Chronic Kidney Disease: A Doctor’s Perspective on Balanced Living
By Dr. Sandy
Meet Uncle Wong, a 62-year-old retiree who loves his char kuey teow. Recently, he came to my clinic with Stage 3 chronic kidney disease (CKD). “Doctor, does this mean I can’t eat anything tasty anymore? What’s the point of living like that?” he asked, torn between humor and worry.
As a doctor, I see many patients like Uncle Wong. CKD, especially in its early stages, is a chance to take control and slow progression. Yet, the fear of dietary restrictions often looms large. Let’s explore how to manage CKD effectively, focusing on what can be done to live well.
As a doctor, I see many patients like Uncle Wong. CKD, especially in its early stages, is a chance to take control and slow progression. Yet, the fear of dietary restrictions often looms large. Let’s explore how to manage CKD effectively, focusing on what can be done to live well.
Understanding CKD and Its Stages
CKD progresses through five stages, from mild kidney damage in Stage 1 to the need for dialysis or transplantation in Stage 5. For early to moderate CKD, the goal is to retard progression, maintaining quality of life for as long as possible.
Uncle Wong’s Stage 3 CKD reflects moderate kidney function decline. By taking proactive measures—focusing on nutrition, medical management, and lifestyle adjustments—he can delay worsening and avoid dialysis.
Uncle Wong’s Stage 3 CKD reflects moderate kidney function decline. By taking proactive measures—focusing on nutrition, medical management, and lifestyle adjustments—he can delay worsening and avoid dialysis.
Steps to Retard CKD Progression
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Manage Blood Pressure and Diabetes
High blood pressure and diabetes are the leading causes of CKD in Malaysia. Patients should aim for a blood pressure below 130/80 mmHg and an HbA1c of <7% for diabetes. Uncle Wong’s love for rich, oily food had worsened his blood sugar control, a major risk factor for CKD progression. - Avoid Nephrotoxic Drugs
Over-the-counter painkillers like ibuprofen and certain herbal remedies—commonly used in Malaysian culture—can harm the kidneys. As I tell patients, “Natural doesn’t always mean safe.” It’s important to consult your doctor before taking supplements or medications. - Adopt a Kidney-Friendly Diet
Nutrition plays a key role in CKD management, but it doesn’t have to mean giving up flavor. Patients often worry that they’ll be stuck eating bland, tasteless food, but this is far from true when guided by skilled nutritionists and dieticians.
Uncle Wong met with a dietitian who introduced him to creative, CKD-friendly recipes. He was delighted to discover he could enjoy dishes like steamed fish with ginger and low-sodium soy sauce, or herbal chicken soup made with wolfberries and cordyceps, carefully adjusted for potassium levels. For festive occasions, his dietician even suggested a modified yee sang, using fresh vegetables, lean protein, and reduced oil and sugar.
Nutritionists and dieticians are the unsung heroes of CKD care. They don’t just plan meals—they help patients rediscover the joy of eating, while ensuring their kidneys are protected.
Nutritionists and dieticians are the unsung heroes of CKD care. They don’t just plan meals—they help patients rediscover the joy of eating, while ensuring their kidneys are protected.
- Stay Hydrated (But Not Overhydrated)
Staying hydrated is crucial, but excessive water intake can strain the kidneys. Patients should follow their healthcare provider’s advice on fluid limits, especially as CKD progresses.
Role of Regular Monitoring
CKD management is an ongoing process. Regular blood tests to check creatinine levels, urine tests for protein, and blood pressure monitoring are essential. These allow doctors to detect early warning signs and adjust treatment plans.
“Your kidneys won’t heal,” I told Uncle Wong, “but they don’t have to fail either.” By working together with his healthcare team, including a dietician, Uncle Wong has a good chance of living well for years to come.
“Your kidneys won’t heal,” I told Uncle Wong, “but they don’t have to fail either.” By working together with his healthcare team, including a dietician, Uncle Wong has a good chance of living well for years to come.
Cultural Context and Food as Community
In Malaysia, food is central to family gatherings and celebrations. The idea of restrictive diets often feels like social isolation to patients. Uncle Wong’s biggest fear was missing out on festive foods like char kuey teow and herbal soups during Chinese New Year.
With proper guidance, however, he learned that CKD doesn’t mean giving up cultural foods. By embracing alternatives—like reducing salt, potassium, and phosphate content in traditional recipes—he could still enjoy these meals without jeopardizing his health.
With proper guidance, however, he learned that CKD doesn’t mean giving up cultural foods. By embracing alternatives—like reducing salt, potassium, and phosphate content in traditional recipes—he could still enjoy these meals without jeopardizing his health.
Nutritionists and Dietitians: The Game-Changers
Nutritionists and dietitians are essential in CKD management, especially in culturally diverse countries like Malaysia. They design recipes that balance health and flavor, respecting cultural preferences while adhering to medical guidelines.
For patients like Uncle Wong, this makes all the difference. Learning to prepare meals that fit CKD needs while remaining flavorful gives them a sense of control and motivation to stick to their plans.
A patient once told me, “I thought I’d lose my identity when I was told to avoid my favorite foods. But now, I feel like I’ve gained something better—health and creativity in the kitchen!”
For patients like Uncle Wong, this makes all the difference. Learning to prepare meals that fit CKD needs while remaining flavorful gives them a sense of control and motivation to stick to their plans.
A patient once told me, “I thought I’d lose my identity when I was told to avoid my favorite foods. But now, I feel like I’ve gained something better—health and creativity in the kitchen!”
Conclusion : Empowerment Through Knowledge
Managing CKD isn’t about deprivation—it’s about adaptation. With the right support, patients can make informed choices to slow the disease’s progression while continuing to enjoy life.
Uncle Wong left my clinic that day with a renewed sense of hope. Thanks to his dietician’s recipes and our ongoing collaboration, he’s learning that CKD isn’t the end of his culinary adventures—it’s an opportunity to embrace healthier living.
Dr. Lee Pei San ( Dr. Sandy Lee)
M.D. (USM)
MMED candidate in sexual and reproductive health (SYD, AUS)
Uncle Wong left my clinic that day with a renewed sense of hope. Thanks to his dietician’s recipes and our ongoing collaboration, he’s learning that CKD isn’t the end of his culinary adventures—it’s an opportunity to embrace healthier living.
Dr. Lee Pei San ( Dr. Sandy Lee)
M.D. (USM)
MMED candidate in sexual and reproductive health (SYD, AUS)
