Kidney Disease: Changing Your Diet

Most people with kidney disease need to limit salt (sodium), protein, and fluids. Some also have to limit minerals, such as potassium and phosphorus.

There is no one diet that is right for everyone with kidney disease. Your doctor or dietitian can tailor a diet for you based on how well your kidneys are working.

To be successful with your diet, you will need to:

• Read food labels and look for hidden sodium. For example, sodium may be listed as monosodium glutamate (MSG) or disodium phosphate.
• Learn about sources of protein. Most people know that meats, fish, and dairy products are high-protein foods. But you may not know that foods such as breads, cereals, and vegetables also contain protein.
• Know which foods have minerals you need to limit. For example, dairy products, nuts, seeds, and beans have a lot of phosphorus. Potatoes and bananas are sources of potassium, but it is also found in other fruits and vegetables as well as many meats, grains, and milk.

It may seem like there is a lot to learn, but your doctor or dietitian can help. A dietitian can plan meals for you that are healthy and give you the right amounts of foods you need to limit.

It may be hard to change your diet. You may have to give up many foods you like. But it is very important to make the recommended changes so you can stay healthy for as long as possible.

Continue to Why?

What you eat has a major impact on the health of your kidneys. Protein, sodium, fluids, and certain minerals are especially important.

• When protein breaks down in your body, it forms waste products. When you have kidney disease, the kidneys have trouble getting rid of waste products. Eating more protein than your body can handle can make you very sick.
• Sodium helps you keep the right balance of fluids in your body. When you have kidney disease, your kidneys have trouble clearing extra sodium from your body. Eating too much sodium can cause fluids to build up.
• Healthy kidneys flush excess fluids from your body. When you have kidney disease, your kidneys have trouble getting rid of extra fluids. The extra fluid can raise your blood pressure and force your heart to work harder.
• Healthy kidneys keep the right balance of minerals such as phosphorus and potassium in the blood. When you have kidney disease, you may need to keep track of these minerals in your diet so you don't get either too much or too little.

A dietitian can help you make an eating plan that provides the nutrients you need but limits ones that can cause problems. Following your eating plan can reduce the workload on your kidneys and help you stay healthy longer.

Continue to How?

The following are general food guidelines for people who have kidney disease. Be sure to follow the diet your doctor or dietitian gave you.

Protein

Eating too much protein can stress the kidneys. But if you don't get enough, you can become weak, tired, and more likely to get infections. To get the right amount of protein:

• Know how much protein you can have each day. Limit high-protein foods to 5 to 7 ounces a day, or less, if your doctor or dietitian tells you to. A 3-ounce serving of protein is about the size of a deck of cards.
• Learn which foods contain protein. High-protein foods include meat, poultry, seafood, and eggs. Milk and milk products, beans, nuts, breads, pastas, cereals, and vegetables also contain protein.

Sodium

To limit sodium:

• Don't add salt to your food. Avoid foods that list salt, sodium, or monosodium glutamate (MSG) on the label. Buy foods that are labeled "no salt added," "sodium-free," or "low-sodium." Foods labeled "reduced-sodium" and "light sodium" may still have too much sodium.
• Avoid salted snacks such as pretzels, chips, and popcorn.
• Avoid smoked, cured, salted, and canned meat, fish, and poultry. This includes ham, bacon, hot dogs, and luncheon meats.
• Don't use a salt substitute or lite salt unless your doctor or dietitian says it is okay. Most salt substitutes and lite salts are high in potassium. Use lemon, herbs, and other spices to flavor your meals.
• Limit how often you eat food from restaurants. Most of the sodium we eat is hidden in processed foods and restaurant food, especially at fast-food and take-out places.

Fluids

If you need to limit fluids:

• Know how much fluid you can drink. Each day, fill a pitcher with that amount of water. If you drink another fluid during the day, such as coffee, pour an equal amount of water out of the pitcher. When the pitcher is empty, you're done drinking for the day.
• Remember that soups and foods that are liquid at room temperature, such as gelatin dessert (for example, Jell-O) and ice cream, count as fluids.
• Be aware that some fruits and vegetables contain a lot of water and will count in your fluid intake. Examples include grapes, oranges, apples, lettuce, and celery.
• Count the liquid in canned fruits and vegetables as part of your daily intake, or drain them well before serving.

Potassium

If you need to limit potassium:

• Choose low-potassium fruits such as apples, blueberries, pears, plums, and tangerines. You can also eat canned fruits, such as fruit cocktail, peaches, and pineapple.
• Choose low-potassium vegetables such as asparagus, bean sprouts, cabbage, cucumber, green beans, and lettuce.

Phosphorus

If you need to limit phosphorus:

• Follow your food plan to know how much milk and milk products you can include.
• Limit nuts, peanut butter, seeds, lentils, beans, organ meats, and sardines. Also limit cured meats such as sausages, bologna, and hot dogs.
• Avoid colas and soft drinks with phosphate or phosphoric acid.
• Avoid bran breads and bran cereals.

General tips

• Don't skip meals or go for many hours without eating. If you don't feel very hungry, try to eat 4 or 5 small meals instead of 1 or 2 big meals.
• If you have trouble keeping your weight up, talk to your doctor or dietitian about ways you can add calories to your diet. Healthy fats such as olive or canola oil may be good choices. Unless you have diabetes, you can use honey and sugar to add calories and increase energy.
• Don't take any vitamins or minerals, supplements, or herbal products without talking to your doctor first.
• Check with your doctor about whether it is safe for you to drink alcohol. If you do drink alcohol, have no more than 1 drink a day. Count it as part of your fluids for the day.

Continue to Where?

Now that you have read this information, you are ready to follow your diet for kidney disease.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor or dietitian. You may want to mark areas or make notes in the margins where you have questions.

If you would like more information on kidney disease, the following resources are available:

Organizations

National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way
Bethesda, MD  20892-3580
Phone:	1-800-891-5390
Fax:	(703) 738-4929
TDD:	1–866–569–1162 toll-free
Email:	nkudic@info.niddk.nih.gov
Web Address:	http://kidney.niddk.nih.gov
The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), a federal agency, is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. The clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, to health professionals, and to the public. NKUDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and government agencies to coordinate resources about kidney and urologic diseases.
National Kidney Foundation
30 East 33rd Street
New York, NY  10016
Phone:	1-800-622-9010
Phone:	(212) 889-2210
Fax:	(212) 689-9261
Web Address:	www.kidney.org
The National Kidney Foundation works to prevent kidney and urinary tract diseases and help people affected by these conditions. Its website has a lot of information about adult and child conditions. The site has interactive tools, donor information, recipes for kidney disease patients, and message boards for many kidney topics. Free materials, such as brochures and newsletters, are available.