Eating Right for Chronic Kidney Disease (CKD)

By: Kellsey Reed RDN, LDN, PatientsLikeMe Contributor

If you have CKD, chances are you have seen so much conflicting information online about what to eat with chronic kidney disease. From Google telling you that you can only eat white bread and grilled chicken to Facebook groups telling you oils are terrible for your kidneys. If you are feeling confused and overwhelmed about how to eat for your kidney health, you are not alone! Knowing the basics of a kidney-friendly diet and how food affects your kidneys is an important first step in learning how to eat for your CKD.

What happens to your body when you have CKD?

The kidneys are responsible for filtering out waste products and toxins of the body, helping to control blood pressure, making red blood cells, and keeping your bones healthy. When you have CKD, your kidneys are likely not working as well as they should. This means that your body may have trouble managing your blood pressure or getting rid of toxins that may build up in the blood. Your kidneys may also have trouble getting rid of excess nutrients from the body like sodium, potassium, phosphorus, and protein. When you have CKD, you are also more likely to experience complications of kidney disease like gout, heart disease, fluid retention and swelling, bone disease, and metabolic acidosis. That is why it is so important to try and manage your kidney disease in a healthy way with medical care, lifestyle choices, and diet.

How does your diet affect your kidneys?

What we eat plays a major role in how our kidneys and body function. Why? Because the foods in our diet contain nutrients, these nutrients impact how the kidneys function. Some of the nutrients that play a major role in kidney disease are protein, sodium, potassium, phosphorus, and fiber. Having excessive amounts of these nutrients can negatively impact the kidneys and make them work harder to do their jobs. When the kidneys have to work harder on a regular basis, this can lead to further progression of CKD.

What does a kidney-friendly diet look like?

Ultimately a kidney-friendly diet looks different for everyone with CKD because everyone has different bloodwork, medical histories, and food preferences. Your CKD diet should be customized and individualized to fit what your body needs. Working with a kidney dietitian can help you determine the best kidney-friendly diet for you. You can find a kidney dietitian in the U.S. by heading here: https://sites.google.com/view/ckdrd/home.

With that being said, there is evidence to support that the best diet for your CKD is one that is:

Lower in protein and contains more plant-based protein than animal-based protein
Lower in sodium
Higher in fruits and vegetables/fiber
Higher in whole grains
Higher in heart-healthy unsaturated fats rather than saturated fats

These recommendations are similar to that of a Mediterranean diet or a DASH diet, both of which are often recommended for health issues such as heart disease, high blood pressure, high cholesterol, and diabetes.

Why is this recommended for you if you have CKD? The typical American diet is centered around protein and animal-meat as well ultra processed foods. This can make it difficult to follow a more kidney-friendly diet. Excess protein can increase the workload of the kidneys, which can therefore cause decreased kidney function. Excess sodium can increase blood pressure, which can in turn cause further progression of CKD. But what about potassium and phosphorus? These nutrients should be individualized based on your bloodwork. For some, the kidneys may have difficulty getting rid of excess potassium and phosphorus and these nutrients can build up in your blood and become harmful for you. Some people with CKD need lower amounts of potassium and others need higher amounts of potassium.

This style of eating is also recommended for those with CKD due to the fact that it can help minimize complications from CKD as well. Ultimately, following a lower sodium, lower animal protein, and higher fiber diet can help with managing diabetes, heart disease, and high blood pressure, all of which play a role in CKD management.

How can you eat a more kidney-friendly diet?

Transitioning to a more kidney-friendly diet can seem like a daunting task, especially when you have conflicting advice from every corner of the internet. You don’t have to throw everything in your pantry and refrigerator away, instead, take it one step at a time. Making small, steady changes can have a huge impact on your overall kidney health! Try these simple swaps to help get you started on your kidney-friendly eating journey:

Instead of salt ➡️ try herbs and spices, unsalted seasoning blends, and lemons, limes, and vinegars to add flavor
Instead of white bread ➡️ try whole-grain bread
Instead of chicken ➡️ try tofu
Instead of beef ➡️ try beans or lentils
Instead of butter ➡️ try olive oil or avocado oil
Instead of avoiding fruits and vegetables ➡️ try adding one extra serving per day

Examples of kidney-friendly meals

Whole grain pasta primavera (whole grain pasta, olive oil, garlic, vegetables of choice)
Loaded veggie sandwich (whole grain bread, low sodium hummus, vegetables of choice)
Vegetarian burrito bowls (brown rice, peppers, onions, low sodium salsa, black beans)
Tofu scramble (tofu, vegetables of choice, nutritional yeast)
Roasted salmon and vegetables (salmon, vegetables of choice, brown rice, coconut aminos, garlic)
Fruit and veggie smoothie (spinach, strawberries, blueberries, almond milk, peanut butter, chia seeds)

If you are trying to juggle all the restrictions of the CKD diet has your head spinning, there are ways you can start managing your diet and keep it kidney-friendly. Check out patientslikeme.com/forum/ckd/topics to join our discussion. You can share what you are going through, ask for advice, and plan a path forward from people who understand. ⁠

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