According to estimates from the Centers for Disease Control, about 35.5 million people in the United States have chronic kidney disease (CKD). When you have chronic kidney disease, your kidneys aren’t functioning as well as they did previously.
The kidneys help make red blood cells, clean the blood, filter out waste products, and play a role in bone health. Since the kidneys have many essential roles in the body, decreased kidney function causes problems that you might have to address with diet and nutrition. Read on to learn more about some nutrition essentials for chronic kidney disease.
Who should follow a special diet for people with chronic kidney disease?
Not every person with chronic kidney disease needs to follow a special renal diet or diet restrictions immediately. It’s less common to have strict diet restrictions for stage 1 or stage 2 CKD, and it's more common for stages 3-5 to have stricter diet recommendations.
Talk to a member of your healthcare team, such as your nephrologist, if you’re unsure if you need to follow a special diet. A registered dietitian specializing in kidney conditions can help you choose appropriate foods and beverages for your personalized nutrition needs.
Other health conditions, like diabetes and high blood pressure, are common in people with CKD. If you have one of these conditions, too, you may have to monitor additional factors in your diet.
What should you eat with CKD?
Even if you have chronic kidney disease, it’s still important to follow the basics of a healthy diet. A healthy diet includes:
- Water
- Good sources of protein
- Fruits
- Vegetables
- Whole grains
- Dairy or dairy substitutes, such as soy, oat, or almond milk products
- Healthy fats, such as avocados or olive oil
However, you may need to monitor servings and portions of some of these foods with CKD or choose foods within each group that fit your personalized diet recommendations.
Important diet considerations in chronic kidney disease
Depending on which stage of chronic kidney disease you’re in, you may need to follow restrictions or aim for goal amounts in some of the following areas: Restrictions and recommendations to limit protein, fluid, sodium, potassium, and phosphorus are common since the kidneys are no longer filtering the blood as well as they used to.
Protein
In general, people who have CKD but are not on dialysis are recommended to eat less protein than a typical person. For earlier stages of CKD, the general guideline is 0.8 grams of protein per kilogram of body weight. For those in later stages of CKD who are not yet on dialysis, guidelines recommend restricting protein further to 0.55 to 0.6 grams of protein per kilogram per day. People who have CKD and are on dialysis need higher amounts of protein.
To calculate how much protein you need daily based on the above recommendations, divide your current weight in pounds by 2.2. This will convert your weight to kilograms. Then, multiply your weight in kilograms x 0.6 or 0.8 to find how many grams of protein you should eat per day.
Protein sources include meats, poultry, fish, eggs, dairy products, tofu, and beans. Eating these foods is still important when limiting protein intake, but you may be limited to smaller portions or fewer servings per day.
Fluid
Depending on your CKD stage, your medical team may recommend a fluid restriction of a certain number of milliliters or ounces per day of total fluids. In stages 3-5 of CKD, the recommendation is typically 1000-1500 ml of total fluid daily.
When counting fluids, it’s important to count all liquids, including water, alcohol, coffee, juices, and anything that would be a liquid at room temperature. Please keep in mind items that melt or have a liquid base, like popsicles, ice, ice cream, jello, and soup.
Some people find it helpful to suck on hard candy, chew gum, or slowly eat ice chips when they have a fluid restriction and feel thirsty.
Sodium
A typical recommendation for CKD is a limit of about 1500 mg of sodium per day. Check the Nutrition Facts label on food and drink packages to understand how much sodium they contain per serving.
Sodium is found in table salt and many seasoning mixes and powders. Restaurant, packaged, and processed foods tend to have more sodium than foods cooked from scratch. Fresh fruits, fresh vegetables, and unflavored rice are naturally lower in sodium.
Processed meats, such as Spam, bacon, or sausages, usually have high amounts of sodium. Sauces are usually high in sodium, so use gravies, soy sauce, or teriyaki sauces sparingly.
Potassium
The amount of potassium a person with CKD is recommended to eat is usually based on their lab test results. If you’re instructed to limit potassium, it’s important to follow the recommendation because high potassium levels can impact the heart.
Potassium is found in a wide variety of foods. Many fruits are high in potassium, including bananas, papaya, mango, and oranges. Vegetables also contain potassium, and high-potassium vegetables include all potato and tomato products.
Phosphorus
Too much phosphorus in the blood can cause issues with your bones and lead to other complications. To prevent these effects, the medical team might recommend a limit on how much phosphorus you eat per day.
Phosphorus is found in many protein-containing foods. It is also present in cow’s milk dairy products, dark sodas, and chocolate. Additionally, phosphorus is found in preservatives and additives in many processed foods.
In addition to recommending a phosphorus limit, your medical team might prescribe medication to help lower your phosphorus levels.
Other nutrition considerations
Some people with chronic kidney disease have poor appetite and struggle to eat enough, especially in the later stages of CKD. If so, your medical team might recommend an oral nutrition supplement (similar to Ensure or Boost but specialized for the kidneys) for you to try.
Sometimes, if you follow a restrictive diet, you miss out on the nutrients necessary for good health. People who follow diet restrictions sometimes need vitamin and mineral supplements to meet their nutritional needs. However, make sure you ask your medical team before starting any new vitamins or mineral supplements if you have CKD.
