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Nutrition and Early Kidney Disease (Stages 14)
Nutrition and Early Kidney Disease (Stages 14)
Kidney-friendly nutrition & COVID-19
Why is good nutrition important for people with kidney disease?
Making healthy food choices is important to us all, but it is even more essential if you have kidney disease (CKD). Good nutrition helps:
- Provide energy to do your daily tasks
- Prevent infection
- Avoid muscle-mass loss
- Help maintain a healthy weight
- Slow down the progression of kidney disease
What are the basics of good nutrition?
A well-balanced diet gives you the right amounts of protein, calories, vitamins, and minerals each day. Eating a healthy diet, staying physically active, and taking all your medicines as prescribed are all important parts to keeping you healthy and feeling well.
Will I need to change my diet if I have kidney disease?
Your kidneys help keep the right balance of nutrients and minerals in your body. But if you have kidney disease, your kidneys may not do this job very well. You may need to make some changes to your diet.
Registered dietitians and kidney disease
Ask your doctor about meeting with a Registered Dietitian with special training in kidney disease. A dietitian can:
- Teach you to make the best food choices based on your lifestyle and lab tests
- Make changes in your diet to help you better control diabetes and high blood pressure
- Help you to keep your kidney disease from getting worse
Meeting with a dietitian is a covered service by Medicare and may also be covered by other types of insurance. You may need to call your insurance provider to determine if your plan covers meeting with a dietitian.
Are you looking for nutrition guidance? Contact a CKD dietitian in your area.
What kinds of changes will I need to make to my diet?
There is no one correct eating plan for everyone with kidney disease. What you can or cannot eat may change over time, depending on your kidney function and other factors. If you are following a special diet for diabetes or heart conditions, you will need to continue following it.
What will I need to control in my diet?
People with kidney disease may need to control the amount of:
- Protein
- Sodium
- Potassium
- Phosphorus
- Calcium
Eating the right amount may help control the buildup of waste and fluid in your blood. This means your kidneys do not have to work as hard to remove the extra waste and fluid. If your kidney disease gets worse, you may need to limit other nutrients as well. Your dietitian or healthcare provider will tell you if you need to do this based on your blood test results.
Protein
Your body needs protein to help build muscle, repair tissue, and fight infection. If you have kidney disease, you may need to watch how much protein you eat. Having too much protein can cause waste to build up in your blood, and your kidneys may not be able to remove all the extra waste. If protein intake is too low, however, it may cause other problems so it is essential to eat the right amount each day.
The amount of protein you need is based on:
- your body size
- your kidney problem
- the amount of protein in your urine
Your dietitian or healthcare provider can tell you how much protein you should eat.
Sodium
Healthy kidneys control how much sodium is in your body. If your kidneys do not work well, too much sodium can cause fluid buildup, swelling, higher blood pressure, and strain on your heart. Your dietitian or healthcare provider can tell you the right amount of sodium you should have each day.
Potassium
Potassium works with the muscles, including the heart. Too much or too little potassium in the blood can be very dangerous. The amount of potassium you need is based on how well your kidneys are working and your medications. Your dietitian or healthcare provider can tell you about foods with potassium and the right amount for you to eat each day.
Phosphorus
As kidney function gets lower, extra phosphorus can start building up in the blood. High phosphorus levels can cause bones to get weaker. Your dietitian or healthcare provider can tell you if you need to limit goods that are high in phosphorus.
Calcium
Foods that are good sources of calcium are often high in phosphorus. Your dietitian or healthcare provider will tell you if you need to limit calcium. Before taking any over-the-counter vitamin D or calcium supplements, talk to your healthcare provider.
Will I need to limit fluid?
Most people in the early stages of kidney disease do not need to limit how much fluids they drink. If you do not know your stage of kidney disease, ask your healthcare provider. If your kidney disease worsens, your dietitian or healthcare provider can let you know if you need to limit fluids and how much to drink each day.
How many calories do I need?
Every person is different. Calories are like fuel. If you dont eat enough, your body will take protein from the muscles for energy. Its important to make sure you get the right amount of calories or you may get weak and cause damage to the kidneys. Eating the proper amount of calories will:
- Help you stay at a healthy weight
- Give you the energy to do your daily tasks
- Help your body use the protein in food to build muscle and tissues
Too many calories can cause extra weight gain, which can burden the kidney. If you are overweight, some weight loss may be beneficial. If weight loss is desired or you have diabetes, you should meet with a dietitian to set up a plan based on your kidney blood tests, current food choices, and daily activities.
Should I be taking any vitamin and mineral supplements?
Most people get enough vitamins and minerals to stay healthy by eating various foods each day, but kidney patients may need to limit these foods. If so, you may need to take special vitamins or minerals but only if a dietitian or healthcare provider tells you to. Some may be harmful to people with kidney disease.
You should check with your healthcare provider before taking any medications you can buy without a prescription. Some over-the-counter medications may be harmful to people with kidney disease. You should also avoid taking herbal supplements.
Last Reviewed: 09/08/2023
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Eating Right for Chronic Kidney Disease
You may need to change what you eat to manage your chronic kidney disease (CKD). Work with a registered dietitian to develop a meal plan that includes foods that you enjoy eating while maintaining your kidney health.
The steps below will help you eat right as you manage your kidney disease. The first three steps (1-3) are important for all people with kidney disease. The last two steps (4-5) may become important as your kidney function goes down.
The first steps to eating right
Step 1: Choose and prepare foods with less salt and sodium
Why? To help control your blood pressure. Your diet should contain less than 2,300 milligrams of sodium each day.
- Buy fresh food often. Sodium (a part of salt) is added to many prepared or packaged foods you buy at the supermarket or at restaurants.
- Cook foods from scratch instead of eating prepared foods, fast foods, frozen dinners, and canned foods that are higher in sodium. When you prepare your own food, you control what goes into it.
- Use spices, herbs, and sodium-free seasonings in place of salt.
- Check for sodium on the Nutrition Facts label of food packages. A Daily Value of 20 percent or more means the food is high in sodium.
- Try lower-sodium versions of frozen dinners and other convenience foods.
- Rinse canned vegetables, beans, meats, and fish with water before eating.
Look for food labels with words like sodium free or salt free; or low, reduced, or no salt or sodium; or unsalted or lightly salted.
Step 2: Eat the right amount and the right types of protein
Why? To help protect your kidneys. When your body uses protein, it produces waste. Your kidneys remove this waste. Eating more protein than you need may make your kidneys work harder.
- Eat small portions of protein foods.
- Protein is found in foods from plants and animals. Most people eat both types of protein. Talk to your dietitian about how to choose the right combination of protein foods for you.
Animal-protein foods:
- Chicken
- Fish
- Meat
- Eggs
- Dairy
A cooked portion of chicken, fish, or meat is about 2 to 3 ounces or about the size of a deck of cards. A portion of dairy foods is cup of milk or yogurt, or one slice of cheese.
Plant-protein foods:
A portion of cooked beans is about cup, and a portion of nuts is cup. A portion of bread is a single slice, and a portion of cooked rice or cooked noodles is cup.
Step 3: Choose foods that are healthy for your heart
Why? To help keep fat from building up in your blood vessels, heart, and kidneys.
- Grill, broil, bake, roast, or stir-fry foods, instead of deep frying.
- Cook with nonstick cooking spray or a small amount of olive oil instead of butter.
- Trim fat from meat and remove skin from poultry before eating.
- Try to limit saturated and trans fats. Read the food label.
Heart-healthy foods:
- Lean cuts of meat, such as loin or round
- Poultry without the skin
- Fish
- Beans
- Vegetables
- Fruits
- Low-fat or fat-free milk, yogurt, and cheese
Learn more about heart-healthy eating.
Limit alcoholDrink alcohol only in moderation: no more than one drink per day if you are a woman, and no more than two if you are a man. Drinking too much alcohol can damage the liver, heart, and brain and cause serious health problems. Ask your health care provider how much alcohol you can drink safely.
The next steps to eating right
As your kidney function goes down, you may need to eat foods with less phosphorus and potassium. Your health care provider will use lab tests to check phosphorus and potassium levels in your blood, and you can work with your dietitian to adjust your meal plan. More information is provided in the NIDDK health topic, Nutrition for Advanced Chronic Kidney Disease.
Step 4: Choose foods and drinks with less phosphorus
Why? To help protect your bones and blood vessels. When you have CKD, phosphorus can build up in your blood. Too much phosphorus in your blood pulls calcium from your bones, making your bones thin, weak, and more likely to break. High levels of phosphorus in your blood can also cause itchy skin, and bone and joint pain.
- Many packaged foods have added phosphorus. Look for phosphorusor for words with PHOSon ingredient labels.
- Deli meats and some fresh meat and poultry can have added phosphorus. Ask the butcher to help you pick fresh meats without added phosphorus.
Foods Lower in Phosphorus
| Foods Higher in Phosphorus
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Your health care provider may talk to you about taking a phosphate binder with meals to lower the amount of phosphorus in your blood. A phosphate binder is a medicine that acts like a sponge to soak up, or bind, phosphorus while it is in the stomach. Because it is bound, the phosphorus does not get into your blood. Instead, your body removes the phosphorus through your stool.
Step 5: Choose foods with the right amount of potassium
Why? To help your nerves and muscles work the right way. Problems can occur when blood potassium levels are too high or too low. Damaged kidneys allow potassium to build up in your blood, which can cause serious heart problems. Your food and drink choices can help you lower your potassium level, if needed.
- Salt substitutes can be very high in potassium. Read the ingredient label. Check with your provider about using salt substitutes.
- Drain canned fruits and vegetables before eating.
Foods Lower in Potassium
| Foods Higher in Potassium
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Some medicines also can raise your potassium level. Your health care provider may adjust the medicines you take.
View tips for people with chronic kidney disease:
