You need to have a kidney-friendly meal plan when you have chronic kidney disease (CKD). Watching what you eat and drink will help you stay healthier. The information in this section is for people who have kidney disease but are not on dialysis.
This information should be used as a basic guide. Everybody is different and everybody has different nutrition needs. Talk to a renal dietitian (someone who is an expert in diet and nutrition for people with kidney disease) to find a meal plan that works for you.
Ask your doctor to help you find a dietitian. Medicare and many private insurance policies will help pay for appointments with dietitians. Check with your insurance company to see if your policy covers medical nutrition therapy (MNT).
Why is an eating plan important?
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.
Healthy diet basics
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 based on 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.
Protein is one of the building blocks of your body. Your body needs protein to grow, heal and stay healthy. Having too little protein can cause your skin, hair and nails to be weak. But having too much protein can also be a problem. To stay healthy and help you feel your best, you may need to adjust how much protein you eat.
The amount of protein you should have depends on your body size, activity level and health concerns. Some doctors recommend that people with kidney disease limit protein or change their source of protein. This is because a diet very high in protein can make the kidneys work harder and may cause more damage. Ask your doctor or dietitian how much protein you should have and what the best sources of protein are for you.
Use the table below to learn which foods are low or high in protein. Keep in mind that just because a food is low in protein, it is not healthy to eat unlimited amounts.
- Pasta and rice
- Red meat
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 likely to get heart disease, which can cause kidney damage.
Sodium (salt) is a mineral found in almost all foods. Too much sodium can make you thirsty, which can lead to swelling and raise your blood pressure. This can damage your kidneys more and make your heart work harder.
One of the best things that you can do to stay healthy is to limit how much sodium you eat. To limit sodium in your meal plan:
- Do not add salt to your food when cooking or eating. Try cooking with fresh herbs, lemon juice or other salt-free spices.
- Choose fresh or frozen vegetables instead of canned vegetables. If you do use canned vegetables, drain and rinse them to remove extra salt before cooking or eating them.
- Avoid processed meats like ham, bacon, sausage and lunch meats.
- Munch on fresh fruits and vegetables rather than crackers or other salty snacks.
- Avoid canned soups and frozen dinners that are high in sodium. • Avoid pickled foods, like olives and pickles. • Limit high-sodium condiments like soy sauce, BBQ sauce and ketchup.
Important! Be careful with salt substitutes and “reduced sodium” foods. Many salt substitutes are high in potassium. Too much potassium can be dangerous if you have kidney disease. Work with your dietitian to find foods that are low in sodium and potassium.
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.
How is a kidney-friendly diet different?
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:
Potassium is a mineral found in almost all foods. Your body needs some potassium to make your muscles work, but too much potassium can be dangerous. When your kidneys are not working well, your potassium level may be too high or too low. Having too much or too little potassium can cause muscle cramps, problems with the way your heart beats and muscle weakness.
If you have kidney disease, you may need to limit how much potassium you take in. Ask your doctor or dietitian if you need to limit potassium.
Use the list below to learn which foods are low or high in potassium. Your dietitian can also help you learn how to safely eat small amounts of your favorite foods that are high in potassium.
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.
Phosphorus is a mineral found in almost all foods. It works with calcium and vitamin D to keep your bones healthy. Healthy kidneys keep the right amount of phosphorus in your body. When your kidneys are not working well, phosphorus can build up in your blood. Too much phosphorus in your blood can lead to weak bones that break easily.
Many people with kidney disease need to limit phosphorus. Ask your dietitian if you need to limit phosphorus.
Depending on your stage of kidney disease, your doctor may also prescribe a medicine called a phosphate binder. This helps to keep phosphorus from building up in your blood. A phosphate binder can be helpful, but you will still need to watch how much phosphorus you eat. Ask your doctor if a phosphate binder is right for you.
Use the list below to get some ideas about how to make healthy choices if you need to limit phosphorus.
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
You need water to live, but when you have kidney disease, you may not need as much. This is because damaged kidneys do not get rid of extra fluid as well as they should. Too much fluid in your body can be dangerous. It can cause high blood pressure, swelling and heart failure. Extra fluid can also build up around your lungs and make it hard to breathe.
Depending on your stage of kidney disease and your treatment, your doctor may tell you to limit fluid. If your doctor tells you this, you will need to cut back on how much you drink. You may also need to cut back on some foods that contain a lot of water. Soups or foods that melt, like ice, ice cream and gelatin, have a lot of water. Many fruits and vegetables are high in water, too.
Ask your doctor or dietitian if you need to limit fluids.
If you do need to limit fluids, measure your fluids and drink from small cups to help you keep track of how much you’ve had to drink. Limit sodium to help cut down on thirst. At times, you may still feel thirsty. To help quench your thirst, you might try to:
- Chew gum
- Rinse your mouth
- Suck on a piece of ice, mints or hard candy (Remember to choose sugar-free candy if you have diabetes.)
Special diet concerns
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.
There are several excellent sources for kidney-healthy recipes that you can find online.
Renal Support Network
Northwest Kidney Centers