Angela Larson is a registered dietitian (RD) who works with Brookshire Brothers promoting real fresh, real delicious healthy foods and providing nutrition education to the community.
Read her advice on Chronic Kidney Disease below.
Learning to eat well with chronic kidney disease (CKD) can seem complicated, but it can actually be quite simple when streamlined to focus on the most important changes that can help keep the kidneys working well. The four areas to focus on when making diet modifications are in eating the right amount of protein, phosphorus, sodium, and potassium. Eating well with chronic kidney disease can be easily combined with any other dietary needs such as eating for diabetes or heart disease, because the foundation of the diet is the same: eat a variety of healthy foods that are simply prepared and wholesome. Track your nutrient intake for a few days to see how your intake of protein, phosphorus, sodium, and potassium measures up to the recommended amount for CKD listed below.
Excess protein can stress the kidneys when their function is already compromised, so eating the right amount without eating too much is helpful to keep your kidneys going strong. Protein is found in meat, seafood, bone broth, eggs, dairy, beans, peas, nuts, and seeds. A small amount of protein is found in foods like grains and vegetables. Your body needs protein to build tissue and stay strong, so eat the right amount without eating an excess. Most people with chronic kidney disease need between 60-70 grams of protein a day, which is the amount in about 7 ounces of meat or 10 large eggs. Individual protein needs will vary based on overall calories needs, activity level, and kidney function. A good rule of thumb is to limit meat to no more than 6 ounces a day. As a reference, a deck of cards looks like about 3 ounces of meat. Six ounces of meat a day will provide about 52 grams of protein, leaving some of your daily protein allowance for other foods like dairy, grains, and veggies.
Phosphorus is an essential nutrient, but it is abundant in a wide variety of foods so it is easy to get more than enough. Protein-rich foods are also high in phosphorus, so as you limit protein consumption your phosphorus intake will also naturally decrease. Not everyone with CKD needs to limit phosphorus – only those with elevated blood phosphorus levels or elevated PTH levels1. Talk to your doctor to see if you need to restrict phosphorus in your diet. For those with elevated blood phosphorus and PTH, dietary phosphorus should be limited to 800-1,000 mg each day.
Foods high in phosphorus include meat, dairy, nuts, seeds, beans, peas, chocolate, whole grains, oatmeal, dark cola, and bottled iced tea. Choose small portions of high phosphorus foods, and try not to eat more than two or three portions of high phosphorus foods in one day. Choose low phosphorus drinks and avoid dark colas and bottled tea.
High sodium intake can increase blood pressure and stress on the kidneys. The best way to limit sodium is by eating foods cooked at home and limiting processed foods and eating out. Aim for a sodium intake of 1,500-2,000 mg per day. One teaspoon of table salt has 2,300 mg of sodium.
Cooking Tips for Lowering Sodium Intake:
- Remember that one teaspoon of table salt has 2,300 mg sodium, enough for an entire day.
- If you are accustomed to eating your food heavily salted, try gradually cutting back to use less over time and allow your palate to adjust slowly.
- Salting food at the table with just a sprinkle on the surface of the food can also make for a saltier taste without using as much salt.
- Remember that some foods are naturally salty, like certain cheeses, preserved meats, and Asian food sauces, so keep the portions on those foods small.
- “Light salt” products have added potassium, so they are not a good choice for those with CKD. Choose salt-free seasonings, herbs, spices, lemon juice, and a very light amount of sea salt at the table for seasoning food.
Shopping Tips for Lowering Sodium Intake:
- Read food labels to get an idea of how much sodium is in the foods you frequently eat.
- Choose products that are labeled low sodium or salt-free when shopping for canned goods.
- Store bought broth tends to be high in sodium even if purchasing the “lower sodium” varieties, so make broth at home when you can.
- Foods that come with flavoring packets and seasonings are typically going to be higher in sodium. Shop the perimeter of the store for fresh ingredients that are naturally lower in sodium.
- Buy sea salt or Himalayan pink salt for a little boost of minerals in your salt.
Eating excess potassium can cause added stress on poorly functioning kidneys, especially in later stages of CKD. If you have advanced chronic kidney disease, aim for 1,500-2,700 mg per day depending on your blood potassium levels and your doctor’s recommendations. Potassium is a part of many healthy foods and is found in most fruits and vegetables in varying amounts. Most people have difficulty eating enough potassium to meet the recommended daily intake unless they eat a lot of fruits and vegetables, particularly high potassium foods, so it is fairly easy to limit potassium to a safe amount for kidney disease. If you need a potassium restriction due to high blood potassium, limit yourself to one or two servings of high potassium foods each day for the entire day, and eat moderate amounts of any other type of fruits and vegetables to keep your potassium within a safe range.
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