- Renal Diet
- Why should kidney patients monitor sodium intake?
- How can patients monitor their sodium intake?
- What is Potassium and its role in the body?
- Why should kidney patients monitor their potassium intake?
- How can patients monitor their potassium intake?
- What is Phosphorus and its role in the body?
- Why should kidney patients monitor Phosphorus intake?
- How can patients monitor their Phosphorus intake?
- Eating Right for Chronic Kidney Disease | NIDDK
- Step 1: Choose and prepare foods with less salt and sodium
- Step 2: Eat the right amount and the right types of protein
- Step 3: Choose foods that are healthy for your heart
- The next steps to eating right
- Step 4: Choose foods and drinks with less phosphorus
- Step 5: Choose foods with the right amount of potassium
- Kidney Disease Diet: Foods for Healthy Kidneys
- Renal Diet: Sodium, Potassium, Phosphorus Intake & Foods to Avoid
- Kidney-friendly diet for CKD
- Eat this … (lower-potassium foods)
- Rather than … (higher-potassium foods)
- Eat this … (lower-phosphorous foods)
- Rather than … (higher-phosphorous foods)
- Following a kidney-friendly meal plan with diabetes
People with compromised kidney function must adhere to a renal or kidney diet to cut down on the amount of waste in their blood. Wastes in the blood come from food and liquids that are consumed.
When kidney function is compromised, the kidneys not filter or remove waste properly. If waste is left in the blood, it can negatively affect a patient’s electrolyte levels.
Following a kidney diet may also help promote kidney function and slow the progression of complete kidney failure.
A renal diet is one that is low in sodium, phosphorous, and protein. A renal diet also emphasizes the importance of consuming high-quality protein and usually limiting fluids.
Some patients may also need to limit potassium and calcium.
Every person’s body is different, and therefore, it is crucial that each patient works with a renal dietitian work to come up with a diet that is tailored to the patient’s needs.
Below are some substances that are crucial to monitor to promote a renal diet:
What is Sodium and its role in the body?
Sodium is a mineral found in most natural foods. Most people think of salt and sodium as interchangeable. Salt, however, is actually a compound of sodium and chloride. Foods we eat may contain salt or they may contain sodium in other forms. Processed foods often contain higher levels of sodium due to added salt.
Sodium is one of the body’s three major electrolytes (potassium and chloride are the other two). Electrolytes control the fluids going in and the body’s tissues and cells. Sodium contributes to:
- Regulating blood pressure and blood volume
- Regulating nerve function and muscle contraction
- Regulating the acid-base balance of blood
- Balancing how much fluid the body keeps or eliminates
Why should kidney patients monitor sodium intake?
Too much sodium can be harmful for people with kidney disease because their kidneys cannot adequately eliminate excess sodium and fluid from the body. As sodium and fluid build up in the tissues and bloodstream, they may cause:
- Increased thirst
- Edema: swelling in the legs, hands, and face
- High blood pressure
- Heart failure: excess fluid in the bloodstream can overwork your heart, making it enlarged and weak
- Shortness of breath: fluid can build up in the lungs, making it difficult to breathe
How can patients monitor their sodium intake?
- Always read food labels. Sodium content is always listed.
- Pay close attention to serving sizes.
- Use fresh, rather than packaged meats.
- Choose fresh fruits and vegetables or no-salt-added canned and frozen produce.
- Avoid processed foods.
- Compare brands and use items that are lowest in sodium.
- Use spices that do not list “salt” in their title (choose garlic powder instead of garlic salt.)
- Cook at home and do NOT add salt.
- Limit total sodium content to 400 mg per meal and 150 mg per snack.
Printable Low Sodium Diet Guidelines (PDF)
What is Potassium and its role in the body?
Potassium is a mineral found in many of the foods we eat and is also found naturally in the body. Potassium plays a role in keeping the heartbeat regular and the muscles working correctly.
Potassium is also necessary for maintaining fluid and electrolyte balance in the bloodstream.
The kidneys help to keep the right amount of potassium in your body and they expel excess amounts into the urine.
Why should kidney patients monitor their potassium intake?
When the kidneys fail, they can no longer remove excess potassium, so potassium levels build up in the body. High potassium in the blood is called hyperkalemia which can cause:
- Muscle weakness
- An irregular heart beat
- Slow pulse
- Heart attacks
How can patients monitor their potassium intake?
When the kidneys no longer regulate potassium, a patient must monitor the amount of potassium that enters the body.
Tips to help keep the levels of potassium in your blood safe, make sure to:
- Talk with a renal dietitian about creating an eating plan.
- Limit foods that are high in potassium.
- Limit milk and dairy products to 8 oz per day.
- Choose fresh fruits and vegetables.
- Avoid salt substitutes & seasonings with potassium.
- Read labels on packaged foods & avoid potassium chloride.
- Pay close attention to serving size.
- Keep a food journal.
Printable Low Potassium Diet Guidelines (PDF)
What is Phosphorus and its role in the body?
Phosphorus is a mineral that is critical in bone maintenance and development. Phosphorus also assists in the development of connective tissue and organs and aids in muscle movement. When food containing phosphorus is consumed and digested, the small intestines absorb the phosphorus so that it can be stored in the bones.
Why should kidney patients monitor Phosphorus intake?
Normal working kidneys can remove extra phosphorus in your blood. When kidney function is compromised, the kidneys no longer remove excess phosphorus. High phosphorus levels can pull calcium your bones, making them weak. This also leads to dangerous calcium deposits in the blood vessels, lungs, eyes, and heart.
How can patients monitor their Phosphorus intake?
Phosphorus can be found in many foods. Therefore, patients with compromised kidney function should work with a renal dietitian to help manage phosphorus levels.
Tips to help 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 at meals and for snacks.
- Eat fresh fruits and vegetables.
- Ask your physician about using phosphate binders at meal time.
- Avoid packaged foods that contain added phosphorus. Look for phosphorus, or for words with “PHOS” on ingredient labels.
- Keep a food journal
Printable Low Phosphorus Diet Guidlines (PDF)
Protein is not a problem for healthy kidneys. Normally, protein is ingested and waste products are created, which in turn are filtered by the nephrons of the kidney. Then, with the help of additional renal proteins, the waste turns into urine. In contrast, damaged kidneys fail to remove protein waste and it accumulates in the blood.
The proper consumption of protein is tricky for Chronic Kidney Disease patients as the amount differs with each stage of disease. Protein is essential for tissue maintenance and other bodily roles, so it is important to eat the recommended amount for the specific stage of disease according to your nephrologist or renal dietician.
Fluid control is important for patients in the later stages of Chronic Kidney Disease because normal fluid consumption may cause fluid build up in the body which could become dangerous. People on dialysis often have decreased urine output, so increased fluid in the body can put unnecessary pressure on the person’s heart and lungs.
A patient’s fluid allowance is calculated on an individual basis, depending on urine output and dialysis settings. It is vital to follow your nephrologist’s/nutritionist’s fluid intake guidelines.
To control fluid intake, patients should:
- Not drink more than what your doctor orders
- Count all foods that will melt at room temperature (Jell-O®, popsicles, etc.)
- Be cognizant of the amount of fluids used in cooking
Eating Right for Chronic Kidney Disease | NIDDK
You may need to change what you eat to manage your chronic kidney disease (CKD). Work with a registered dietitian to develop a meal plan that includes foods that you enjoy eating while maintaining your kidney health.
The steps below will help you eat right as you manage your kidney disease. The first three steps (1-3) are important for all people with kidney disease. The last two steps (4-5) may become important as your kidney function goes down.
Step 1: Choose and prepare foods with less salt and sodium
Why? To help control your blood pressure. Your diet should contain less than 2,300 milligrams of sodium each day.
- Buy fresh food often. Sodium (a part of salt) is added to many prepared or packaged foods you buy at the supermarket or at restaurants.
- Cook foods from scratch instead of eating prepared foods, “fast” foods, frozen dinners, and canned foods that are higher in sodium. When you prepare your own food, you control what goes into it.
- Use spices, herbs, and sodium-free seasonings in place of salt.
- Check for sodium on the Nutrition Facts label of food packages. A Daily Value of 20 percent or more means the food is high in sodium.
- Try lower-sodium versions of frozen dinners and other convenience foods.
- Rinse canned vegetables, beans, meats, and fish with water before eating.
Look for food labels with words sodium free or salt free; or low, reduced, or no salt or sodium; or unsalted or lightly salted.
Look for sodium on the food label. A food label showing a Percent Daily Value of 5% or less is low sodium. Also look for the amount of saturated and trans fats listed on the label.
Step 2: Eat the right amount and the right types of protein
Why? To help protect your kidneys. When your body uses protein, it produces waste. Your kidneys remove this waste. Eating more protein than you need may make your kidneys work harder.
- Eat small portions of protein foods.
- Protein is found in foods from plants and animals. Most people eat both types of protein. Talk to your dietitian about how to choose the right combination of protein foods for you.
A cooked portion of chicken, fish, or meat is about 2 to 3 ounces or about the size of a deck of cards. A portion of dairy foods is ½ cup of milk or yogurt, or one slice of cheese.
A portion of cooked beans is about ½ cup, and a portion of nuts is ¼ cup. A portion of bread is a single slice, and a portion of cooked rice or cooked noodles is ½ cup.
Step 3: Choose foods that are healthy for your heart
Why? To help keep fat from building up in your blood vessels, heart, and kidneys. To help keep fat from building up in your blood vessels, heart, and kidneys.
- Grill, broil, bake, roast, or stir-fry foods, instead of deep frying.
- Cook with nonstick cooking spray or a small amount of olive oil instead of butter.
- Trim fat from meat and remove skin from poultry before eating.
- Try to limit saturated and trans fats. Read the food label.
- Lean cuts of meat, such as loin or round
- Poultry without the skin
- Low-fat or fat-free milk, yogurt, and cheese
Learn more about heart-healthy eating.
Choose heart-healthy foods to help protect your blood vessels, heart, and kidneys.
Drink alcohol only in moderation: no more than one drink per day if you are a woman, and no more than two if you are a man. Drinking too much alcohol can damage the liver, heart, and brain and cause serious health problems. Ask your health care provider how much alcohol you can drink safely.
The next steps to eating right
As your kidney function goes down, you may need to eat foods with less phosphorus and potassium. Your health care provider will use lab tests to check phosphorus and potassium levels in your blood, and you can work with your dietitian to adjust your meal plan. More information is provided in the NIDDK health topic, Nutrition for Advanced Chronic Kidney Disease.
Step 4: Choose foods and drinks with less phosphorus
Why? To help protect your bones and blood vessels. When you have CKD, phosphorus can build up in your blood. Too much phosphorus in your blood pulls calcium from your bones, making your bones thin, weak, and more ly to break. High levels of phosphorus in your blood can also cause itchy skin, and bone and joint pain.
- Many packaged foods have added phosphorus. Look for phosphorus—or for words with “PHOS”—on ingredient labels.
- Deli meats and some fresh meat and poultry can have added phosphorus. Ask the butcher to help you pick fresh meats without added phosphorus.
| Foods Lower in Phosphorus|| Foods Higher in Phosphorus|
Your health care provider may talk to you about taking a phosphate binder with meals to lower the amount of phosphorus in your blood. A phosphate binder is a medicine that acts a sponge to soak up, or bind, phosphorus while it is in the stomach. Because it is bound, the phosphorus does not get into your blood. Instead, your body removes the phosphorus through your stool.
Step 5: Choose foods with the right amount of potassium
Why? To help your nerves and muscles work the right way. Problems can occur when blood potassium levels are too high or too low. Damaged kidneys allow potassium to build up in your blood, which can cause serious heart problems. Your food and drink choices can help you lower your potassium level, if needed.
- Salt substitutes can be very high in potassium. Read the ingredient label. Check with your provider about using salt substitutes.
- Drain canned fruits and vegetables before eating.
| Foods Higher in Potassium|
Some medicines also can raise your potassium level. Your health care provider may adjust the medicines you take.
View tips for people with chronic kidney disease:
Kidney Disease Diet: Foods for Healthy Kidneys
If you have chronic kidney disease (CKD), it’s important to watch what you eat and drink. That’s because your kidneys can’t remove waste products from your body they should. A kidney-friendly diet can help you stay healthier longer.
It’s a way of eating that helps protect your kidneys from further damage. It means limiting some foods and fluids so certain minerals don’t build up in your body. At the same time, you’ll have to make sure you get the right balance of protein, calories, vitamins, and minerals.
If you’re in the early stages of CKD, there may be few, if any, limits on what you can eat. But as your disease gets worse, you’ll have to be more careful about what you put into your body.
Your doctor may recommend you work with a dietitian to choose foods that are easy on your kidneys. Here are some things he might suggest:
DASH stands for Dietary Approaches to Stop Hypertension. It’s a diet rich in fruits, veggies, low-fat dairy products, whole grains, fish, poultry, beans, seeds, and nuts. It’s low in sodium, sugars and sweets, fats, and red meats.
Talk to your doctor about it if you have CKD. He’ll let you know if there are certain reasons you shouldn’t try the DASH diet.
It’s not an option if you’re on dialysis.
This mineral is found naturally in many foods. It’s most common in table salt.
Sodium affects your blood pressure. It also helps to maintain the water balance in your body. Healthy kidneys keep sodium levels in check. But if you have CKD, extra sodium and fluids build up in your body.
This can cause a number of problems, swollen ankles, high blood pressure, shortness of breath, and fluid buildup around your heart and lungs. You should aim for less than 2g of sodium in your daily diet.
Try these simple tips to cut the sodium in your diet:
- Avoid table salt and high-sodium seasonings (soy sauce, sea salt, garlic salt, etc.).
- Cook at home — most fast foods are high in sodium.
- Try new spices and herbs in place of salt.
- Stay away from packaged foods, if possible — these tend to be high in sodium.
- Read the labels when shopping and choose foods that are low-sodium.
- Rinse canned foods (veggies, beans, meats, and fish) with water before serving.
You need these minerals to keep your bones healthy and strong. When your kidneys are healthy, they remove the phosphorus you don’t need. But if you have CKD, your phosphorous levels can get too high. This puts you at risk for heart disease. What’s more, your calcium levels begin to drop. To make up for it, your body pulls it from your bones. This can make them weak and easier to break.
If you have late-stage CKD, your doctor may advise you take in no more than 1,000 milligrams (mg) of phosphorus mineral each day. You can do this by:
- Choosing foods with low levels of phosphorous (look for “PHOS” on the label)
- Eating more fresh fruits and veggies
- Choosing corn and rice cereals
- Drinking light-colored sodas
- Cutting back on meat, poultry, and fish
- Limiting dairy foods
Foods that are high in calcium also tend to be high in phosphorous. So, your doctor might recommend you cut back on calcium-rich foods. He might tell you to stop taking over-the-counter calcium supplements, too.
This mineral helps your nerves and muscles work properly. But when you have CKD, your body can’t filter out excess potassium. When you have too much of it in your blood, it can lead to serious heart problems.
Potassium is found in a lot of fruits and veggies, bananas, potatoes, avocados, and melons. These foods can affect potassium levels in your blood. Your doctor will let you know if you need to limit this mineral in your diet. If so, he may recommend you try low-potassium foods, :
- Apples and apple juice
- Cranberries and cranberry juice
- Strawberries, blueberries, raspberries
- Boiled cauliflower
As your CKD gets worse, you may need to make other changes to your diet. This might involve cutting back on foods that are high in protein, especially animal protein. These include meats, seafood, and dairy products.
If you have early-stage CKD, you probably don’t need to cut back on fluids. But if your condition gets worse, your doctor will let you know if you need to limit those, too.
American Kidney Fund: “Kidney-friendly Diet for CKD,” “Nutrition and Chronic Kidney Disease,” “Nutrition and Early Kidney Disease,” “The DASH Diet.”
National Kidney Disease Education Program: “Eating Right for Kidney Health — Tips for People With Chronic Kidney Disease (CKD).”
Mayo Clinic: “Low-phosphorous Diet: Best for Kidney Disease.”
© 2018 WebMD, LLC. All rights reserved.
Renal Diet: Sodium, Potassium, Phosphorus Intake & Foods to Avoid
Eating correctly is important for kidney health. People with kidney disease need to monitor intakes of sodium, potassium, and phosphorus especially.
People with kidney disease may need to control several important nutrients. The following information will help you adjust your diet.
Please discuss your specific and individual diet needs with your doctor or dietitian.
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Kidney-friendly diet for CKD
What you eat and drink affects your health. Staying at a healthy weight and eating a balanced diet that is low in salt and fat can help you control your blood pressure. If you have diabetes, you can help control your blood sugar by carefully choosing what you eat and drink. Controlling high blood pressure and diabetes may help prevent kidney disease from getting worse.
A kidney-friendly diet may also help protect your kidneys from further damage. A kidney-friendly diet limits certain foods to prevent the minerals in those foods from building up in your body.
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With all meal plans, including the kidney-friendly diet, you need to track how much of certain nutrients you take in, such as:
To make sure you are getting the right amounts of these nutrients, you need to eat and drink the right portion sizes. All of the information you need to keep track of your intake is on the “Nutrition Facts” label.
Use the nutrition facts section on food labels to learn more about what is in the foods you eat. The nutrition facts will tell you how much protein, carbohydrates, fat and sodium are in each serving of a food. This can help you pick foods that are high in the nutrients you need and low in the nutrients you should limit.
When you look at the nutrition facts, there are a few key areas that will give you the information you need:
Your body gets energy from the calories you eat and drink. Calories come from the protein, carbohydrates and fat in your diet. How many calories you need depends on your age, gender, body size and activity level.
You may also need to adjust how many calories you eat your weight goals. Some people will need to limit the calories they eat. Others may need to have more calories. Your doctor or dietitian can help you figure out how many calories you should have each day. Work with your dietitian to make a meal plan that helps you get the right amount of calories, and keep in touch for support.
Carbohydrates (“carbs”) are the easiest kind of energy for your body to use. Healthy sources of carbohydrates include fruits and vegetables. Unhealthy sources of carbohydrates include sugar, honey, hard candies, soft drinks and other sugary drinks.
Some carbohydrates are high in potassium and phosphorus, which you may need to limit depending on your stage of kidney disease. We'll talk about this in more detail a little later. You may also need to watch your carbohydrates carefully if you have diabetes. Your dietitian can help you learn more about the carbohydrates in your meal plan and how they affect your blood sugar.
You need some fat in your meal plan to stay healthy. Fat gives you energy and helps you use some of the vitamins in your food. But too much fat can lead to weight gain and heart disease. Try to limit fat in your meal plan, and choose healthier fats when you can.
Healthier fat or “good” fat is called unsaturated fat. Examples of unsaturated fat include:
- Olive oil
- Peanut oil
- Corn oil
Unsaturated fat can help reduce cholesterol. If you need to gain weight, try to eat more unsaturated fat. If you need to lose weight, limit the unsaturated fat in your meal plan. As always, moderation is the key. Too much “good” fat can also cause problems.
Saturated fat, also known as “bad” fat, can raise your cholesterol level and raise your risk for heart disease. Examples of saturated fats include:
Limit these in your meal plan. Choose healthier, unsaturated fat instead. Trimming the fat from meat and removing the skin from chicken or turkey can also help limit saturated fat.
You should also avoid trans fat. This kind of fat makes your “bad” (LDL) cholesterol higher and your “good” (HDL) cholesterol lower.
When this happens, you are more ly to get heart disease, which can cause kidney damage.
Choosing healthy foods is a great start, but eating too much of anything, even healthy foods, can be a problem. The other part of a healthy diet is portion control, or watching how much you eat.
To help control your portions:
- Check the nutrition facts label on a food to learn the serving size and how much of each nutrient is in one serving. Many packages have more than one serving. For example, a 20-ounce bottle of soda is really two-and-a-half servings. Many fresh foods, such as fruits and vegetables, do not come with nutrition facts labels. Ask your dietitian for a list of nutrition facts for fresh foods and tips for how to measure the right portions.
- Eat slowly, and stop eating when you are not hungry any more. It takes about 20 minutes for your stomach to tell your brain that you are full. If you eat too quickly, you may eat more than you need.
- Avoid eating while doing something else, such as watching TV or driving. When you are distracted you may not realize how much you have eaten.
- Do not eat directly from the package the food came in. Instead, take out one serving of food and put the bag or box away.
Good portion control is an important part of any meal plan. It is even more important in a kidney-friendly meal plan, because you may need to limit how much of certain things you eat and drink.
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When your kidneys are not working as well as they should, waste and fluid build up in your body. Over time, the waste and extra fluid can cause heart, bone and other health problems. A kidney-friendly meal plan limits how much of certain minerals and fluid you eat and drink. This can help keep the waste and fluid from building up and causing problems.
How strict your meal plan should be depends on your stage of kidney disease. In the early stages of kidney disease, you may have little or no limits on what you eat and drink. As your kidney disease gets worse, your doctor may recommend that you limit:
Eat this … (lower-potassium foods)
- Apples, cranberries, grapes, pineapples and strawberries
- Cauliflower, onions, peppers, radishes, summer squash, lettuce
- Pita, tortillas and white breads
- Beef and chicken, white rice
Rather than … (higher-potassium foods)
- Avocados, bananas, melons, oranges, prunes and raisins
- Artichokes, winter squash, plantains, spinach, potatoes and tomatoes
- Bran products and granola
- Beans (baked, black, pinto, etc.), brown or wild rice
Your doctor may also tell you to take a special medicine called a potassium binder to help your body get rid of extra potassium.
Learn more about high potassium and its treatment here
Eat this … (lower-phosphorous foods)
- Italian, French or sourdough bread
- Corn or rice cereals and cream of wheat
- Unsalted popcorn
- Some light-colored sodas and lemonade
Rather than … (higher-phosphorous foods)
- Whole-grain bread
- Bran cereals and oatmeal
- Nuts and sunflower seeds
- Dark-colored colas
Following a kidney-friendly meal plan may make it hard for you to get all of the vitamins and minerals you need. To help you get the right amounts of vitamins and minerals, your dietitian may suggest a special supplement made for people with kidney disease.
Your doctor or dietitian might also suggest a special kind of vitamin D, folic acid or iron pill, to help prevent some common side effects of kidney disease, such as bone disease and anemia.
Regular multi-vitamins may not be healthy for you if you have kidney disease. They may have too much of some vitamins and not enough of others.
Your doctor or dietitian can help you find vitamins that are right for you.
Important! Tell your doctor and dietitian about any vitamins, supplements or over-the-counter medicines you are taking. Some can cause more damage to your kidneys or cause other health problems.
Following a kidney-friendly meal plan with diabetes
If you have diabetes, you need to control your blood sugar to prevent more damage to your kidneys. Your doctor and dietitian can help you create a meal plan that helps you control your blood sugar, while also limiting sodium, phosphorus, potassium and fluids.
A diabetes educator can also help you learn how to control your blood sugar. Ask your doctor to refer you to a diabetes educator in your area. A list of diabetes educators is available from the American Association of Diabetes Educators at www.diabeteseducator.org or 1.800.338.3633. Medicare and many private insurance policies may help pay for appointments with a diabetes educator.
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In Kidney Kitchen, you can take a deep dive into what each nutrient means for people with kidney disease, and how much of these nutrients common foods contain. Learn what healthy eating means for people in every stage of kidney disease, including those on dialysis or living with a kidney transplant. Find recipes on Kidney Kitchen.
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Learn more about managing your phosphorus in real-life situations, shopping in a grocery store or eating in a restaurant. Watch these videos.
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