The RenalTracker Team
April 7, 2021

I hope you enjoy reading this blog post. It has been written and vetted by RenalTracker's team of kidney experts and researchers. The same team was awarded the KidneyX Prize organized by the American Society of Nephrology and HHS for pre-dialysis solution in Washington DC in 2019.   

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When you have chronic kidney disease (CKD), limiting your sodium intake is an expected course of action.

Although some sodium is necessary for you to remain healthy, there are dangerous consequences when you consume too much. Normally, your kidneys can filter out the excess and keep your body in balance, but that may no longer be the case if you have CKD.

It is now your responsibility to keep your sodium consumption at a manageable level. And that's why we came up with this article, to guide you through the ins and outs of low sodium dieting!

Most people associate sodium with table salt, but it’s actually found naturally in most foods, even fruits and vegetables. 

And while you should consume less sodium, that doesn't mean you should remove it entirely from your diet. Your body actually needs some of it to function properly.

low sodium diet words made out of grains of salt

What is sodium's role in the body?

Sodium is one of the three major electrolytes of the body. The other two are chloride and potassium. Along with them, sodium contributes to:

  • Conducting nerve impulses
  • Contracting and relaxing muscles
  • Maintaining the proper balance of water and minerals
  • Regulating blood pressure, volume, and pH balance

Why do I need to limit my sodium intake?

Even though sodium contributes to vital bodily functions, you still need to cut back. And there’s a simple reason why:

It doesn't take much sodium to get the job done. 

sodium word on paper being cut

It is estimated that 500 milligrams (mg) daily is enough to perform those vital functions.

And yet the average American consumes 1.5 teaspoons of salt every day. That's about 3400 mg of sodium! It's clear even at a glance that this is far too much. 

An excess of sodium in your diet can lead to many negative effects, including a dangerous rise in blood pressure. It can increase the risk of heart disease and stroke.

the word bad spelled out in salt

How does sodium affect people with CKD?

We've discussed some of the negative effects of eating too much sodium. But when you have CKD, there's even more that you have to watch out for.

When kidneys are healthy, they can filter out excess sodium and fluid from your body. 

But when kidney function has deteriorated, this can no longer be accomplished effectively. Sodium and fluid build up in your bloodstream, which can lead to:

  • Increased thirst
  • High blood pressure
  • Edema: Swelling in the ankles, legs, hands, and face
  • Shortness of breath: Fluid accumulates in the lungs, making it hard to breathe
  • Heart failure: Excess fluid in the bloodstream overworks the heart, causing it to enlarge and weaken

What is the recommended sodium consumption for a healthy adult vs someone with CKD?

Now that you know why it's important to limit sodium intake, you're probably wondering how much is too much. Or how much is just enough.

Luckily there are established guidelines we can follow:

  • For healthy adults, no more than 2300 mg per day is the recommended amount. This is equivalent to about 1 teaspoon of salt.

  • If you have CKD and/or high blood pressure, the recommended sodium consumption can vary from 750 mg - 2000 mg per day.

Ask your doctor or dietitian about how much sodium you need per day.

How do I reduce my salt intake?

If you're concerned that you've been eating too much sodium, don't worry! It's never too late to improve your diet.

Here are some quick tips to effectively cut down your sodium intake:

1. Ease up on the saltshaker

salt shaker

This first step to reducing your sodium intake can be pretty simple: eat less salt.

You can start by lessening the amount you use in cooking or during actual meals. The less salt you use, the less you'll crave over time. Reduce your use of the saltshaker, and you'll eventually prefer less salty food.

2. Use herbs and spices

herbs and spices

You can add flavor to your meals by using herbs and spices instead. There are so many options to choose from.  For example, bay leaf and basil are a great match for most vegetables, as well as pork and beef. Cardamom is great with fruit and as a secret ingredient in baked goods. It can be fun to try different combinations!

Of course, you can always go for the classics too, like chicken and rosemary or lemon and fish.

3. Pay attention to food labels

All companies are required to show the sodium content in their food products.

When it comes to sodium, there are two crucial pieces of information you should look for in food labels: the serving size, and the milligrams (mg) of sodium per serving

Of course, the important part about looking at labels is understanding what they mean. To help with that, we’ve prepared some tips that’ll bring you up to speed:

Tips on how to read nutrition labels

Tip #1: Understand the terms

  • Sodium-free: less than 5 mg of sodium per serving
  • Very low sodium: 35 mg or less per serving
  • Low sodium: 140 mg or less per serving
  • Reduced sodium: sodium level of food is reduced by 25%
  • Light (or lite) in sodium: sodium level of food is reduced by at least 50%

Tip #2: Check the numbers

As a general guideline, you shouldn’t get a product if the sodium content is more than 20% of your recommended daily limit. Most of the foods you eat will have sodium in some form, so your intake can build up without you noticing. It will be easier to keep your consumption down if you limit yourself to products that are about 5% sodium at most.

Tip #3: How high is it on the ingredient list?

Check the list of ingredients. If sodium is among the first five ingredients, there's probably too much of it in that item.

Tip #4: Compare before you choose

There are so many varieties of foods available in today's markets. Take advantage of that and compare similar products and brands. Choose the one with the lowest sodium content for the same serving size.

4. Avoid high sodium foods

Even when you can check labels, some foods are just generally high in sodium and are best avoided. Here are some of them:

  • Seasonings and sauces e.g. soy sauce, sea salt, teriyaki sauce, garlic salt, onion salt
  • Most frozen dinners and canned foods: Salt and other preservatives are often added to these foods to increase their shelf life or to improve their taste, texture, and appearance
  • Processed meats e.g. sausages, hot dogs, bacon, ham, deli meats
  • Salted snacks e.g. chips, crackers, pretzels, popcorn
  • Dehydrated or canned soups e.g. packaged noodle soup, cup ramen
  • Most fast foods, restaurant foods, and take-out

Food manufacturers tend to cater to the general population’s preference for saltier food to attract more customers. It also reduces costs for them, since sodium makes certain foods easier to process and acts as a preservative.

5. Choose low sodium foods

Yes, there are a lot of sodium-rich foods you should be avoiding. But the good news is that there are just as many low sodium alternatives you can choose from!

There are options for every food group. Here are some examples

  • Wheat and grains: most pastas and rice (just don't add salt when cooking), granola, puffed rice, rolled oats, shredded wheat, unsalted popcorn, bread, and baked goods without salted tops
  • Vegetables (fresh/frozen/canned with no sauces): particularly broccoli, cabbage, cauliflower, chickpeas, cucumber, green peppers, lima beans, sweet potatoes
  • Fruit juices or fruit (fresh/frozen/canned with no sauces): apples, bananas, blackberries, cherries, peaches, pears, raspberries, watermelons
  • Protein: Fresh or frozen beef, veal, lamb, pork, poultry, or fish prepared without salt and without the skin; eggs and egg substitutes
  • Condiments and seasonings: fresh garlic, fresh onions, spices (e.g. black pepper, chili powder, paprika), herbs (e.g. basil, rosemary, sage), vinegar, lemon juice, dry mustard, low sodium/ salt-free seasonings
low sodium diet written in notebook

What are salt substitutes?

There are sodium-free products sold on the market that are intended to replace table salt. Although these products may contain little or no sodium, in reality, these companies usually just switch it with another mineral -- potassium.

If you have CKD, you may also need to limit potassium in your diet other than sodium. That's why salt substitutes might not be an ideal alternative.

Remember to check with your doctor or dietitian before using any salt substitutes. Better yet, opt for a flavorful mix of herbs and spices instead!

Before you go...

Great job on reaching the end of this article! We hope you've picked up some information that can help you start your low sodium diet.

Having salt and sodium-rich foods are routine for many of us, so we know how tough it can be to go without (or with less). But while change can be challenging, we know you can do it! 

Start small and gradually reduce your salt intake. Be consistent, and be persistent as well. If you fall off track for a day or two, don’t beat yourself up over it and give up! Be kind to yourself and just get back on track as soon as you can. 

“There are no shortcuts to any place worth going.”

That’s according to acclaimed soprano Beverly Sills, and we wholeheartedly agree. Dedication and determination are what you need to be successful with low sodium dieting -- and your entire renal diet, really.

So when your journey to better kidney health seems rough and the road seems long, always remember that a healthier, better you is at the end of it. 

We hope to see you there!