RenalTracker Team
August 30, 2022

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.   

If you want to join our exclusive coaching on how to avoid dialysis, book a call to see if you qualify.

CKD Patient Concern

This is where it started for Emma.

Her husband, David, has a Glomerular Filtration Rate (GFR) of 28.7 and a Creatinine of 2.3. This means that if David’s not careful in the next following months, he’s going to be a candidate for dialysis. 

This was not only hard on David, but for Emma as well as she is the only support system that her husband has. So, when they got home, she directly took out her laptop and decided to look for answers herself. 

Here are some of the questions that she decided to ask Google: 

What kind of foods should he eat that will improve his numbers?
What kind of foods should I avoid or look out for when preparing his meals? 
How much should he have?

After looking at different websites, she read our content on how to tweak your lifestyle with a CKD diet. And that’s when she signed up, wrote us that email, and got started with the coaching program with David. 

From there, she learned 3 things: 

1. You need to make changes to your diet.

According to a study on The Effect of Diet on the Survival of Patients with Chronic Kidney Disease [1] which assessed the association between four lifestyle factors (diet, physical activity, body mass index—BMI, and smoking) with all-cause mortality among CKD participants [2]. It demonstrated that individuals in the highest quartile of the weighted healthy lifestyle score had a 53% lower risk of death compared with those in the lowest quartile.

[1] The Third National Health and Nutrition Examination Survey (NHANES III) Linked Mortality File
[2] The Effect Of Diet on the Survival of CKD Patients:

The truth is, the renal diet is not easy to understand at first glance because it is NOT intuitive.

2. You need to limit your SPPP.

These changes in diet may include limiting your Sodium, Potassium, Protein, and Phosphorus (also known as your SPPP) to keep them below dangerous levels.

You may need to restrict ALL of SPPP or only one of those nutrients. This would then change what food you can eat and what food you should avoid. This is why it’s important to start with finding out what restriction is applicable to you by consulting a dietitian first. 

3. You can achieve the same results as CKD Chef Duane.

Here’s a quick recap of his CKD story:

For the first 20 years of his life, it was good. His family was happy and healthy and loved teaching his craft (cooking and baking) to his students. He was happy.

But one morning, he woke up with half his face swollen. After which, he had his first migraine which was caused by the dinner they ate the night before that was loaded with salt.

He was in-and-out at the doctor’s office and was being treated for symptoms such as migraines and high blood pressure. To make things worse, his lab results showed he was spilling a ton of protein. It was clear that his kidney wasn't doing its job.

So, he was told to stop eating animal protein and his life will return back to normal. But of course, it wasn’t easy to do. Months later, he was being tested for high blood pressure and was later admitted to the hospital.

This is where diet as treatment is important.

When he went to see a nephrologist, he was never told what foods he should eat and avoid. Instead, he was given high blood pressure medication but it didn’t work much since his creatinine levels kept rising.

Fast forward months after his diagnosis, his creatinine level reached 4.99. If his creatinine levels reached 5, he would have to undergo dialysis. He knew he needed to do something.

So, he met with his colleague (who is a registered dietitian, by the way) and wanted him to completely take off animal protein and sodium for 90 days.

It honestly wasn’t easy for him to do at first given it was a completely different lifestyle. But it was the best thing he could have done. Within two weeks, he started to feel better. A LOT BETTER. Because of this, his creatinine went from 4.99 to a 0.8 and is already off his medication, thanks to his diet. 

Today, Chef Duane has successfully avoided dialysis through proper diet, nutrition, and lifestyle changes. 

CKD Chef Duane Gives Speech About Kidney-Friendly Diet

(Here’s him giving a speech on kidney-friendly diet and recipes at the 2018 Breakfast of Hope)

And we’d like the same for you. That being said, let’s go through the Sodium, Protein, Potassium, and Phosphorus (SPPP) food items to eat and avoid that has not only helped 33,000+ CKD patients, but to Chef Duane as well: 


In the right amounts, sodium is actually an important part of one’s diet. Our bodies need this mineral in order to:

  • Keep our muscles and nerves functioning.
  • Keep our cells properly hydrated.
  • Maintain our blood volume and blood pressure, among others.

Unfortunately, since most foods naturally have some sodium in them + we love table salt too much, it is common for people to go overboard.

The best way to cut down on your sodium intake is to choose fresh ingredients when cooking.

This is probably what you serve at the table most of the time because it’s easiest to prepare (USDA values per 100 g):

High Sodium Foods and CKD Diet

None of that anymore. Now you need to replace these foods with unprocessed, low-sodium ones, like the following:

Low-Sodium Foods


Without protein, your body won’t function the way it’s supposed to. It’s needed for most bodily processes, especially for growth, maintenance, and repair. It also plays a major role in building up muscle and fighting infection.

Too much protein in the body can also cause a buildup of creatinine, another by-product of metabolism as protein is used up. Creatinine, whether you’re aware or not, is one of the key determinants of kidney damage.

Which is why limiting protein foods to smaller portions is essential in protecting your kidneys. But you must consult a dietitian about how to choose the right protein for you. 

Remember that there are two general types of protein to choose from: 

1. High-value proteins refer to the protein you get from animal sources like the following:

High-Value Protein

2. Low-value proteins refer to the protein you get from plant sources. Vegetables, cereals, beans, bread, rice, and pasta or noodles are some good examples.

Low-Value Protein

To maintain a healthy diet, it’s important to strike a good balance between these two.


Potassium is a fairly common nutrient that can be found in almost any food. It is responsible for keeping your nerves and muscles healthy and maintaining the normal rhythm of your heartbeat. However, if your potassium levels are too high or too low, this is not good.

Salt substitutes are often high in Potassium. Be sure to read the ingredient label or check your provider about using salt substitutes. Also, drain fruits and vegetables before eating. 

In general, any food that contains more than 200 mg potassium per serving is high in Potassium.

So, you’ll have to start watching out for high-potassium foods (USDA values per 100 g), such as: 

High-Potassium Foods

You need to avoid these food items and find lower potassium foods (USDA values per 100 g). Like:

Low-Potassium Foods


As suggested by the National Kidney Foundation (NKF), the ideal phosphorus intake limit for people with kidney conditions is 800-1000 mg daily. But limiting this nutrient is easier said than done.

You see, most of the things that we enjoy are actually high-phosphorus food items, especially milk and dairy products such as ice cream, puddings, or yogurt. Meat and protein foods are also phosphorus-rich. 

Here are some other examples:

High-Phosphorus Foods

*USDA values per 100 g; Milk values from 1 cup (244 g) serving

But you don’t need to worry much about it, as there are low-phosphorus alternatives, such as these:

Low-Phosphorus Foods

*USDA values per 100 g, Almond Milk values from 1 cup (262 g) serving

Just as long as you know the basics of what you should eat and avoid, and work with your doctor and dietitian, you can learn how to integrate this information into your diet and learn how to prepare it yourself. 

And that’s exactly what Emma and David did! We’re still waiting for David’s results but here’s an email that David personally sent to me weeks ago. Now mind you, Emma has warned me that she is not tech-savvy, so we’re touched by his efforts:

CKD Patient Success Story

I’m glad that they seem a bit more confident than when Emma emailed me the first time 😀

Remember, you do NOT need to be an experienced chef to be able to make this work. As long as you keep your kidney health goal in mind, there’s nothing you can’t do!

We're here to make things easier for you, too. That being said, if you want to learn more of how CKD Chef Duane did it, you can click here to watch: How to avoid dialysis like CKD Chef Duane