Kidney Diet Tips


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Fighting Phosphorus with Kidney-Friendly Mac & Cheese Recipes

Macaroni and cheese is a family favorite! It is a comfort food that many have grown up on, and continues to be a go-to food. Let’s be honest, for some of us at one point in our lives this may have been the only food we would eat!

Following a kidney diet can be very difficult, as many of the foods we know and love are either slimmed down to much smaller portions, or even cut out in order to limit our intake of nutrients like phosphorus and potassium. Mac & cheese is usually considered a no-no due to the high phosphorus content in the cheeses used, such as cheddar, American cheese, or processed cheese product. Don’t despair! We can work this one out!

Every month, I prepare a recipe from in the attempt to give my patients back
the foods that have been “taken away”. In April, we tried Creamy Shells with Peas and Bacon. This recipe is essentially a renal-friendly mac & cheese, with the addition of peas and bacon (which are also normally limited on a renal diet). The preparation was extremely simple, and the patients loved it!


In this recipe, the normally high phosphorus cheeses have been swapped out with high protein, lower phosphorus cheese options. The substitutions in this recipe come in the tasty form of part-skim ricotta cheese and grated Parmesan cheese which combined provided for a nice creamy texture and bold flavor. Many of the patients were surprised to see that bacon was part of the recipe. Bacon tends to be high in sodium, and contains additives that contribute to the potassium and phosphate content. In this recipe, you only use three slices of bacon for eight servings. This allows you to have the flavor of the bacon, without overdoing it in the nutrients of concern.

The Shopping & Prepping

The ingredients were easy to find at multiple grocery stores and preparing this recipe was extremely simple! There was very little preparation, and for most of the time, you just stir ingredients together!

I would definitely recommend going with a brand name part-skim ricotta cheese. The first time I made this recipe, I used a store brand option, and the sauce turned out to be a little “cottage cheesy.” The second time I prepared the recipe, I used a name brand option, and the sauce came out much smoother!


I served this recipe to the patients as a hot dish and most everyone enjoyed it. Some patients thought it would be just as tasty if served as a chilled pasta salad. I tried it at home, and it was good chilled, but I would consider modifying the recipe a little if you were going to serve it cold. Perhaps, omit the butter, and stir the cooked onions and cheeses together. Allow the cheese mixture and pasta to cool separately, then stir them together and serve.

Additions & Substitutions

This recipe is great on its own, but may be even better with some additional items such as grilled chicken or shrimp to add some more protein.

Similar Recipes from

In addition to Creamy Shells with Peas and Bacon, try one of these kidney-friendly macaroni and cheese recipes:

Joseph Ewing, RD, LDN

Joseph Ewing, RD, LDN

Joseph Ewing, RD, LDN is a renal dietitian with DaVita, a freelance dietitian and a personal chef in addition to being a co-author of four cook books. Among them is the "Feed Your Athlete: A Cookbook to Fuel High Performance". Joseph has degrees in culinary nutrition and culinary arts from Johnson and Wales University and completed a dietetic internship program at the University of Maryland. Joseph has over a decade of experience in the culinary nutrition industry.