis machines to go around and medical knowledge about kidney disease was limited. It is no longer true today.

How long you can live with CKD depends on your age, other health problems, and how involved you become in your care. Most people with early CKD will never have kidney failure. Others will reach kidney failure and may live for decades with dialysis or kidney transplants.

There are major advances in today's healthcare. We have better drugs, know more about how to slow down kidney failure, and have updated dialysis machines. But the most important factor is still the person who has the disease. Research shows that people who become partners in their care live longer. So, ask questions, and explore with your doctor and care team the best way for you to help manage your disease.

Q: How good will my life be with CKD?

A: How good your life can be with CKD depends on YOU! In the early stages, CKD may have symptoms that are so subtle you may not even notice them. In later stages, fatigue, itching, loss of appetite, and other symptoms can reduce your quality of life—if you don't act. How? All of these symptoms can be treated.

Learn what to watch for and tell your doctor, so you can get the help you need. You can also keep a good quality of life by following your treatment plan. For example, taking your medications in the right doses at the right times may help slow your kidney disease. Your quality of life with CKD depends on your attitude, and how you accept the changes and take control of your health and your life.

Q: Can I still have a good life if I need dialysis?

A: Yes, you can live long and live well with dialysis. Many people—even those with loved ones on dialysis—don't know that there are many types of dialysis. You can choose a treatment that lets you keep doing all or most of the things you value.

People who are very sick before they start dialysis are often surprised to find that they feel much better a few weeks or months later. The unknown you imagine is often much scarier than the reality. Learn all you can, and talk to people who are doing well—like people who do their treatments at home, or while they sleep. You'll see that you can have a good life on dialysis.

Q: I'm tired all the time. Is there a treatment for fatigue?

A: Even healthy people complain of being tired. But people with CKD can be so exhausted that they fall asleep during the day—even after 8 to 10 hours of sleep at night. One reason for fatigue can be anemia, a shortage of oxygen-carrying red blood cells. People with CKD often have anemia because damaged kidneys make less of a hormone callederythropoietin (epoetin, or EPO). EPO tells the bone marrow to make new red blood cells. Without a fresh supply of red blood cells, the body has less oxygen. This makes you more tired and cold, and less able to focus and fight disease. If your fatigue is due to anemia, your doctor may prescribe iron and injections of a man-made form of EPO.

Q: How can I keep my kidneys working as long as possible?

A: There are a number of treatments, including medications and lifestyle changes, that may help keep your kidneys working longer. People can even get transplants before having dialysis, especially if they have a willing living donor. Ask your doctor what would help you. 

Q: Should I keep working?

A: Yes! Most people find that disability pays much less than working—but their bills don't go away just because they're ill. If you have CKD and a job, try to keep it if you can, or find a new one. Work can make you feel like you're still you, and that you are still helping to support your family. Work may also be a vital part of your social life. If your job comes with a health plan, it can also help you get good care and pay for prescription drugs.

If you find that you feel too tired to work, see your doctor! Fatigue can be caused by anemia, which can be treated. Ask your employer if you need an accommodation—more breaks, a different shift time, or energy-saving devices to keep your job. You can find helpful information about employment support programs, laws, and resources to help people with disabilities on the Social Security website.

Q: What questions should I ask my doctor?

A: No two people are alike. Asking questions is the best way to find out about your health.

 If you write your questions and show the list to your doctor, you may be more likely to get them answered. Write down the answers, too—or have someone come along to help you remember the answers.

1. What percent of kidney function do I have now?
2. What is the cause of my kidney problem?
3. What are my lab test results right now?
4. What can I do to keep my kidneys working as long as possible?
5. What treatment can I get for my symptoms? (List symptoms)
6. What are the next steps for my treatment?
7. Will I need dialysis or a transplant? If so, how long might it be until I do?

Been aware of your Organs will help you to stay healthy.

Adapted from lifeoption.org

How alcohol affects the body

Alcohol travels through the body from the mouth, to the stomach, into the circulatory system, the brain, kidneys, lungs, and liver. As alcohol is consumed and absorbed, the following may occur:

Mouth

• Alcohol passes over sensitive membranes which may became irritated if the alcohol content is high enough
• Heavy drinkers run a much higher risk of mouth and throat cancer

Stomach

• Alcohol does not have to be digested as its molecule is very small and can easily pass through the stomach lining
• When the stomach is empty, alcohol passes directly into the bloodstream
• When the stomach has food in it, particularly food high in protein, the rate of alcohol absorption is slowed but not stopped
• Carbonation in beverages that may be mixed with alcohol speeds up alcohol absorption
• Alcohol in small amounts stimulates the appetite because of an increase in the flow of stomach juices
• Because of the large amounts of stomach juices produced, greater amounts of alcohol dull the appetite and can cause malnutrition
• Excessive alcohol consumption stimulates the flow of gastric juices in the stomach and when combined with the high alcohol content causes irritation to the lining of the stomach resulting in ulcers
• When the concentration of alcohol and gastric juices becomes high enough and irritation to the lining is increased, the reflex action of vomiting is triggered as the body's way of relieving some of this irritation
• 20% of alcohol consumed is absorbed into the bloodstream through the stomach and 80% (the remaining alcohol) is absorbed into the bloodstream from the small intestine

Circulatory system

• Once in the bloodstream, alcohol is quickly distributed evenly throughout the body
• Alcohol dilates or widens the blood vessels as it enters the bloodstream causing:
  • greater flow of blood to the skin surface (blushing)
  • temporary feeling of warmth
  • increased heat loss and rapid body temperature decrease
  • drop in blood pressure

Brain

• When alcohol reaches the brain it immediately affects the brain's ability to control behavior and body functions
• As the concentration of alcohol in the bloodstream (BAC levels) increases, the body's functions and other behavior changes
• At specific BAC levels the effects are:
  • BAC .02% Judgment, inhibitions, and emotions begin be affected and results are increased relaxation and excessive talking
  • BAC .06% Reaction time is decreased, coordination is affected, but neither may be very obvious
  • BAC .10% Vision, speech, balance, perception and self control are affected
  • BAC .18% Walking and standing are noticeably affected. (walking a straight line, buttoning a coat)
  • BAC .20% Memory is impaired, the brain centers for intelligence, emotions and sensory motor abilities are affected; cannot think clearly and become excited or angered easily
  • BAC .30% The body is thrown into a complete state of confusion and the signs are: slurred speech, double vision, hearing impairment, difficult or impossible to judge distances, no longer able to walk normally and sudden mood changes
  • BAC .40% The brain can barely function and the nervous system is ineffective ; the person is unconscious or almost unconscious; the body may seem frozen or barely able to move, vomiting or uncontrolled urination may occur
  • BAC .50% A person slips into a coma; breathing, heart action and blood pressure are decreased drastically to a dangerously low point; the brain cannot control body temperature; death can and often does occur

 Kidneys

• Alcohol acts as a diuretic which means it increases urine formation
• A person will urinate more frequently causing dehydration and thirst

Lungs

• Alcohol in its gaseous state, can be inhaled into the lungs and from there will go rapidly into the bloodstream
• Five percent of the alcohol taken into the body leaves through the lungs, kidneys, and the skin; the rest is removed by the liver

Liver

• Ninety-five percent of alcohol that is put into the body leaves the body when it is oxidized in the liver
  • oxidation is the converting of alcohol into water and carbon dioxide
  • the liver can only oxidize about one drink per hour. (This is the reason that only time can sober up a person.)
• Alcohol damages the liver when it is consumed on a regular basis. Damage that occurs include:
  • Fatty Liver
    • Alcohol interferes with the liver's ability to break down fats which collect in the liver
    • When drinking stops, the condition is usually reversed
  • Cirrhosis of the liver
    • Heavy alcohol use destroys normal liver tissue and it is replaced by scar tissue.
    • Cirrhosis of the liver decreases blood flow and liver functioning
    • Progressive cirrhosis (scarring or hardening of liver)
       

Alcohol and health

• Alcohol in low doses reduced the risk of coronary heart disease, with 80% reduced risk at a consumption of two drinks per day (20g alcohol)
• Beyond two drinks per day the risk of heart disease increases, being more than the risk of an abstainer
• With heavy drinking, any potential benefits are outweighed by greater risks.

Lets try to stay healthy by controlling our alcohol intake.

Liver Failure,Causes,Symptoms, Treatment and Prevention

Liver failure occurs when large parts of the liver become damaged beyond repair and the liver is no longer able to function.

Liver failure is a life-threatening condition that demands urgent medical care. Most often, liver failure occurs gradually and over many years. However, a more rare condition known as acute liver failure occurs rapidly (in as little as 48 hours) and can be difficult to detect initially.

What Causes Liver Failure?

The most common causes of chronic liver failure (where the liver fails over months to years) include:

• Hepatitis B

• HepatitisC

• Long term alcohol consumption

• Cirrhosis

• Hemochromatosis (an inherited disorder that causes the body to absorb and store too much iron)

• Malnutrition

The causes of acute liver failure, when the liver fails rapidly, however, are often different. These include:

• Acetaminophen (Tylenol) overdose.

• Viruses including hepatitis A, B, and C (especially in children).

• Reactions to certain prescription and herbal medications.

• Ingestion of poisonous wild mushrooms.

 

What Are the Symptoms of Liver Failure?

The initial symptoms of liver failure are often ones that can be due to any number or conditions. Because of this, liver failure may be initially difficult to diagnose. Early symptoms include:

• Nausea

• Loss of appetite

• Fatigue

• Diarrhea

However, as liver failure progresses, the symptoms become more serious, requiring urgent care. These symptoms include:

• Jaundice

• Bleeding easily Jaundice

• Swollen abdomen

• Mental disorientation or confusion (known as hepatic encephalopathy)

• Sleepiness

• Coma

How Is Liver Failure Treated?

If detected early enough, acute liver failure caused by an overdose of acetaminophen can sometimes be treated and its effects reversed. Likewise, if a virus causes liver failure, supportive care can be given at a hospital to treat the symptoms until the virus runs its course. In these cases, the liver will sometimes recover on its own.

For liver failure that is the result of long-term deterioration, the initial treatment goal may be to save whatever part of the liver is still functioning. If this is not possible, then a liver transplant is required. Fortunately,Liver transplantis a common procedure that is often successful.

How Can Liver Failure Be Prevented?

The best way to prevent liver failure is to limit your risk of developing cirrhosis or hepatitis. Here are some tips to help prevent these conditions:

• Get a hepatitis vaccine or an immunoglobulin shot to prevent hepatitis A or B.

• Eat a proper diet from all of the food groups.

• Drink alcohol in moderation. Avoid alcohol when you are taking acetaminophen (Tylenol).

• Practice proper hygiene. Since germs are commonly spread by hands, be sure to wash your hands thoroughly after you use the bathroom. Also, wash your hands before you touch any food.

• Don't handle any blood or blood products.

• Don't share any personal toiletry items, including toothbrushes and razors.

• If you get a tattoo or a body piercing, make sure the conditions are sanitary and all equipment is aseptic (free of disease-causing microorganisms).

• Be sure to use protection (condoms) when having sex.

• If you use illegal intravenous drugs, don't share needles with anyone.

adapted from http://www.webmd.com

Diet For Renal Patient

Fluid & Fluid Control

Kidneys help control the amount of fluid that leaves your body. If your kidney disease progresses, your kidneys may be unable to regulate the removal of fluid from your body and as a result your doctor may ask you to limit your fluid intake. Too much fluid may cause swelling, shortness of breath, or high blood pressure.

What exactly is a fluid? Fluids are any food that is liquid or anything that melts into a liquid. Examples of fluids include the following:

• Coffee
• Tea
• Sodas
• Soups
• Popsicles
• Ice cream, sherbet
• Ice cubes
• Gelatin
• Milk, liquid creamer
• Water
• Wine and beer

If your doctor advises you to decrease the amount of fluids you eat and drink each day these tips may help you.

• Drink only when thirsty. Do not drink out of habit or to be social
• Eat less salt so you will feel less thirsty
• Suck on ice chips. (Measure small units into a cup)
• Brush your teeth three to four times a day; this is to prevent your mouth from drying out
• Suck on a lemon wedge
• If you have diabetes, control your blood sugar
• Chew sugarless gum or suck on sugarless hard candy
• Take your medications with sips of fluid
• When dining out, ask your beverage to be served in a child-size glass
• Measure how much fluid your favorite cup or glass holds so you will be better able to monitor the amount of fluid you drink
• After measuring out the total amount of fluid you can drink for the day, place the water in a container. During the day drink only from this container so you can keep an eye on the amount of fluid you have consumed.

The Renal Diet- Phosphorus

Before making any changes to your diet, make sure you discuss them with your doctor or dietitian.

Phosphorus is a mineral that works with calcium to keep your bones healthy and strong. Phosphorus is needed by the body for building and maintaining bones and teeth and for normal nerve and muscle function. When kidney function declines, the body has a difficult time keeping phosphorus and calcium in balance. As a result of this imbalance, the body cannot get rid of excess phosphorus (phosphorus levels increase) and the body cannot take in enough calcium (calcium levels decrease). To try and correct this imbalance the body will “steal” calcium from the bones, which makes the bones weak. Problems associated with high phosphorus levels include itchy skin, bone and joint pain, and brittle bones.

Foods that are high in phosphorus include:

• Cola Drinks
• Peanut Butter
• Cheese
• Sardines
• Chicken/beef liver
• Nuts
• Caramels
• Beer
• Ice Cream

Lower phosphorus food substitutes include:

• Broccoli
• Non-dairy milk substitute
• Sherbet
• Non-cola soda
• Zucchini squash
• Hard Candy

A large serving size of a low phosphorus food can become a high phosphorus food.

If your phosphorus level remains high your doctor may prescribe a phosphate binder for you to take. This medication will bind with the phosphorus in the food you eat and prevent phosphorus from being absorbed in the body.

It is important that you take this medication exactly as instructed by your doctor.

The Renal Diet- Potassium

Before making any changes to your diet, make sure you discuss them with your doctor or dietitian.

Potassium helps to keep your nerves and muscles, especially your heart, working properly. Potassium is a mineral and can be found in many foods. The kidneys are responsible for helping to keep the correct amount of potassium in your body. It can be very dangerous if your potassium level is too high. Too much potassium can make your hear beat irregularly or even stop without warning.

Foods that are high in potassium include the following:

Fruits Vegetables Other Food
Bananas Broccoli Chocolate
Oranges Potatoes Coffee (limit to 2 cups per day)
Cantaloupe Tomatoes Salt Substitute
Prunes Mushrooms Bran & bran products
Raisins Greens (swiss chard, Nuts & dried fruit
Collard, dandelion,
Mustard, and beet)
Apricots

Low-potassium foods include the following:

Fruits Vegetables Other Food
Apples Beans (green or wax) Rice
Grapes Cucumber Noodles
Pears Onions Cake
Watermelon Lettuce Cereal
Cranberries Carrots Bread & bread products
Cherries

It is important to remember that almost all foods contain potassium. Serving size will determine whether foods are a low, moderate, or high potassium level.

A large serving size of a low potassium food can become a high potassium food.

The Renal Diet- Protein

Before making any changes to your diet, make sure you discuss them with your doctor or dietitian.

Diet plays an important role in the management of kidney disease. The diet your physician will ask you to follow will be based upon your level of kidney function, your body size, and any other medical conditions you may have. Your diet may be helpful in delaying the need for dialysis.

Protein is needed to maintain muscles, aid in building resistance to infections, and repair and replace body tissue.
As your body breaks down protein foods, waste products called urea are formed. As kidney function declines, urea builds up in the bloodstream.
Eating to much protein may cause urea to build up more quickly. This will make you feel sick.
Eating less protein may be helpful in reducing your blood urea levels.
Reducing protein intake must be monitored by your doctor and dietician.
Examples of foods high in protein are:
• Meat
• Poultry
• Milk Products
• Eggs

Foods low in protein includes the following:
• Fresh beans (pinto, kidney, navy)
• Grains
• Vegetables

You need both high quality and low quality protein in your diet. Your physician will determine how much protein should be in your diet.

The Renal Diet- Sodium

Before making any changes to your diet, make sure you discuss them with your doctor or dietitian.

Sodium is needed by the body for many functions such as controlling muscle contractions, balancing fluids, and controlling blood pressure. Healthy kidneys remove excess sodium in the urine. As kidney function declines, sodium and fluids may accumulate in your body. Fluid retention may cause swelling in your eyes, hands, and/or ankles. To keep your sodium level in balance, your doctor may ask you to limit the sodium in your diet.
Foods high in sodium include the following:
• Table salt
• Bouillon cubes
• Potato chips
• Nuts
• Bacon
• Cold Cuts
• Cheese
• Canned, dehydrated, or instant soup
• Canned vegetables
• Processed dinner mixes (such as Hamburger Helper, Rice-a-Roni)

Low sodium alternatives:
• Season with a variety of spices like garlic and oregano
• Use lemon

Adapted from http://www.mcw.edu/Nephrology