Patient education: Diet for people with nondialysis chronic kidney disease (The Basics)

What is chronic kidney disease? — Chronic kidney disease ("CKD") is when the kidneys stop working as well as they should. When they are working normally, the kidneys filter blood and remove waste and excess salt and water (figure 1).

In people with CKD, the kidneys slowly lose the ability to filter blood. In time, the kidneys can stop working completely. That is why it is so important to keep CKD from getting worse.

This information is for people with CKD who are not on dialysis. People who are on dialysis need to make other specific changes to their diet.

Why do I need a special diet? — Your body needs certain amounts of calories, protein, vitamins, and minerals to work right. The kidneys balance the level of many things in your diet. They filter the blood and try to keep normal levels of sodium (salt), potassium, phosphorous, calcium, protein, and water. Changing your diet is a way to protect your kidneys and keep CKD from getting worse.

Most people with CKD need to pay attention to certain things in what they eat and drink. These include:

●Sodium − This is the main ingredient in table salt. Most people with CKD need to limit how much sodium they eat. That's because eating a lot of sodium can raise your blood pressure. It can also make you thirsty and make you drink more than you should. To know how much sodium or other nutrients are in a food, look at the food's label (figure 2). Try to eat foods that are naturally low in sodium. Check for labels that say "sodium-free" or "very low in sodium."

●Potassium − This is a nutrient that affects your heartbeat. Some people with CKD need to limit how much potassium they eat. If too much potassium builds up in your body, it can cause problems with your heart rhythm. If you need to limit dietary potassium, try to eat foods that are low in potassium (table 1) and avoid foods that are high in potassium (table 2).

●Phosphorus − This is a nutrient found in many foods. Foods like milk, other dairy foods, nuts, beans, liver, and chocolate have high levels of phosphorus. Some people with CKD need to avoid foods with high levels of phosphorus. That's because if phosphorus builds up in your body, it can cause weak bones and other problems. Your doctor might also prescribe a medicine for you to take with your meals and snacks. This medicine can help keep your phosphorus level low.

●Protein – Protein helps your muscles stay strong. Foods with a lot of protein include meat, chicken, fish, and eggs. Most people with CKD need to eat a lower amount of protein. When your body breaks down protein to be used, it makes waste products. Your kidneys help get rid of these waste products.

●Fluids − Based on your stage of kidney disease, you might need to watch how much you drink. Ask your doctor if you need to limit fluids.

Your doctor will probably prescribe a vitamin for you to take every day. That way, your body can get the vitamins and minerals that might be missing in your diet.

What can I eat and drink on a kidney disease diet? — There is no specific diet plan for all people with CKD. Your diet recommendations will be based on how well your kidneys work, the type of kidney disease you have, and any other health problems you might have.

Your doctor, nurse, or dietitian can talk to you about what specific foods are good to eat, and what to limit or avoid. They can also help you understand how much you should eat in each "serving." A dietitian can work with you to make a specific meal plan based on your needs.

What else should I know? — General recommendations for most people with CKD include:

●Try to limit sodium (salt) in your foods. Choose fresh or frozen fruits and vegetables when possible, and avoid or limit processed foods. Processed foods include most foods that are sold in cans, boxes, jars, and bags. If you do buy these foods, look for labels that say "low-sodium." Use herbs, lemon, and spices to season your food instead of salt.

●Eat a lower amount of protein. Try to choose proteins that come from plants such as nuts and nut butters, legumes (such as peas, beans, and lentils), soy products (such as tofu, edamame, and tempeh), and quinoa. Other good sources of protein include eggs, chicken, and fish.

●If you need to limit your potassium intake, choose foods with low levels of potassium (table 1). Avoid or eat only small amounts of foods with high levels of potassium (table 2).

●If you need to limit your phosphorous intake, avoid milk and products made with milk like cheese or ice cream. Choose Greek yogurt, almond milk, rice milk, and cottage cheese.

●Depending on your weight and health, it might help to try to lose weight. Managing your weight can be helpful in preventing kidney diseases. Choose low-fat foods, and take in a moderate amount of calories each day.

More on this topic

Patient education: Chronic kidney disease (The Basics)
Patient education: Low-sodium diet (The Basics)
Patient education: Low-potassium diet (The Basics)
Patient education: Hyperkalemia (The Basics)

Patient education: Chronic kidney disease (Beyond the Basics)
Patient education: Low-sodium diet (Beyond the Basics)
Patient education: Low-potassium diet (Beyond the Basics)