While your kidneys are not working properly, you have special nutritional needs. This guide contains specific diet and nutrition information to help with those needs.

The normal working kidney filters out waste products from the blood. When your kidneys are not working well, certain foods need to be limited to prevent the build-up of waste products. This guide contains information on how to eat a diet to control the production of waste products, which can slow the progression of kidney disease.

A diet with enough protein is needed for the maintenance and growth of body tissue. However, eating large amounts of protein can cause more waste products to build up in your blood and possibly harm your kidneys.  So, the amount of protein in your diet may need to be limited.

Your dietitian will decide the amount of protein that you should have each day to meet your body’s needs. Meat, poultry, fish, eggs, and dairy products contain large amounts of high quality protein. Protein from plants such as nuts, beans, soy, and seeds are not as high quality of protein, but may be easier for your kidneys to handle. Small amounts of proteins should be included in each meal.  Breads, cereals and vegetables also have small amounts of protein.

Listed below is the number of servings you should eat each day from the meat, milk, and starch food groups to maintain a proper protein intake.

Milk*__________choices daily

Each of these is equal to one choice:

Each choice contains 8 grams of protein.

• 1 cup milk
• 1 cup yogurt
• ¾ cup custard
• 1 cup cream (milk-based) soup
• ½ cup ice cream
• 1 cup milk based pudding

Each of these is equal to one choice:

Each choice contains 7 grams of protein.

• 1 oz. beef, lamb, pork, poultry or fish
• ¼ cup salmon, tuna, crab, poultry, fish, lobster, or clams
• ¼ cup cottage cheese
• 1 oz. or 5 medium shrimp
• 1 egg
• 2 Tbsp. Peanut butter
• ¼ cup egg substitute
• 4 oz. tofu
• ½ cup cooked dried beans, peas, lentils and soybeans (edamame)
• 1 oz natural cheese (Swiss, Cheddar, etc.)

Each of these is equal to one choice:

Each choice contains 2 grams of protein.

• Biscuit (2”)
• 1 dinner roll
• 1 slice bread
• ½ cup cooked cereal
• ½ hamburger bun
• ¾ cup dry cereal
• 1 muffin
• ¼ cup Grapenuts
• 2 pancakes (4”)
• 3 graham crackers (2 ½” sq.)
• 6 saltines
• 2 ½ Tbsp. Flour
• ½ cup rice, cooked
• ½ cup pasta, cooked
• ½ English muffin
• 3 cups popcorn
• ½ cup potatoes
• ½ bagel
• ½ pita (6”)
• 1 flour tortilla (7”)
• 2 breadsticks, 4” long x ½”

Your diet should be limited to moderate amounts of sodium and fluid. The goal of sodium and fluid control is to lessen fluid weight gain.

Fluid intake should be limited to 4-6 (8 oz.) cups per day. The more urine that you produce, the less restrictive you need to be. Fluids include water, soups, beverages, and any foods that are liquid at room temperature, such as ice cream, sherbet, popsicles and jello. The table below shows the fluid content of various foods

To limit your sodium intake:

• Do not use salt at the table.
• Use only half the amount of salt (or less) normally used in recipes and in cooking.
• Avoid foods high in sodium as listed below.

All salted or smoked meat or fish, such as:

Cheeses:

Convenience and processed foods, such as:

Try these spices and herbs to cut the salt but not the flavor:

Seasonings that contain sodium:

Certain foods and condiments are high in sodium and should be used in moderation:

Peanut butter

Catsup

Commercial salad dressing

You may also need to control your phosphorus intake through diet and medicines. If phosphorus builds up in the blood it can cause weak and brittle bones and skin itching. To control phosphorus levels, phosphorus-binding medicines must be taken at the proper time. Take TumsÒ (Calcium Carbonate), Phoslo or Renagel with meals and AllucapsÒ (Aluminum Hydroxide) after meals.

Phosphorus is in many foods, but is especially high in the foods listed below. Ask your dietitian if you may use them.

Dairy products:

• Milk and cream
• Cheeses and cottage cheese
• Yogurt
• Custard and pudding
• Ice cream and ice milk
• Casseroles with cheese

Protein foods:

• Meat*
• Poultry and fish
• Eggs
• Organ meats
• Dried beans and peas
• Nuts, seeds and peanut butter
• Soybeans and tofu
• Lentils
• Salmon and sardines

*beef and veal are lower in phosphorus than other meats

Whole grain foods:

• Bran products
• Oatmeal
• Brown rice
• Whole grain breads and cornbread
• Wheat germ

Other foods:

• Chocolate, cocoa
• Caramel
• Beer
• Carbonated colas
• Dried fruit
• Molasses
• Pizza

Phosphorus content of carbonated beverages:

Potassium

Some people with kidney disease may need to limit their potassium intake.  In fact, some medicines, (i.e. lisinopril or enalapril) may be prescribed to help preserve kidney function, but may have a side effect that causes high potassium levels.  Your doctor or dietitian will tell you if your potassium level is too high or too low.  Some control of your potassium level can be made through your dietary intake.

The foods that contain the most potassium are the foods high in protein (dairy products and meats), fruits and vegetables.  Most salt substitutes also contain potassium and should be avoided.  Be sure to check the labels on “low sodium” or “low salt” foods and avoid those using potassium salts.

The following tables list fruits and vegetables that contain low, medium, and high amounts of potassium.  Your dietitian will tell you how many servings from each group you may have if potassium is a concern in your diet.

(serving sizes are ½ cup unless otherwise noted.)

These foods have less than 150 milligrams potassium (or 4 milliequivalents) per choice.

Apple juice

Applesauce

Apple, med, w/o skin

Apricots, canned

Blackberries

Blueberries

Boysenberries

Cranberries

Cranberry sauce

Cranberry juice

Figs, canned

Fruit cocktail, canned

Gooseberries

Grapes, canned or fresh

Lemon, 1 medium

Lime, 1 medium

Nectars: peach, pear, or apricot

Mandarin oranges

Peaches and pears, canned

Pear, fresh, 1 medium

Pineapple, raw or canned

Plums, canned

Raspberries

Rhubarb

Strawberries

Tangerine

Bean sprouts

Beans, green or wax

Broccoli, fresh or boiled

Cabbage

Cauliflower

Celery, 1 stalk, fresh

Cucumber

Eggplant

Greens, raw, cooked: collard, dandelion, kale, mustard, turnip

Hominy

Leeks

Lettuce: cos, romaine, iceberg, leaf, endive, watercress

Mushrooms

Onion: green, red, yellow, white

Peas, green

Peppers, sweet or hot

Potatoes, soaked**

Squash: summer, spaghetti

Radishes, fresh

Turnips

Water chestnuts

**Instructions for soaking potatoes:  Peel the potato, cut into ¼ inch slices and soak in 10 times the amount of water to the amount of potato for at least 2 hours.  Discard the water and cook until tender in 5 times the amount of water.

(Choice sizes are ½ cup unless otherwise noted.)

These foods have 150-250 milligrams of potassium (4-6.5 milliequivalents) per choice.

Apple-1 medium with skin

Apricots, fresh—2 medium

Casaba, cubed

Cherries—15 fresh or canned

Figs, fresh—2 medium

Grape juice, canned

Grapefruit—1/2 medium

Grapefruit juice

Orange, 1 medium

Orange juice, frozen, concentrate

Peach, fresh—1 medium

Pineapple juice

Plums, fresh—2 medium

Watermelon, 1 cup, cubed

Artichoke hearts, boiled

Brussels sprouts

Carrots

Cauliflower

Corn, canned or 1 small ear

Garbanzo beans

Greens, frozen, cooked: kale, turnip

Mixed vegetables

Okra

Peas, green

Summer squash: yellow, crookneck, white scallop

(Choice sizes are for ½ cup unless otherwise noted.)

These foods have more than 250 milligrams potassium (more than 6.5 milliequivalents) per choice.

Avocado—1/2 fruit

Banana—1/2 medium

Cantaloupe, ¼ medium

Dried fruits: apricots, dates, figs, prunes, raisins

Kiwi fruit, 1 medium

Mango, 1 medium

Nectarine, 1 medium

Prune Juice

Tangelo 

Artichoke, 1 medium

Asparagus, raw, cooked

Beets, beet greens

Dried beans and peas: kidney, lima, navy, pinto, black eyed peas, split peas

Kohlrabi

Okra, raw, cooked

Potato:  baked, boiled or fried and unsoaked

Pumpkin

Rutabaga, cooked

Spinach

Sweet potato or yams

Tomato, fresh or canned

Unsalted tomato juice

Unsalted vegetable juice

Winter squash: acorn, butternut, hubbard

The calories that you eat should be adequate to maintain or achieve a proper body weight. If your weight is below what has been determined “normal” for you, adding extra foods to your meals from these groups is suggested. These foods provide calories but are practically free of protein, potassium, sodium, and phosphorus.

(45 calories per serving)

• 1 teaspoon margarine, butter, shortenings
• 1 teaspoon mayonnaise, cooking oils
• 1 tablespoon salad dressings
• 2 tablespoons sour cream or liquid creamer
• 1 tablespoon powdered creamer
• ¼ cup whipped topping
• 1.5 oz. non-dairy milk substitute

(50 calories per serving)

• 1 tablespoon honey and jellies
• 1 tablespoon sugar
• 5 lifesavers
• ½ oz. jelly beans
• ½ oz hard candy
• ½ oz. gum drops
• 2-3 marshmallows (large)
• 1 tablespoon syrup (corn or maple)