Kidney Diet Tips

USDA’s new Chose My Plate and your kidney diet

Last week a new diet tool to help guide people toward healthier eating, called My Plate, was unveiled by the United States Department of Agriculture (USDA). The website, ChooseMyPlate.gov, provides detailed information on five Food Groups (Grains, Vegetable, Fruit, Dairy, and Protein Foods) including which foods are in each group, how much is needed each day, what counts as a serving and health benefits and nutrients. Visually, a plate divided into sections shows how much food from the food groups to fill your plate.

If you have chronic kidney disease or you are on dialysis, your needs are different from a person on a normal, healthy diet, so some of the recommendations do not apply to your kidney diet. However, there are some great tips that you can use to choose the best foods on a renal diet. Although you may feel your diet has many restrictions, there are still many healthy foods for a kidney diet you can choose that will make a difference in your health.

The Food Groups from My Plate are included below with my comments related to following a kidney diet. In the future you will see this new plate tool used in a variety of ways to help people eat healthy. Even on a kidney diet there’s a wealth of information to help in making sure you are eating healthy despite the restrictions of a kidney diet.

Grains

The Grains Group includes whole grains and refined grains. A healthy diet emphasizes whole grains, but these are limited if you are restricting phosphorus and potassium. However, refined grains which are recommended for kidney diets are enriched; this means some of the B vitamins (folic acid, thiamin, riboflavin and niacin plus iron) lost in processing are added back. Fiber is lost but is not added back. The phosphorus in whole grains is absorbed 40% to 60% compared to phosphate additives in processed foods that are nearly 100% absorbed. For this reason you may be able to include some whole grains and still maintain a normal phosphorus level. Work with your dietitian if you decide to make  diet changes, as they can help monitor your lab results and response to new food additions.

Vegetables

The Vegetable Group is divided into dark green vegetables, red and orange vegetables, starchy vegetables and beans and peas. There are equal amounts of high potassium and low potassium vegetables in the food list so even on a low potassium diet you have plenty of choices.  Vegetables provide fiber, plus phytochemicals that protect against heart disease and cancer.  Vegetables are a good source of folate, vitamin C and vitamin A. Beans and peas are very high in potassium and phosphorus, so these may be limited in your renal diet. Your individual kidney diet meal plan may recommend fewer servings than shown, to help you keep potassium levels normal. This is especially important if you are on hemodialysis or you have problems with high potassium levels. If you have chronic kidney disease and do not need to restrict potassium, the higher potassium vegetables may help with blood pressure control.

Fruits

The Fruit Group lists commonly eaten fruits, combining high potassium and low potassium fruits and juices.  Like vegetables, eating fruit gives you added protection against heart disease and cancer. Fruits are high in vitamin C, folate and fiber. All fruit contains potassium, so if you are on a potassium restricted diet refer to your kidney diet plan as a guide for how many servings and which fruits are low potassium choices. If you are on peritoneal dialysis you may need to include some of the high potassium fruits to prevent low potassium levels.

Dairy

The Dairy Group includes milk, cheese, yogurt and desserts made with milk.  Dairy foods provide calcium, potassium, phosphorus, protein and vitamin D. The recommended 3 cups a day for a healthy diet provides way too much potassium and phosphorus for a kidney diet. Most renal dietitians advise limiting foods from the dairy group to 1/2 cup or one small serving, especially for patients on dialysis or those with high potassium or phosphorus levels. While milk products do contribute to bone health in people without kidney disease, dialysis patients or non-dialysis chronic kidney disease patients may have imbalances of calcium and phosphorus, and require a special active vitamin D prescribed by their kidney doctor. Too much dairy can cause high levels of phosphorus and calcium, and must be limited or avoided.

Protein Foods

The Protein Foods Group contains meats, poultry, eggs, seafood, nuts and seeds, and beans and peas, including soy foods. Protein foods provide high quality protein, which is essential for all kidney patients whether you are on a low protein diet or a high protein diet. In addition to high quality protein, this group provides niacin, thiamine, riboflavin, and B6, vitamin E, iron, zinc, and magnesium. Lean proteins and fish high in Omega-3 fats are great choices for a healthy kidney diet. Foods in the nuts and seeds list and the beans and peas list are very high in potassium and phosphorus, and may be restricted on your kidney diet.

For more information on the different kidney diets, you can find these articles on DaVita.com:

The chronic kidney disease non-dialysis diet

The diabetic dialysis diet

The hemodialysis diet

The peritoneal dialysis diet

The transplant diet

Kidney diet resources from DaVita.com

Sara Colman, RD, CDE

Sara Colman, RD, CDE

Sara is a renal dietitian with over 20 years experience working with people with diabetes and kidney disease. She is co-author of the popular kidney cookbook "Cooking for David: A Culinary Dialysis Cookbook". Sara is currently the Manager of Kidney Care Nutrition for DaVita. She analyzes recipes and creates content, resources and tools for the kidney community. In her spare time Sara loves to spend time with her young grandson, including fun times together in her kitchen.