Did you know that one in three American adults is at risk for kidney disease? And while most people think of kidney disease as a problem that only affects the elderly, it can actually occur at any age. If you have kidney disease or are at risk for it, then it’s important to take steps to protect your kidneys by making healthy dietary choices. The good news is that there are many ways to eat for kidney health. In this article, we will explore the renal diet basics – what foods you should eat and which you should avoid if you have kidney disease or are at risk for it. We will also provide some tips on how to make healthy dietary changes gradually and easily. So let’s get started.
What Is A Renal Diet?
A renal diet is a type of special, low protein diet that some people with chronic kidney disease follow to reduce the strain on their kidneys and control their levels of waste products in the blood (3). The main source of these waste products is from protein metabolism. When your body digests protein it produces waste products which normally get processed by your kidneys and removed from the body (19).
If you have significant kidney damage, these waste products can accumulate in your blood and will make you feel sick.
The renal diet limits protein intake because processing large amounts of protein puts a lot of strain on impaired kidneys. This also reduces the amount of waste products that get created from digestion, allowing your kidneys to function better.
The diet is called a “renal” diet because it focuses on foods that are lower in protein and certain electrolytes (salts). The renal diet is generally used with other treatments for kidney disease, such as medications and dialysis.
How Does A Renal Diet Work?
The key to eating properly on a renal diet is limiting foods that are high in protein and some electrolytes, especially sodium, potassium, and phosphorus (9). Your doctor will likely recommend a specific set of rules for what types of food you can have, or they may give you some general guidelines from which you can make your own decisions. Most patients also work with a registered dietitian.
These rules can vary depending on whether you have early-stage or late-stage kidney disease, how well your kidneys are working, and other medical conditions you may be dealing with. This is why it’s important to be monitored and work closely with both your physician and dietitian.
There are a few general guidelines for this diet, including:
If you are not on dialysis, you may be told to limit high protein foods. This includes red meat, pork, poultry (chicken or turkey), fish, and seafood; also cheese, eggs, nuts, and legumes. You still need some protein though, so getting the right balance is key. And if you do start dialysis, you will need to eat more protein.
- Avoid potassium-rich foods. This includes bananas, oranges, and orange juice; baked potatoes with skin; dried fruit like raisins or apricots; potato chips; lentils; avocados; and mushrooms.
- You’ll need to limit salt (sodium). Try to use only the amount of salt listed in a recipe, and don’t add any extra salt at the table. Avoiding processed foods is helpful because they tend to be very high in sodium.
- Limit your intake of phosphorus from soft drinks, dairy, certain animal proteins, and baked goods. Some healthy foods like whole grains, nuts, and most high-protein foods contain phosphorus, so it’s a balancing act. You may also be prescribed a medication to help prevent you from absorbing too much phosphorus, called a phosphate binder.
- In the early stages, you probably won’t have to limit your fluid intake, but as time goes on or if you go on dialysis, your providers may give you a daily limit. You’ll need to consider both the fluids you drink and also foods that contain a lot of water (like soups, popsicles, gelatin, and some fruits and vegetables).
- Stay away from alcohol and caffeine.
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List Of Foods You Can Eat On A Renal Diet
Some foods are good for people with kidney disease because of their nutritional profile. Here are some examples of what you can eat while on a renal diet.
Cauliflower is a nutritious vegetable that provides healthy amounts of vitamin C, vitamin K, and B vitamins. It’s also rich in anti-inflammatory compounds like indoles and has fiber to support digestion (10). Mashed cauliflower is a great alternative to mashed potatoes for a low-potassium side dish.
Unlike most whole grains, buckwheat is low in phosphorus. It’s also gluten-free making it a great choice for people with celiac disease. Buckwheat has antioxidant properties and is high in fiber, manganese, magnesium, copper and B vitamins making it great for your heart and digestive system (5). Enjoy buckwheat flour pancakes or buckwheat cereal made into a hot breakfast for best results.
Just like buckwheat, bulgur is low in phosphorus compared to other grains. It’s also low in potassium and this makes it a kidney-friendly whole grain. Bulgur is high in fiber and protein. It’s also rich in iron (rare for grains) making it an especially good choice for vegetarians who need additional iron daily.
Cabbage is a great kidney-friendly vegetable that goes well with many dishes. You can enjoy cabbage raw, or cook it into a delicious soup or casserole. Cabbage is rich in vitamin K and fiber, and low in phosphorus and potassium.
A renal diet doesn’t have to be bland. Bell peppers are a great choice because they’re low in potassium, phosphorus and sodium. Yellow bell peppers are higher in vitamin C than green or red varieties which provide good levels of folate and fiber as well (7). You can add chopped pepper to salads, soups or rice dishes.
Although a limited protein intake is necessary for some people with kidney issues, providing the body with an adequate amount of high quality protein is vital for health. Since protein is made up of the essential amino acids the body cannot make itself, it’s important to choose high quality sources. Skinless chicken thighs are a rich source of easily digestible protein that provide the body with all several essential amino acids for optimal health (17).
When buying chicken, choose free-range, organic chicken to avoid potentially harmful antibiotics and hormones.
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Although eggs are high in cholesterol, they’re also full of essential minerals like selenium, vitamin D and B12. Eggs provide the body with protein too which is important for repairing muscles and tissues or keeping hunger at bay between meals (18). You can scramble them or fry them sunny side up for a tasty and healthy breakfast.
Depending on the progression of your kidney disease, you may have to eat egg whites only. This is especially true if you have high levels of creatinine in your blood.
Another kidney-friendly protein choice, salmon is full of omega-3 fatty acids which are necessary for proper kidney function (13). Omega-3s also reduce inflammation throughout the body and protect the heart by keeping bad cholesterol levels low (14). Like all fish and other animal proteins, salmon contains quite a bit of phosphorus, so just keep your portion sizes small and make sure to take your phosphate binder if they have been prescribed to you.
Steam, poach or grill salmon for a delicious, healthy meal. If you’re concerned about mercury, choose varieties that are lower in mercury like sardines and ask your doctor whether you should limit your intake of fish-based omega-3s.
Onions are a great choice for kidney diets because they have anti-inflammatory properties, are low in potassium and phosphorus, but still provide the body with important vitamins and antioxidants (4). Whether you enjoy them raw or cooked, onions are full of flavor that can add healthy zest to any dish.
Although high in sugar, cranberries are low in potassium and phosphorus which makes them kidney friendly. Cranberries also contain antioxidants like anthocyanin which may reduce the risk of heart disease and cancer (6).
If you’re concerned about your intake of sugars or sodium, look for no added sugar varieties like unsweetened cranberry juice or dried cranberries.
Macadamia nuts are a rich source of heart-healthy monounsaturated and polyunsaturated fats that can actually lower your risk of developing kidney disease (8). They’re also low in sodium, phosphorus (unlike most other nuts) and potassium so they won’t contribute to high blood pressure or fluid retention.
Add macadamia nuts to salads, rice dishes or trail mix for a sweet-smoky crunch.
Garlic is a great addition to any kidney-friendly diet because it contains anti-inflammatory, antibacterial and antiviral properties that promote cardiovascular health. Garlic has been known to reduce the risk of heart attacks, improve blood vessel elasticity and even lower total cholesterol while raising HDL (11). If you’re concerned about your sodium intake too, choose fresh garlic instead of jarred, canned or marinated which can be very high in sodium.
People with advanced kidney disease sometimes have trouble keeping weight on, so high-calorie foods like olive oil can be helpful. Olive oil is full of monounsaturated fats that help lower bad cholesterol levels and raise good cholesterol, reducing the risk of heart disease. It also contains polyphenols that can reduce oxidative stress on the kidneys so they stay healthy as well (20).
Add olive oil to salad dressings, dips for raw veggies or drizzle it over cooked meats and vegetables for a healthy boost of flavor.
Unlike most tropical fruits, pineapple is low in potassium and phosphorus, but high in the antioxidants vitamin C and manganese. Pineapples are also full of enzymes that have anti-inflammatory properties (16).
Add fresh, canned or frozen pineapple to your shopping cart for a sweet snack or to add to fruit salad. Be careful , however, as canned pineapple is often packed in heavy syrup so read the label before you buy.
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Whereas green vegetables like kale and spinach are rich in potassium, arugula is low in potassium, calcium, and phosphorus. Arugula is also packed with Vitamin K which is needed for blood clotting and to protect arteries from damage caused by plaque buildup (21).
Arugula’s slightly bitter taste makes it a great addition to salads or you can lightly sauté it with olive oil and garlic to make an easy side dish.
Like pineapple, radishes are packed with antioxidants and anti-inflammatory properties that help cleanse the blood vessels and kidneys. They’re also low in potassium and high in magnesium which has been shown to help lower cardiovascular disease risk (12).
Add sliced radish to salads or veggie trays for a bit of spicy crunch.
Flax seed is packed with cholesterol-lowering fiber and omega-3 fatty acids. Omega-3s have been shown to reduce inflammation in the body which can protect the kidneys from damage caused by high blood pressure or debris buildup.
Stick to the recommended serving size, because they do contain some phosphorus. Add ground flaxseed to yogurt or oatmeal, or sprinkle flax seeds on salads for a heart-healthy boost!
Blueberries are full of antioxidants that have anti-inflammatory properties which can help aid in kidney health (1). Blueberries are also low in potassium and phosphorus so they won’t contribute to high blood pressure or fluid retention.
Add blueberries to your morning cereal or oatmeal for an antioxidant boost, or try them in salads and smoothies.
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How To Avoid Foods Bad For Kidneys
While on a renal diet, you may need to limit several important nutrients. Here are some tips to help you stick to your diet:
Learn To Read Food Labels
It’s important to read food labels so you can keep track of how many grams of protein, sodium, phosphorus, and potassium are in your diet. Knowing the nutritional information will help you estimate how much of those nutrients remain as part of your daily caloric intake.
Avoid foods that have more than 300mg of sodium per serving. Also avoid foods that have salt in the first 4 or 5 items in the ingredient list.
Be sure to look for options of your favorite foods that are labeled “no salt added”, or have lower salt quantities.
Use Fresh Herbs For Flavor
Cook with fresh herbs and spices instead of high-sodium ingredients like bouillon cubes, soy sauce, and prepared mustard. Fresh basil, parsley and thyme all add fresh flavor to your cooking without adding excess salt or high-sodium ingredients.
Cut Back On Dairy
Many dairy products are rich in phosphorus which can lead to high blood phosphorus levels (15). This can be particularly dangerous for patients with kidney disease, especially if you’re also on dialysis. Limit foods like milk, yogurt, and cheese during your renal diet so that they don’t contribute to too much phosphorus in your diet.
Alcohol can dehydrate the body which affects fluid levels in your blood vessels and puts extra stress on your kidneys (2). The best way to avoid alcohol is to stay away from binge drinking or drinking more than one alcoholic drink per day. Limit yourself to no more than two drinks per week, or give it up altogether if possible.
The Bottom Line
The renal diet is a diet that’s low in protein, potassium, phosphorus, sodium and fluids. It’s recommended for patients who have chronic kidney disease or are going through dialysis treatment. By limiting these important nutrients, you protect your kidneys from damage and speed up recovery time after a session on the dialysis machine.
By sticking to a renal diet food list and avoiding high-sodium foods, you can still enjoy a balanced diet that’s full of healthy nutrients. Be sure to work closely with your doctor and dietitian.
This article is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional advice or help and should not be relied on to make decisions of any kind. Any action you take upon the information presented in this article is strictly at your own risk and responsibility!
- A Blueberry-Enriched Diet Improves Renal Function and Reduces Oxidative Stress in Metabolic Syndrome Animals: Potential Mechanism of TLR4-MAPK Signaling Pathway (2014, journals.plos.org)
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- An integrative review of the methodology and findings regarding dietary adherence in end stage kidney disease 2017, biomedcentral.com)
- A review of anti-inflammatory, antioxidant, and immunomodulatory effects of Allium cepa and its main constituents (2021, ncbi.nlm.nih.gov)
- Buckwheat as a Functional Food and Its Effects on Health (2015, pubmed.ncbi.nlm.nih.gov)
- Cranberries and Their Bioactive Constituents in Human Health | Advances in Nutrition | Oxford Academic (2021, academic.oup.com)
- Determination of Vitamin C in Various Colours of Bell Pepper (Capsicum annuum L.) by Titration Method (2018, researchgate.net)
- Dietary polyunsaturated fatty acids and incidence of end-stage renal disease in the Southern Community Cohort Study (2016, biomedcentral.com)
- Diet – chronic kidney disease: MedlinePlus Medical Encyclopedia (2019, medlineplus.gov)
- Frontiers | Mechanisms Underlying Biological Effects of Cruciferous Glucosinolate-Derived Isothiocyanates/Indoles: A Focus on Metabolic Syndrome | Nutrition (2020, frontiersin.org)
- Garlic: a review of potential therapeutic effects (2014, ncbi.nlm.nih.gov)
- Higher Intakes of Potassium and Magnesium, but Not Lower Sodium, Reduce Cardiovascular Risk in the Framingham Offspring Study (2021, mdpi.com)
- Omega-3 and Renal Function in Older Adults (2009, ncbi.nlm.nih.gov)
- Omega-3 Fatty Acids – Health Professional Fact Sheet (2021, ods.od.nih.gov)
- Phosphorus and Your Diet (2019, kidney.org)
- Properties and Therapeutic Application of Bromelain: A Review (2012, hindawi, com)
- Role of poultry meat in a balanced diet aimed at maintaining health and wellbeing: an Italian consensus document (2015, ncbi.nlm.nih.gov)
- The Golden Egg: Nutritional Value, Bioactivities, and Emerging Benefits for Human Health (2019, mdpi.com)
- The role of the kidney in protein metabolism: the capacity of tubular lysosomal proteolysis in nephrotic syndrome – ScienceDirect (2013, sciencedirect.com)
- Virgin Olive Oil and Health: Summary of the III International Conference on Virgin Olive Oil and Health Consensus Report, JAEN (Spain) 2018 (2019, mdpi.com)
- Vitamin K: the effect on health beyond coagulation – an overview (2012, tandfonline.com)