CHRONIC KIDNEY DISEASE Diet: What to Eat, What to Skip
Updated: Nov 11
I've taken an interest in this topic as it hits close to home. My Dad has Chronic Kidney Disease (CKD) + I wanted to learn more to empower my family to know more about it + how to shop + meal plan. The only person that is truly in control however, is my Dad aka Papa Ed, so I hope this post helps him as well as others with Chronic Kidney Disease (CKD).
They're small, but your kidneys have a mighty job—filtering out waste from the blood. If they aren’t working well things can go wrong, like unhealthy blood pressure + electrolyte levels. That's why if you have chronic kidney disease (CKD), your diet can help determine your destiny. Still, “it’s not one-size-fits-all,” warns Mohamed Atta, M.D., professor of medicine in the division of nephrology at the Johns Hopkins University School of Medicine in Baltimore.
“Nutritional support is important, but you have to tailor that support based on the cause of the kidney disease.”
The VICIOUS Circle of CKD + Other HEALTH Conditions
Chronic kidney disease is always caused by another condition, most often diabetes or high blood pressure (HBP), which both can damage the kidneys’ blood vessels. What's more, as CKD progresses it often leads to HBP (or makes it worse), increasing your risk for cardiovascular issues like heart attack + stroke.
This is why it’s super important to eat foods that support your kidney function and lower your risk for heart problems.
Here, I’ll walk you through a CKD-friendly diet. (Remember, always consult with your doctor and/or nutritionist about your own individual needs before embarking on a new eating plan.)
Try This "HEART SMART" Dietary Approach For CKD
Unless you’re already on dialysis, start with a balanced diet, says Krista Maruschak, R.D., a registered dietitian with Cleveland Clinic’s Center for Human Nutrition in Ohio. Since CKD + heart problems often go hand-in-hand, heart-smart eating helps reduce fats that build up in your kidneys, heart + blood vessels. The general approach as you cruise your grocery store aisles? Maruschak suggests picking up lots of fruits + vegetables, whole grains, low- or no-fat dairy, lean proteins + healthy fats such as olive + flaxseed oils. Limit saturated fats to 5% to 6% of your total daily calories + avoid trans-fats.
SKIP The SALT
Now, for some specifics. “I tell my patients salt is their number-one enemy, the number-one cause of problems,” says Dr. Atta. Reducing the amount of sodium you eat can help control HBP and diabetes + lower your risk of heart problems, he adds. Keep your intake to under about
1 tsp. a day, advises Maruschak.
To lower your intake, buy fresh food (packaged + prepared food tends to be high in sodium); cook with herbs + spices instead of salt; rinse canned meat, beans + veggies before eating; + check food labels—the sodium Daily Value should be under 20%.
Choose LEAN PROTEINS + Cut Down on Red Meat
Protein creates waste that your kidneys must filter out. Eating too much of it forces damaged kidneys to work even harder, making CKD worse. Limiting protein to 0.6–0.8 g/kg of body weight is especially important in Stages 3 to 5 of CKD because such restrictions can help slow down disease progression, Maruschak says. Red meat is “a stress test to the kidney,” adds Dr. Atta. It has a surplus of saturated fat, cholesterol + salt + it delivers high levels of acid that your kidneys can’t remove.
Choose fish, poultry, eggs, nuts, beans + grains for your protein needs instead.
WATCH Your POTASSIUM Intake
In Stages 3 to 5 of CKD, your lab tests may start showing higher levels of potassium because your kidneys can’t filter it out, says Maruschak. High potassium can cause serious heart problems, including sudden death from your heart stopping, says Dr. Atta. Symptoms of life-threatening levels include leg weakness, chest pain, difficulty breathing, abnormal heartbeat, nausea, or vomiting.
If your potassium level is too high, you’ll need to limit high-potassium foods like oranges, bananas, dairy, nuts, potatoes, beans + whole-wheat. This can be tricky, especially on a heart-healthy diet, so you’ll probably need a dietitian’s help.
LIMIT Foods With PHOSPHORUS
Like potassium, your phosphorus levels may begin to rise as your kidney function decreases. Too much phosphorus can weaken your bones, cause calcification of your arteries + lead to heart disease. Dr. Atta says he has patients limit phosphorus once their kidney function is at 50%.
Foods + drinks higher in phosphorus include dark sodas, canned + processed food, chocolate, dairy, meat, bran + oats. These restricted low-potassium + low-phosphorus diets are “why we have patients meet with a nutritionist to make sure they know what to avoid,” Dr. Atta added.
Bite Into APPLES + BERRIES
One of the biggest benefits of apples + berries like strawberries + blueberries for people with CKD is that they’re extremely low in potassium, says Dr. Atta. All three—especially blueberries—also have antioxidants called anthocyanins, which, according to recent study published in Food and Nutrition Research, may help prevent heart disease, diabetes, cancer, inflammation + obesity.
They all contain fiber + vitamin C, too. Keep in mind that eating a bunch of low-potassium foods in one day can add up, so enjoy these fruits in moderation, Dr. Atta says.
Try More OMEGA-3 Rich FISH
Omega-3 fatty acids are an important part of a healthy diet because research has found that they can boost your heart health, lowering your risk of heart disease, blood clots + arrhythmias. They help keep plaque out of your arteries + curb inflammation, too.
Omega-3s may also lower blood pressure, a potentially big benefit when you have CKD. You have to get Omega-3 fatty acids through your food since your body doesn’t make them.
The best sources are fish like salmon, herring, mackerel, lake trout, bluefin tuna, anchovies + albacore tuna. Aim for 2+ servings a week.