When you have chronic kidney disease (CKD), your diet is one of the most important tools you can use to help keep healthy.
With CKD, your kidneys can’t filter blood as well as they should, causing excess waste to build in your body. Depending on the stage of your kidney disease, you may be asked to avoid or limit protein, sodium, potassium, or phosphorus, all of which can cause health complications if they are not properly filtered by the kidneys.
The health of your kidneys is also intimately connected to your metabolic and cardiovascular health, which gives you an additional reason to choose healthy foods. Both high blood sugar levels and hypertension (high blood pressure) can damage the kidneys’ blood vessels, leaving them unable to do their job properly, says Krista Maruschak, RD, a registered dietitian at Cleveland Clinic. “Untreated or uncontrolled diabetes and high blood pressure can have a significant effect on the development of CKD over time,” says Maruschak.
A healthy diet can help you prevent or manage conditions like diabetes and high blood pressure, in turn supporting your kidney health, she says.
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7 Diet Tips to Help Manage Chronic Kidney Disease
Explore potential dietary changes for better kidney health.
1. Portion Your Plate
As a general rule of thumb, Maruschak suggests following the MyPlate method at every meal: Fill roughly half of your plate with vegetables and fruits, one-quarter with lean protein, and one-quarter with whole grains.
Part of the U.S. Department of Agriculture’s Dietary Guidelines for Americans, the MyPlate visual is an effective dietary education tool that’s clear and easy to follow. Those who use it to portion their food tend to plan meals that contain more fruits and vegetables and fewer grains, dairy, and overall calories, supporting the management of type 2 diabetes and kidney health as a result.
2. Limit Your Salt Intake
Sodium sneaks its way into all sorts of places you wouldn’t imagine, especially packaged foods like soups and breads. Limiting your sodium intake helps keep your blood pressure under control. Aim for 2,300 milligrams (mg) per day, which is about 1 teaspoon (tsp) of table salt.
Limit Ordering Takeout and Eating at Restaurants “Salt is often added to your food, and items used in restaurant kitchens may have added sodium,” says Maruschak. When you do eat out, do your research. You can sometimes find the sodium content of dishes on the restaurant’s website, she adds.
Cook at Home With Whole, Unprocessed Foods When you prepare meals at home using fresh ingredients, you control exactly how much sodium (and fat) goes into each bite.
Get Creative With Seasonings Maruschak suggests avoiding salt when cooking or at the table. Instead, use spices, herbs, lemon, and other sodium-free seasonings.
Check Packages Any prepared food with 20 percent or more of your daily value of sodium is considered high-sodium. Choose soups, frozen meals, and other packaged foods labeled as “reduced sodium,” “low-sodium,” or “salt-free” whenever you can.
Rinse Canned Foods Before Eating This quick extra step helps remove excess sodium.
3. Be Mindful of Protein
When you eat protein, your body produces waste that’s filtered through your kidneys. While protein is an important part of a healthy diet, eating more protein than you need may cause your kidneys to work harder. While research on the effects of a high-protein diet on overall kidney health is still evolving, your doctor will likely recommend a lower-protein diet if you already have CKD. “Having too much protein can cause waste to build up in your blood, and your kidneys may not be able to remove it,” says Maruschak.
Opt for healthier protein sources and watch your portion sizes. Good sources of protein include:
Lean meat, fish, or poultry (one portion size is 3 ounces [oz], or about the size of a deck of cards)
Dairy (one portion size of yogurt and milk is 1 cup, while one portion of cheese is 1.5 oz, or about the size of your two thumbs together)
Legumes (one portion is ¼ cup)
Nuts (one portion size of nut butter is 1 tablespoon [tbsp])
Be sure to speak with a registered dietitian nutritionist to determine the right amount of protein for you.
4. Choose Complex Carbs Over Simple Carbs
Carbohydrates are your body’s main source of energy, and those that occur naturally in fresh foods are filled with fiber to support heart and gut health and keep your blood sugar levels steady. However, simple carbs, such as added sugars in desserts, sweetened beverages, and many packaged foods, can spike blood sugar and increase the risk of obesity, type 2 diabetes, and heart disease.
As part of an overall healthy diet, you should limit sweets and foods with added sugars. Check food labels closely because added sugars are found in surprising places like fruit yogurt, says Maruschak. Healthier carbohydrate choices include whole grains, fruits, vegetables, beans, and lentils.
If you have diabetes and are on insulin, you may need to be even more careful about your carbohydrate intake. “It’s likely that people will need to count carbohydrates at mealtimes so they can dose their insulin correctly,” says Maruschak.
5. Limit Saturated Fats, and Avoid Trans Fat
Diets that are high in saturated and trans fats increase the risk of heart disease, and what’s bad for your heart is bad for your kidneys. “Heart health and kidney health are interconnected, as the heart constantly pumps blood throughout the body, and the kidneys continuously filter the blood in order to remove waste products and excess fluid from the body,” says Maruschak.
Limit saturated fats to less than 10 percent of your total daily calories.Main sources include meats, full-fat dairy products, butter, lard, coconut oil, and palm oil, says Maruschak. And try to avoid trans fats, which are found in baked goods and fried foods. Instead, fill up on heart-healthy unsaturated fats like those found in fatty fish, avocados, olives, and many types of nuts.
6. Watch Your Alcohol Intake
Alcohol harms your kidneys in several ways, says Maruschak. It’s a waste product that your kidneys have to filter out of your blood, and it makes your kidneys less efficient. It’s dehydrating, which can affect the kidneys’ ability to regulate your body’s water levels. It can affect your liver function, which can impact blood flow to the kidneys and exacerbate CKD. And high alcohol intake is linked to an increased risk of high blood pressure, which only makes kidney disease progress more quickly.
Maruschak says both men and women should drink no more than one alcoholic beverage per day. That’s 12 oz of regular beer, 5 oz of wine, or 1.5 oz (one shot glass) of distilled spirits. “It’s always best to speak with your physician about your alcohol intake because some people should not be consuming any alcohol at all,” she says.
7. Talk to Your Doctor About Whether You Need to Limit Phosphorus and Potassium
Phosphorus and potassium are minerals that your body needs for certain processes. Phosphorus helps build strong bones, while potassium helps regulate your heartbeat and keeps your muscles working properly.
If you have CKD, however, these minerals can build in your blood, causing problems throughout your body. High levels of phosphorus can pull calcium from your bones, making them weak and more likely to break, and may cause itchy skin and pain in bones and joints. You may need to limit foods high in phosphorus, such as animal-based proteins, and foods and beverages with added phosphorus like deli meats and dark-colored sodas. High levels of potassium (found in canned fruits and vegetables and salt substitutes) can cause heart problems. Your doctor will run blood tests to check your potassium and phosphorus levels. Be sure to ask if you’re not sure whether you need to keep tabs on your intake of these minerals.
8. Work With a Dietitian
Making changes to your diet can be hard. If you’re struggling to stick to a healthy diet, a registered dietitian nutritionist can help you develop a meal plan that’s tailored to your individual needs.
“It can seem overwhelming to manage your diet,” says Maruschak. “A [registered dietitian] can help you find foods that fit into your specific dietary requirements.”
The Takeaway
A healthy diet can help you prevent or manage chronic conditions like diabetes and high blood pressure, both of which can have a significant impact on kidney function as well.
Pay close attention to the portions on your plate, prioritizing plenty of fruits and vegetables and being selective with high-quality protein and complex carbohydrate sources, to nourish your body and reduce your risk of kidney problems.
Keep a careful eye on your sodium intake to prevent or manage high blood pressure and, in turn, protect your kidney health.
If you have chronic kidney disease, you may need to keep an eye on your phosphorus and potassium levels as well, which may require avoiding certain animal-based meats, canned fruits and vegetables, salt substitutes, and processed foods and beverages.
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Igor Kagan, MD, is an an assistant clinical professor at UCLA. He spends the majority of his time seeing patients in various settings, such as outpatient clinics, inpatient rounds, and dialysis units. He is also the associate program director for the General Nephrology Fellowship and teaches medical students, residents, and fellows. His clinical interests include general nephrology, chronic kidney disease, dialysis (home and in-center), hypertension, and glomerulonephritis, among others. He is also interested in electronic medical record optimization and services as a physician informaticist.
A native of Los Angeles, he graduated cum laude from the University of California in Los Angeles (UCLA) with a bachelor's in business and economics, and was inducted into the Phi Beta Kappa honor society. He then went to the Keck School of Medicine at the University of Southern California (USC) for his medical school education. He stayed at USC for his training and completed his internship and internal medicine residency at the historic Los Angeles County and USC General Hospital. Following his internal medicine residency, Kagan went across town to UCLA's David Geffen School of Medicine for his fellowship in nephrology and training at the UCLA Ronald Reagan Medical Center. After his fellowship he stayed on as faculty at UCLA Health.
Colleen de Bellefonds is a freelance journalist and editor who covers science, health, and parenting. Her reporting and writing regularly appears online for Well+Good, The Bump, and What to Expect, as well as in U.S. News & World Report, Women's Health, Self, and many other publications. She lives in Paris with her husband and two kids.
