Eating Right for Kidney Disease

Nutrition is key to managing kidney disease and your overall health. Making healthy food choices is important for everyone, but it is even more important if you have chronic kidney disease. Good nutrition helps to 

• Provide energy for daily tasks 
• Prevent infection 
• Avoid loss of muscle mass 
• Help maintain a healthy weight 
• Help keep kidney disease from getting worse 

Your kidneys help to keep the right balance of nutrients and minerals in your body. But if you have kidney disease, your kidneys may not be able to do this job very well. You may need to make some changes to your diet. 

To manage your kidney disease, you may need to change the way you eat. Planning a healthy diet requires special training in nutrition for patients with kidney disease. Schedule an appointment with a registered dietitian nutritionist (RDN). Meeting with a dietitian is covered by Medicare. The service also may be a covered benefit by other types of insurance. Here are a few ways to find a dietitian who specializes in kidney disease:

• Ask your doctor for a referral 
• Go to the CKD Kidney Dietitian Directory 
• Phone the Academy of Nutrition and Dietetics at 800.877.1600 
• Go to www.eatright.org 

The dietitian will work with your doctor to decide what foods to include in your diet. You may have other conditions, such as diabetes or high blood pressure, that require changes in what you eat and drink. Dietitians are trained to evaluate your specific needs at each stage of kidney disease. 

When your kidneys aren’t working as well as they should, extra waste and fluid can build up in your body. You can help your kidneys maintain their function and slow the progression of kidney disease by making changes to your diet. 

Understanding more about protein; sodium; potassium and phosphorous; calories; and fluid will help you make the best choices. A registered dietitian nutritionist can help you create a meal plan that is customized to your individual needs, preferences, and stage of kidney disease. 

Here are some ways to limit sodium in your diet: 

• Use less salt, salt seasoning blends, garlic salt, and onion salt. Instead, use spices and herbs to season your food. 
• Use less high sodium sauces like soy sauce, teriyaki sauce, and hot sauce. 
• Cook food from scratch more often. Choose minimally processed foods. 
• Choose low sodium canned foods and soups more often. Rinse canned vegetables and beans with water before using. 
• Check for sodium on the Nutrition Facts label. A Daily Value of 20% or more means the food is high in sodium. 

Limit snack foods that are high in salt like chips and crackers. 

Your dietitian can teach you how to choose foods that are lower in sodium. To know how much sodium is in the food you buy, read Nutrition Facts labels. Look for words like sodium free or salt free, reduced or low sodium, or unsalted or lightly salted. 

Potassium and phosphorus are important minerals that we don’t think about unless our kidneys aren’t working well. Sometimes people with kidney disease need to limit potassium and phosphorus in their diet. It is important to understand the role of these minerals in the body and what foods contain them. 

Foods Lower in Potassium 

• Spices and herbs (not salt substitutes because they often contain potassium) 
• Fruits like apples, peaches, lemons, limes, berries, pineapple, watermelon (limit to 1 cup), and apple, grape, or cranberry juice 
• Vegetables like bell peppers, cooked cabbage (red or green), cooked carrots, corn, cucumbers, lettuce 

Foods Higher in Potassium 

• Fruits like bananas, melons, nectarine, kiwi, raisins, oranges/orange juice, prunes/prune juice 
• Vegetables like spinach, beet and other greens, avocado, baked beans, potatoes, split peas, lentils, beans, black-eyed peas, sweet potatoes, raw carrots, okra, Chinese cabbage, tomatoes/tomato juice/ tomato sauce 
• Brown and wild rice 
• Dairy foods 
• Bran cereals 

Phosphorous is a mineral that is found in almost all foods. It works with calcium to keep your bones healthy. Your kidneys help keep your phosphorus in check. If your kidneys are not working well, phosphorus can build up in your blood, blood vessels, heart, joints, muscles, and skin. Many people with kidney disease need to limit phosphorous and foods that contain phosphorus additives. 

High phosphorus levels can cause your bones to become weak and break easily. This is because calcium is pulled from your bones when there is a lot of phosphorus in your blood. 

Depending on your stage of kidney disease, your healthcare provider may prescribe a medicine called a phosphate binder. This medicine keeps phosphorous from building up in your blood. Even if you take a phosphate binder, you will still need to watch what phosphorus foods you eat. Your dietitian can help you choose the right foods for you. 

You absorb a lot of phosphorus from these phosphorus-rich foods:

• Processed, convenience, and fast foods that have phosphorus additives
• Beverages like cocoa, beer, and dark cola drinks 
• Dairy products like milk, cheese, yogurt, ice cream, and pudding 

You absorb less phosphorus from these phosphorus-rich foods: 

• Bran cereals, oatmeal, whole grains, breads, pasta, rice, corn cereals, rice cereals 
• Milk alternatives (check labels as some brands may add phosphorus) 
• Dried beans and peas 
• Nuts and nut butters 
• Fresh poultry, fish, seafood, beef, and pork 
• Some fruits and vegetables 
• Dried beans and peas 

Learn to read Nutrition Facts labels. Look for words like phosphorus, pyrophosphate, or words that start with PHOS. 

If your provider tells you to limit your fluid intake, check out this mobile app. It is designed to help people with hyponatremia, kidney failure, or heart disease. 

H2Overload: Fluid Control for Heart Kidney Health