The RenalTracker Team
June 21, 2022

Your kidneys don’t function optimally when you have chronic kidney disease. Waste and fluid can build up in the body, which the kidneys cannot properly filter as CKD progresses. 

Although CKD is generally progressive and irreversible, you can slow its progression and protect your kidneys from further damage. Following a kidney-friendly diet may help decrease the accumulation of waste products and improve kidney function. 

A kidney-friendly diet prevents certain minerals from accumulating in the blood and other serious health issues. It also manages high blood pressure and diabetes, which are common risk factors for CKD. 

Following a renal-friendly diet helps you get the right balance of nutrients to give you the energy to perform daily tasks, prevent infection, and maintain a healthy weight. 

Patients in the early stages of CKD don’t usually manifest symptoms, as the kidneys still function even when they aren’t at their 100% capacity. They are typically unaware of their kidney disease only until their kidney condition worsens, discovering it only due to a routine check, or were being tested for a health condition that is a risk factor for CKD. Each CKD patient has different nutritional requirements depending on various factors such as existing comorbidity. Hence, you must check with your nephrologist or renal dietitian for a custom diet plan. 

Your CKD eating plan may change  throughout the journey of your condition, but it will generally provide you with the right amount of the following, based on the current stage of CKD: 

  • Sodium
  • Potassium
  • Phosphorus
  • Protein

Sodium

salt fine

salt fine

When your kidneys are not working well, too much salt can cause fluid buildup and swelling. This may lead to higher blood pressure or strain on the heart if it goes untreated for long periods! Too much sodium can cause edema or swelling of the feet, hands, ankles, and legs. A dietitian will be able to tell you what amount is right for YOU, depending on your CKD stage and existing comorbidity. Packaged, processed, and fast foods have high sodium content that can be bad for the kidneys. Although your nephrologist will determine your sodium limit, generally speaking, it’s advised to keep your sodium intake to no more than 2,000 mg a day to help control blood pressure. 

To avoid spiking your blood pressure, try not to add salt to your food when cooking or eating. Use natural herbs and spices instead to make your food more flavorful. Skip on canned vegetables and consume fresh or frozen vegetables, but if you use canned vegetables, rinse them well to remove extra salt. Try not to use salt substitutes as they can spike your potassium level, which is another nutrient you need to watch out for.

Instead of ordering takeout or eating out, try making your favorite dishes at home. But, if ordering or eating out is something of a treat, try to research and o check the sodium content of your chosen food item on a restaurant’s website before you go, that way there would be no surprises when it’s time to chow down!

Potassium

Your doctor will check phosphorus and potassium levels in your blood with lab tests, but you can work closely alongside a dietitian to create the perfect meal plan. Too much potassium (hyperkalemia) or too little potassium (hypokalemia) can cause muscle cramps, muscle weakness, and heart issues. People with moderate to severe CKD need to lower their potassium intake to less than 3,000 mg per day. 

If you want to consume high potassium vegetables, leaching them will help pull out some of the potassium in the vegetables. However, leaching will not pull all of the potassium from vegetables. You still need to keep tabs on the amount of potassium you consume. Consult with your renal dietitian on the amount of leached high potassium vegetables that you can safely include in your diet.

It’s best to avoid using or drinking the liquid from canned fruits and vegetables, as they have high potassium content. Potassium is found in most foods we eat, but some have a lot more than others. The size of your serving matters when it comes to how much potassium you get.

Phosphorus

Phosphorus is a mineral that helps keep your bones healthy by working together with calcium and vitamin D. When you have too much phosphorus in the blood, it can lead to weak bones and teeth that will likely break. It can also cause itchy skin, and bone and joint pain. It’s been suggested to not exceed your daily intake of 1,000 mg if you have CKD to avoid impacting your bones and heart.

You can help prevent nutrient deficiencies by purchasing fresh meats without added phosphorus. When shopping for groceries, look out for foods with “PHOS” on their ingredient labels. This means they contain some form of the mineral in question! Some popular deli items such as turkey or ham may also have excess amounts that could be hazardous to your health if consumed daily. Ask your butcher for some fresh meats in exchange for deli items. 

Protein

The body needs proteins to maintain healthy hair, skin, and nails. Proteins are also essential for the rebuilding process after exercise or injury. Too much protein makes your kidneys start working overtime to filter waste materials. A low protein diet of 0.6-0.8 g/kg/day is often recommended to manage your kidney disease. However, when you are on dialysis, you may need more protein as dialysis remove protein from the blood. You need to replace protein lost during dialysis and to help nourish your body. Check in with your primary healthcare provider about your protein intake. 

Kidney-friendly Lunch Recipes

It’s possible to enjoy your food while watching your nutrients. Here are renal-friendly recipes you can try at home:

Pasta with Cauliflower

Nutrient Analysis

Makes 8 servings

Sodium

133 mg

Protein

12 g

Potassium

420 mg

Phosphorus

231 mg

Calcium

89 mg

Calories

298 kcal

Fat

6 g

Carbohydrates

49 g

Ingredients

1 medium head cauliflower

2 tablespoons olive oil

1 medium onion

3 garlic cloves

1/4 teaspoon black pepper

1/4 teaspoon crushed red pepper

14 ounces of low-sodium chicken broth

16 ounces whole-wheat linguine, uncooked

8 tablespoons grated Parmesan cheese

2 tablespoons fresh parsley

Directions

  1. Wash cauliflower and cut it into bite-sized pieces. Finely chop the onion and mince garlic.
  2. Heat olive oil in a large pot over medium heat. Add onion and garlic and sauté for about 5 minutes until the onion is transparent.
  3. Add cauliflower, black and red pepper, and sauté for 5 minutes.
  4. Add chicken broth and bring to a boil. Reduce heat to simmer and allow cauliflower to cook until tender.
  5. Cook linguine according to package directions, omitting salt. Drain and return to the pot used to cook it. Add several spoonfuls of the broth from the cauliflower mixture to linguine and toss to prevent sticking.
  6. Divide linguine into 8 individual servings and top with cauliflower and broth.
  7. Add 1 tablespoon grated Parmesan cheese and more black and red pepper to taste. Chop parsley and garnish each serving evenly.

Basic Pasta Primavera 

Nutrient Analysis

Makes 2 servings

Sodium

24 mg

Protein

4 g

Potassium

200 mg

Phosphorus

63 mg

Calcium

41 mg

Calories

158 kcal

Fat

5 g

Carbohydrates

Water

25 g

70 g

Ingredients

  • 1/2 cup frozen whole baby onions

  • 1/2 cup frozen broccoli, cauliflower, carrot mix

  • 1 cup cooked tri-color spiral pasta

  • 1/4 cup red bell pepper

  • 2 teaspoons olive oil

  • 2 teaspoons unseasoned rice vinegar

  • 1/2 teaspoon Mrs. Dash® original blend herb seasoning

  • 1 tablespoon parsley

  • 2 lemon wedges

Directions

  1. Chop bell pepper and parsley.
  2. Prepare frozen vegetables according to package instructions.
  3. Mix oil, vinegar, and Mrs. Dash®'s herb seasoning. Toss with vegetables and hot pasta.
  4. Sprinkle with chopped parsley. Serve with a lemon wedge.

Beef Barley Soup

Nutrient Analysis

Makes 10 servings

Sodium

0 mg

Protein

8 g

Potassium

678 mg

Phosphorus

0  mg

Calcium

0 mg

Calories

270 kcal

Fat

10 g

Carbohydrates

Water

22 g

90 g

Ingredients:

  • 2 lbs Beef Stew Meat (diced 1 inch)4 tablespoons Vegetable Oil
  • 1 cup Chopped Onion
  • 1/2 cup Sliced Mushrooms
  • 1/2 teaspoon Garlic (minced)
  • 1/4 Teaspoon Dried Thyme
  • 1 can (14.5 ounces) Chicken Broth (Low Sodium)
  • 3 cups Water
  • 1 (16 ounces) Frozen Package Vegetables
  • 2 (soaked) Potatoes (Diced)
  • 1/2 cup Barley

Directions:

  1. Season beef with pepper.
  2. Add 2 Tbsp oil to the stew pot and saute for 5 mins.
  3. Add 2 more Tbsp of oil and add onions, carrots, and mushrooms.
  4. Saute for 5 mins and stir often.
  5. Add garlic and thyme and saute for 3 mins.
  6. Add chicken broth and water to the pot.
  7. Add mixed vegetables, potatoes, and barley.
  8. Stir and bring to boil.
  9. Cover and reduce heat.
  10. Simmer 1 to 1 1/2 hours

New Orleans-Style Rice Dressing

Nutrient Analysis

Makes 4 serving

Sodium

113 mg

Protein

 27g

Potassium

377 mg

Phosphorus

228 mg

Calcium

43 mg

Calories

393 kcal

Fat

19 g

Carbohydrates

Water

28 g

40 g

Ingredients:

  • 2 tablespoons vegetable oil  
  • ¼ cup green peppers, chopped
  • 1 pound lean ground turkey
  • ½ teaspoon cayenne pepper
  • 2 tablespoons all-purpose flour
  • 1 clove of garlic, chopped
  • ¼ cup onion, chopped
  • 2 cups hot cooked rice
  • ¼ cup green onions, chopped
  • 1 cup low sodium chicken broth
  • ¼ cup celery, chopped

Directions:

  1. Heat oven to 350 ºF
  2. Heat oil in a skillet, add meat and cook on medium heat until browned.
  3. Remove meat and drain on a paper towel. 
  4. Add flour to skillet and brown to make a dark roux.
  5. Add onions, celery, peppers, and garlic to roux and cook until vegetables are tender.
  6. Add cooked rice and meat to the skillet.
  7. Add low sodium broth a little at a time until the mixture is moist. If the mixture is too dry may add water.
  8. Pour into a 1 ½ quart baking dish.
  9. Bake for 20 minutes

French Toast with Cinnamon

Nutrient Analysis

4 servings

Sodium

194 mg

Protein

7 g

Potassium

128 mg

Phosphorus

61 mg

Calcium

60 mg

Calories

125 kcal

Fat

Carbohydrates

Water

5g

14 g

20 g

Ingredients:

  • 4 large egg whites, slightly beaten
  • ¼ cup 1% milk
  • ½ teaspoon cinnamon
  • ¼ teaspoon allspice
  • 4 slices of white bread (maybe toasted)
  • 1 tablespoon margarine

Directions:

  1. Add milk, cinnamon, and allspice to egg whites.
  2. Dip bread into batter one piece at a time.
  3. Place on a heated grill or in a skillet with melted margarine.
  4. Turn bread after it is golden brown.
  5. Serve hot with syrup (sugar-free if diabetic).

How to make your favorite meals kidney-friendly

Modifying recipes to make it kidney-friendly doesn’t have to be drastic. You may need to experiment with ingredients to get the best results, but consider these tips:

Sugar

Instead of adding sugar to a recipe, consider using spices or herbs such as nutmeg, cinnamon, cloves, or vanilla extract that will boost the flavor and sweetness of a dessert. Consequently, you can cut down your sugar by one-half or one-third, and instead, add spices or herbs. For example, adding cinnamon, nutmeg, cloves, or vanilla extract can boost the flavor and sweetness of a dessert.

Sodium

Skip adding table salt and use pepper, Italian herbs, olive oil, lemon, onions, garlic, scallions, vinegar, tahini, fresh ginger, lime, or low sodium broth. 

Fat

You can cook without oil, especially in baking, broiling, roasting, and air frying. You can also cut fat in a recipe by using cooking spray, water, or broth for stir-fries. 

Potassium

Instead of using whole wheat noodles, go for egg noodles, rice vermicelli, enriched pasta, or white rice. Enriched pasta includes spaghetti, fettuccine, linguine, elbow, etc.)

When using vegetables, leach potassium by slicing the vegetables into thin slices and boiling them for at least 10 minutes. Note that soaking and blanching vegetables will remove some vitamins.

Phosphorus

This mineral isn’t easily removed like potassium, so leaching isn’t as helpful. Use non-dairy foods and beverages to avoid raising your phosphorus to dangerous levels.

The Bottomline

Tweaking your diet and adjusting your recipes can help slow down the progression of your kidney disease, protect your kidneys and nourish your body. You don’t have to sacrifice flavors when it comes to cooking your favorite recipes, as there is a workaround you can do to enjoy your food, by simple substitution or finding alternatives. Consult a renal dietitian for a custom meal plan that meets your nutritional requirements without acutely impacting your kidneys. 


Sources:

Flavorful Lunch Ideas for Dialysis Diets

https://www.freseniuskidneycare.com/eating-well/recipes/lunches


A Family Recipe Book for Kidney Patients

https://www.kidney.org/sites/default/files/docs/kidney_cookbook_lr.pdf


5 Quick, Kidney-Friendly Weeknight Meals - E-Kidney | Sep 2013

https://www.kidney.org/news/ekidney/september13/5quick_KidneyFriendly_Weeknight_Meals


Sodium and Your CKD Diet: How to Spice Up Your Cooking

https://www.kidney.org/atoz/content/sodiumckd

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