The RenalTracker Team
January 14, 2022

As one of the body’s major electrolytes, sodium controls the fluids going in and of the body’s tissues and cells. It regulates blood pressure and blood volume and helps transmit impulses for never functioning and muscle contraction. The kidneys filter the extra sodium and remove it through urine. 

If you are in the early stages of Chronic Kidney Disease, your nephrologist and dietitian will monitor your blood pressure. You may be recommended to follow a low sodium diet if your blood pressure is high or if you are retaining fluid. A low sodium diet will help control blood pressure and fluid intake.

Excessive sodium and fluid buildup in your body, when you have CKD, cause edema–swelling of any part of the body such as arms, hands, legs, feet, and ankles. You may also experience a spike in blood pressure, breathlessness, and/or fluid around the heart and lungs. It can cause a strain on your kidneys, thus further worsening your condition.

Recommended Sodium Intake

Healthy adults are recommended an intake of no more than 2300 mg sodium per day that equates to a teaspoon of salt. Your exact sodium limit as a CKD patient is determined by your primary healthcare provider based on your lab results. Nevertheless, CKD patients – especially those with high blood pressure– are suggested to keep their sodium intake between 750mg and 2000mg per day.

Foods High in Sodium

Most foods have natural sodium or have sodium as part of their ingredients. Among these high sodium foods include:

  • Cured foods (Bacon, Ham, sauerkraut, herring)
  • Processed Foods
  • Luncheon Meats (Hot Dogs, Cold cuts, deli meats, Sausage, Corned Beef)
  • Cheese
  • Canned Foods
  • Sauces (Barbecue, Teriyaki, Soy, and Oyster)
  • Marinades
  • Bouillon cubes and granules
  • Kosher salt
  • Lemon pepper
  • Meat Tenderizer
  • Salt Seasonings

More so, many medicines and products also contain sodium. These ingredients can compromise your kidney function.

Cutting back on Sodium

You don’t have to entirely give up sodium, as you still need it for essential body function. The key is cutting back or lessening your intake to avoid worsening your condition. Here are tips to manage your sodium intake:

1.) Read food labels.

Checking sodium content on food labels allows you to understand which foods to avoid and which ones you could include in your diet. Consider reading the serving size and the milligrams per serving when reading the food label. If salt is listed in the first five ingredients on the label, the food item is probably high in sodium. Label terms to consider:

  • Sodium Free - Contains a small amount of sodium per serving.
  • Very Low Sodium - 35 mg or less of sodium per serving
  • Low Sodium - 140 mg or less of sodium per serving
  • Reduce Sodium - The level of sodium in foods is cut down by 25%
  • Light or Lite in Sodium - The level of sodium in foods is cut down by 50%

2.) Watch out for condiments and sauces.

Condiments and sauces can increase sodium intake. Sodium in condiments can have as much as 900mg per serving. The same amount of sodium can be found in soy sauce per serving, while barbecue sauce can add over 150mg. A quarter cup of tomato sauce can contain 400 mg, while seasonings can have up to 690 per serving. Hence, you must read the nutrition label of your seasonings to know how much salt they have per serving.

3.) Ask for dressings and sauces on the side when eating out.

Dressings and sauces can have large amounts of salt. Ask for foods prepared unsalted and have the dressings and sauces served separately. It allows you to have control over the portion of the sauces/dressings that will go on your food.

4.) Consider Salt Alternatives, not Substitutes.

Your foods don’t have to be bland just because you need to limit your sodium intake. Using herbs and spices instead of salt can bring out the natural flavor and taste of your food. Among the spices and herbs you can incorporate into your food include:

  • Tarragon (vegetables)

  • Bay leaves (vegetables)

  • Caraway (Asparagus, green beans, cabbage, cauliflower, beets, and in dips and sauces)

  • Curry (Carrots, green beans, and marinades)

  • Cardamom (Fruits and baked goods)

  • Dill (Cabbage, carrots, green beans, peas, and in dips)

  • Cinnamon (Fruits and baked goods)

  • Nutmeg (Vegetables and baked goods)

  • Lemon Juice (Carrots, broccoli, and cauliflower)

You can head to our recipe section for kidney-friendly recipes.

Cooking suggestions for spices

  1. Try adding chili powder to your taco meat flavoring for a little kick. Chili powder tastes great in spices too. 

  2. Paprika powder gives marinades a smoky flavor. It also works well as breadcrumb casserole toppings, barbecue rubs, and seasoning blends for searing proteins. 

  3. Dried Oregano improves the flavor of sauces and mixes well with lemon zest. Toss salad with dried oregano for a fresh and earthy taste. You can also enjoy fajita with dried oregano. 

  4. Finish off gravies with a blend of oregano, basil, and thyme. Italian seasoning is perfect for baked, grilled, and or sauteed proteins. 

  5. Garlic and Onion Powder are universal spices that complement just about any recipe. Sprinkle these spices on proteins or vegetables before cooking or even after. 

  6. Mexican-inspired dishes taste amazing with Cumin as it gives a smoky, almost spicy, flavor. Cumin also complements Indian dishes. 

  7. Rosemary and Thyme are your best choice when it comes to flavoring poultry dishes. They are also amazing in fish and white beans.

  8. Dill Weed is also versatile when it comes to complementing dishes. It tastes great on fish and proteins. 

  9. Using crushed Red Pepper flakes & Cayenne Pepper will give your dish the right amount of kick. Note that the longer you cook these spices, the hotter they become.

Don’t stock up herbs and spices in bulk, as they lose their flavor when they’re stocked for a long time. Dried herbs are best crushed before using to bring out their flavors. Add your ground spices to your food within 15 minutes before the end of your cooking. On the other hand, throw in your whole spices to your recipe at least an hour before you end your cooking.  

Be wary of salt substitutes since most of them have potassium chloride. For many CKD Patients, these salt substitutes have too much potassium for kidneys to filter. They can be dangerous if you are asked to lower your potassium intake or if you take certain hypertension medications. 

Consuming potassium-enriched salt substitutes can increase the risk of hyperkalemia and its main adverse consequences, such as arrhythmias and sudden cardiac death. However, the evidence regarding the impact of potassium-enriched salt substitutes on the occurrence of hyperkalemia is still inadequate. 

Although not all CKD patients need to lower their potassium intake, it may help if you avoid artificial potassium in your diet. Hyperkalemia is a medical condition where a potassium level in the blood is higher than normal. When you have hyperkalemia, you may feel abdominal pain, chest pain, heart palpitations, irregular fast or fluttering heartbeat (arrhythmia), muscle weakness, nausea and vomiting. Consult with your dietitian or nephrologist before using salt substitutes.


Bottomline

Cutting down on sodium doesn’t mean eating bland foods. Plenty of herbs, spices and seasonings can bring out the flavor of your dishes. However, never assume that spices don’t have sodium. Make it a habit to read the nutrition label. 

Consequently, try to steer clear from adding salt substitutes to your dish as they can spike your potassium level. Too much potassium can cause hyperkalemia along with arrhythmia. Experiment with herbs and spices instead to find the right flavor without having to add salt, which could influence your total sodium intake.

Always work with your dietitian or primary health care provider to know your sodium limits and get renal diet guidance.

Sources:

What You Need to Know About Salt Substitutes and Hypertension -
https://www.samuelfinkmd.com/blog/what-you-need-to-know-about-salt-substitutes-and-hypertension

Salt and Kidney Disease -
https://www.freseniuskidneycare.com/eating-well/managing-your-diet/salt-and-kidney-disease


Sodium and Your CKD Diet: How to Spice Up Your Cooking -
https://www.kidney.org/atoz/content/sodiumckd


Focus on Hyperkalemia -
https://www.medpagetoday.com/resource-centers/focus-hyperkalemia/salt-substitutes-whats-scoop/2800


Danger of salt substitutes that contain potassium in patients with renal failure -
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124926/


The Best Salt Substitute for Kidney Patients -
https://www.thekidneydietitian.org/salt-substitute-for-kidney-patients/


Sodium Intake and Chronic Kidney Disease -
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369961/

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