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Best Diets for People with Kidney Disease

Medically reviewed by Susan Kerrigan, MD and Marianne Madsen on February 12, 2023

Your body is a complex, integrated mechanism. If one component isn’t performing at 100%, everything else can suffer. Imagine owning a top-of-the-line, gas-powered luxury car. If the oil filter isn’t working properly, debris and damaging particles accumulate in the motor oil. Eventually the engine can get damaged, and the vehicle’s performance declines. 


Your kidneys are a lot like an oil filter. Instead of filtering oil, they filter blood–-around half a cup every minute. They remove wastes, extra fluid, and acid produced by your cells. Perfectly performing kidneys keep a healthy balance of water, salts, and minerals in your blood. A healthy diet helps your kidneys perform at a high level. Most of the time when diet is discussed, it’s in terms of losing weight or keeping your heart healthy. Yet a poor diet affects everything––just like high-end cars require premium fuel, if you want to keep your body at the high-end level, you need premium fuel, too.  If you are facing kidney disease, eating the right foods is vital. Here are some of the best kidney disease diet choices.


DASH Delivers for Early Stage Patients


Fist-sized and bean-shaped, the kidneys rest below your ribs––like bookends for your spine. When this pair of organs isn’t working properly, your nerves, muscles, and other tissues can be affected. Kidneys also produce a hormone that regulates blood pressure, produces red blood cells, and keeps your bones strong. In the U.S., one out of three adults is considered at risk for kidney disease. Early stage kidney disease is often asymptomatic––which is why testing is important. 


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Tests for Kidney Function

Tests for Kidney Function

A blood test determines your glomerular filtration rate (GFR) which indicates kidney function, while a urine test is used to find the albumin (type of protein) to creatinine ratio . Protein should be found in your blood–not your urine. Discovering the protein called albumin in your urine is an indicator that your kidneys aren’t filtering properly. At stage one, your kidneys are functioning, but there are early stages of damage. Stage five represents total kidney failure. Knowing the foods to avoid with kidney disease along with the foods that are good for kidneys won’t solve everything. Still, the right dietary choices can delay or even prevent your kidneys from reaching stage five. 


The key to a healthy kidney disease diet is keeping in mind how the organ functions. Reducing what it needs to filter keeps it from overworking. For anyone at stage one, reducing sodium is a priority. Since this is key for anyone with high blood pressure, the DASH (Dietary Approaches to Stop Hypertension) diet is ideal. Rich in fruits and vegetables along with whole grains, fish, and poultry, DASH has been shown to be beneficial in studies of patients with moderate chronic kidney disease.


A good rule of thumb is that fresh fruits and vegetables along with homemade meals are lower in sodium than anything canned, processed, or packaged. If you must eat canned fruits or veggies, rinse the items with clean water first. Get used to reading nutrition labels––daily values over 20 percent of sodium mean that you should avoid that food. Instead of using salt, flavor food with spices, herbs, or sodium-free seasonings. 


When you shop, imagine the grocery store is a race track. Following the outer circle of the track leads you to fresh fruits and veggies, along with dairy products, eggs, lean meats, and fish. Getting “off track” means venturing into the inner aisles where foods bad for kidneys like cookies and frozen dinners lurk. One advantage of “staying on track” is it makes shopping easier. However, if your kidney disease is progressing and reaches stage two or three, your diet will need to be more restrictive.


Managing with Less Meat


In Western cultures, deficiencies of vitamins like D or minerals like zinc are fairly common. Yet one thing most of us consume in abundance is protein. Notice that the typical American diet of “meat and potatoes” places a primary protein source at the top of the list. Fast-food chains are usually devoted to protein–from burgers to chicken. A macronutrient, protein is made up of amino acids that are vital for building muscle and developing strength. However, unless you are an elite athlete, chances are you’re getting more than enough. Because your kidneys remove the waste produced by your body whenever it uses protein, the more of it you consume, the harder the organs have to work. 


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Wellness - Vitamin D Deficiency

Wellness - Vitamin D Deficiency

One tip to finding foods good for kidneys is by “eating the rainbow.” By consuming different colors of fruits and veggies each day, you’ll increase the variety of nutrients you take in. Neutral colors––like brown rice and whole wheat pasta should take up far smaller portions of your plate. As a general rule, avoid white things–white flour, white rice, white potatoes, white sugar, and white bread. The final part of your diet is lean poultry or fish –– which should be no larger than a deck of playing cards with dinner. Red meat should be limited to no more than one serving a week while processed meats (luncheon meats, hot dogs, bacon, sausage, salami, pepperoni, etc.) should be avoided altogether. 


As your kidney function declines, the kidneys will have a tougher time removing certain electrolytes from your blood, particularly phosphorus and potassium. you’ll need to reduce your consumption of foods that are high in phosphorus. Besides poultry, meat, and fish, this includes oatmeal, beans, lentils, nuts, and sodas. Other foods that should be restricted are those that are higher in potassium like oranges, bananas, and whole-wheat bread. Instead, eat low-phosphorus foods like fresh fruits and veggies and cereals made of corn and rice along with low-potassium choices including apples, peaches, rice milk, and wheat cereals. 


It can be tough removing beloved items from your meal plan. Working with a registered dietitian can make it easier to substitute kidney-healthy foods for familiar ones. Reducing your intake of sodium and other things that are difficult for your kidneys to process will not only improve your kidneys’ health but your entire body’s health as well.


Written by John Bankston

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