When you have chronic kidney disease, the foods you eat can affect your blood pressure, fluid balance, blood sugar, and the levels of certain minerals in your blood. Making informed food choices may also help you feel better and support your overall treatment plan.
However, there is no single kidney diet that is right for everyone. Your nutritional needs can change based on your stage of kidney disease, blood test results, medications, other health conditions, and whether you receive dialysis.
Instead of removing healthy foods from your diet without medical guidance, work with your nephrologist or a renal dietitian to identify the nutrients that you personally need to limit.
Key Takeaway
People with chronic kidney disease are often advised to limit foods high in sodium, added phosphorus, and added sugar. Some people may also need to reduce potassium or adjust how much protein they eat. These recommendations are not the same for every patient. Your CKD stage, laboratory results, medications, and dialysis status should guide your food choices.
Why Does Diet Matter When You Have Kidney Disease?
Healthy kidneys remove waste and extra fluid from the blood while helping maintain the right balance of minerals. When kidney function declines, sodium, phosphorus, potassium, fluid, and waste products may build up in the body.
Choosing foods that support your individual health needs can help manage problems such as high blood pressure, swelling, high potassium, and elevated phosphorus. Nutritional needs may also change as kidney disease progresses, which is why regular laboratory testing and personalized nutrition guidance are important.
The following categories include foods that many people with kidney disease may need to limit. They should not be treated as a universal list of foods that every CKD patient must completely avoid.
1. Foods High in Sodium
Sodium helps regulate fluid in the body, but too much can cause the body to hold on to extra fluid. This may contribute to swelling and higher blood pressure, placing additional stress on the kidneys and heart.
Some of the largest sources of sodium are not the salt added at the dinner table. Sodium is commonly found in packaged, canned, frozen, restaurant, and fast foods.
Foods that may contain large amounts of sodium include:
- Canned soups
- Frozen dinners
- Pizza
- Chips and salted crackers
- Deli meat
- Bacon and sausage
- Hot dogs
- Fast food
- Boxed rice and pasta mixes
- Bottled sauces and salad dressings
- Canned vegetables with added salt
Better Choices
Choose fresh or frozen foods without added sauces when possible. Look for products labeled “low sodium” or “no salt added,” but still check the Nutrition Facts label to compare products.
Flavor meals with garlic, onion, lemon juice, vinegar, pepper, or salt-free herbs and spices. Do not automatically use a salt substitute. Some salt substitutes contain potassium chloride, which may not be appropriate if your potassium level is high.
2. Packaged Foods With Added Phosphorus
Phosphorus is a mineral that helps support bones and other functions. When kidney function declines, phosphorus may build up in the blood. High phosphorus levels can affect bone and blood vessel health and may cause symptoms such as itchy skin or bone and joint discomfort.
Phosphorus occurs naturally in many foods, including meat, dairy products, beans, nuts, and seeds. It is also added to many processed foods to improve flavor, texture, shelf life, or moisture.
Phosphorus additives may be absorbed more easily than phosphorus that occurs naturally in food. Packaged and processed foods with added phosphorus may therefore be an important area to address.
Common sources can include:
- Processed meats
- Deli meats
- Packaged baked goods
- Fast food
- Dark-colored cola
- Flavored drinks
- Processed cheese
- Instant pudding
- Shelf-stable meals
- Some enhanced meat and poultry products
Better Choices
Read the ingredient list and look for words containing “phos.” Examples may include phosphoric acid, disodium phosphate, monosodium phosphate, and sodium polyphosphate.
Choose less-processed foods when possible. Fresh meat or poultry without phosphorus additives may be a better option than processed or enhanced products.
Do not stop eating all foods that naturally contain phosphorus without guidance. Many of these foods also provide protein, fiber, and other important nutrients. A nephrologist or renal dietitian can help you balance your phosphorus needs with adequate nutrition.
3.High-Potassium Foods—When Your Potassium Is Elevated
Potassium supports normal muscle, nerve, and heart function. However, damaged kidneys may have difficulty removing extra potassium from the blood.
Both high and low potassium levels can cause serious health problems. For that reason, people with CKD should not begin a low-potassium diet unless their healthcare team recommends it based on their laboratory results and medical needs.
When potassium restriction is needed, foods that may need to be limited include:
- Bananas
- Oranges and orange juice
- Avocados
- Potatoes
- Sweet potatoes
- Tomatoes and tomato sauce
- Dried fruit
- Melons
- Beans
- Some dairy products
- Coconut water
- Products containing potassium chloride
Better Choices When You Need Less Potassium
Depending on your recommended potassium level and portion sizes, alternatives may include:
- Apples
- Berries
- Grapes
- Pineapple
- Cabbage
- Cauliflower
- Green beans
- Cucumbers
- Lettuce
- Peppers
Portion size still matters. A large serving of a lower-potassium food may contain more potassium than a small serving of a higher-potassium food.
Certain cooking techniques, such as boiling or leaching vegetables, may reduce some of their potassium. Ask a renal dietitian whether these methods are appropriate for your meal plan.
4. Excess Protein and Processed Meats
Protein helps maintain muscles, tissues, organs, and the immune system. As the body uses protein, it produces waste that the kidneys must remove.
Some people with CKD who are not receiving dialysis may be advised to eat moderate amounts of protein. However, eating too little protein can contribute to malnutrition, weakness, and muscle loss.
People receiving dialysis may need more protein because dialysis can remove protein from the blood. Protein recommendations therefore need to be based on your treatment, kidney function, weight, nutritional status, and overall health.
Foods to limit may include:
- Oversized portions of meat
- Bacon
- Sausage
- Hot dogs
- Deli meat
- Canned meat
- Processed meat snacks
- Some protein bars and shakes
- Heavily breaded or fried meat
Processed meats are especially important to limit because they may contain large amounts of sodium and phosphorus additives.
Better Choices
Ask your healthcare team how much protein you need each day. When appropriate, select reasonable portions of lean protein such as fish, poultry, eggs, or lean meat.
Plant-based proteins may also be included in some kidney-friendly eating plans. However, their potassium and phosphorus content should be considered if you have been instructed to limit those minerals.
Patients receiving hemodialysis should follow the protein recommendations provided by their renal dietitian rather than automatically cutting back on protein.
5. Foods and Drinks High in Added Sugar
Foods and beverages with large amounts of added sugar can make it more difficult to manage blood sugar and maintain a healthy weight. This is especially important for people who have both diabetes and kidney disease.
Common sources of added sugar include:
- Regular soda
- Sweet tea
- Energy drinks
- Candy
- Cookies
- Pastries
- Sweetened cereals
- Flavored coffee drinks
- Sweetened fruit drinks
- Desserts
- Syrups and sweet sauces
Some sugary drinks may also contain phosphorus or potassium additives, making the ingredient list just as important as the amount of sugar.
Better Choices
Choose unsweetened beverages that fit within your fluid and mineral recommendations. Water may be appropriate for many people, but patients who have been given a fluid limit should follow the amount recommended by their healthcare team.
Fresh fruit may be an alternative to candy or pastries, but select fruits and portions that fit your potassium and blood sugar goals.
Products labeled “sugar-free” are not automatically kidney-friendly. They may still contain sodium, phosphorus additives, or potassium chloride.
How Can You Read Food Labels for Kidney Health?
A food does not have to be labeled “kidney-friendly” to fit into your meal plan. Learning how to evaluate the package can help you compare your choices.
When reading a label:
- Check the serving size.
The nutrient amounts apply to one serving. Eating two servings doubles the sodium, sugar, and other listed nutrients.
- Compare sodium amounts.
Similar products may have very different sodium levels.
- Read the ingredient list.
Look for phosphorus additives containing “phos.”
- Look for potassium chloride.
It is sometimes added to products marketed as reduced-sodium or low-sodium.
- Be cautious with health claims.
Terms such as “natural,” “plant-based,” or “heart healthy” do not guarantee that a food meets your kidney-related needs.
- Consider the entire meal.
A single food may fit your plan, but several foods high in the same nutrient can add up quickly.
Does a Kidney Diet Change When You Start Dialysis?
Yes. Diet recommendations can change when a person begins dialysis.
Many people receiving dialysis need more protein than they did during earlier stages of CKD. They may also need closer control of sodium, phosphorus, potassium, and fluid because these substances can build up between treatments.
The recommendations may differ depending on whether you receive hemodialysis or peritoneal dialysis. Your urine output, laboratory results, appetite, and body weight may also affect your plan.
Do not continue following an older CKD diet without asking whether your needs have changed after starting dialysis.
Frequently Asked Questions About Foods to Avoid With Kidney Disease
What foods should I avoid with chronic kidney disease?
Many people with CKD benefit from limiting highly processed foods, salty restaurant meals, processed meats, sugary drinks, and products containing phosphorus additives. Potassium and protein restrictions should be based on your laboratory results, CKD stage, and treatment plan.
Can people with kidney disease eat bananas?
Some can. Bananas contain potassium, but not every person with kidney disease needs to follow a low-potassium diet. Ask your healthcare team whether your potassium level requires you to limit bananas and other potassium-rich foods.
Is sugar bad for the kidneys?
Eating large amounts of added sugar may make blood sugar and weight harder to manage. This can be especially concerning for someone who has diabetes and CKD. An occasional sweet may fit into some meal plans, depending on the person’s overall nutritional needs.
Should people with CKD drink more water?
Not necessarily. Some people with early CKD may not need a fluid restriction, while people with advanced kidney disease, swelling, heart problems, or dialysis treatment may need to limit fluids. Ask your healthcare team how much fluid is right for you.
Are leafy greens and whole grains always kidney-friendly?
They can provide important nutrients, but the best choices depend on the individual. Certain leafy greens may be high in potassium, and some whole grains contain more phosphorus than refined grains. These foods should not automatically be avoided, but portions and laboratory results should be considered.
What is the best diet for kidney disease?
There is no single best diet for everyone with kidney disease. The right plan depends on kidney function, blood pressure, diabetes, medications, potassium and phosphorus levels, nutritional status, and whether the person receives dialysis.
Build a Kidney-Friendly Eating Plan That Fits Your Needs
A kidney-friendly eating plan is not simply a list of foods you can and cannot eat. It should provide enough calories and nutrients while helping manage the substances your kidneys may have difficulty removing.
Before making major changes, ask your healthcare team:
- Do I need to limit potassium?
- What is my phosphorus level?
- How much sodium should I have?
- How much protein do I need?
- Do I need to limit fluids?
- Would nutrition counseling help me plan meals?
Dallas Nephrology Associates offers personalized care for people living with chronic kidney disease and other kidney conditions. Our nephrologists and nutrition professionals can help you understand how your kidney function, laboratory results, and treatment affect your nutritional needs.
Schedule an appointment with Dallas Nephrology Associates to discuss your kidney health and develop a care plan that is appropriate for you.