Kidney Diet Tips

Fluid Balance and Fruits & Vegetables

For people with end stage kidney disease (ESKD) on hemodialysis, it can be challenging to keep the body hydrated without becoming “fluid overloaded.” Drinking too much fluid can lead to serious health problems such as high blood pressure, cramping during dialysis, swelling of the feet, legs, hands and face and heart problems (1). At the same time, most people on a kidney diet need to include 2 to 3 servings of fresh fruit (1/2 cup or 1 small fruit) and 2 to 3 servings of vegetables (1/2 cup raw, cooked or frozen) each day that provide essential fiber, vitamins and minerals (2).

How to Balance Fluid Intake with Fruits and Vegetables Intake

How do you know how much fluid is a safe amount to drink? Most people on hemodialysis who do not urinate (pee) need to consume 32 fluid ounces daily.

If you still make urine, measure the total daily amount by collecting your urine for 24 hours. Add the total amount of your urine output to the 32 fluid ounces. For example, if you urinate 16 ounces for the whole day, you can drink a total of 48 fluid ounces per 24 hours. Make sure to include fluid (liquid) beverages such as water, coffee, tea and juice as well as foods that melt at room temperature such as frozen desserts, gelatin and ice.  Even though fresh fruits and vegetables contain water, it is not necessary to restrict them from your diet.

Include a variety of fresh fruits and vegetables in your daily diet. For most people eating a variety of fresh fruits and vegetables does not lead to fluid overload. In fact, restricting fruits and vegetables in an effort to manage fluid intake has more harmful effects and health benefits.

Here is an approximate guide to account for the fluid content in certain vegetables (3):

Vegetable (1 cup) Water
Tomatoes 6 ounces
Zucchini 6 ounces
Cabbage 5 ounces
Okra 5 ounces
Celery 3.4 ounces
Broccoli 3 ounces
Green bell pepper 3 ounces
Lettuce < 1 ounce

Here is another guide to account for the fluid content in certain fruits (4):

Fruit (1 cup) Water
Grapefruit* 7 ounces
Cantaloupe 5.6 ounces
Oranges 5.5 ounces
Mangoes 5 ounces
Peaches 5 ounces
Papaya 4.5 ounces
Blackberries 4.5 ounces
Nectarines 4.4 ounces
Apples 3.8 ounces

If you have questions about how many fruits and vegetables to include in your specific kidney diet, talk with your renal dietitian. They can help you plan healthy and safe amounts of fruits and vegetables to enjoy. *Be sure to speak with your doctor or pharmacist to see if you are on any medications that could interact with grapefruit.






Additional Kidney Diet Resources

Visit and explore these diet and nutrition resources:

DaVita Food Analyzer

DaVita Dining Out Guides

Today’s Kidney Diet Cookbooks

DaVita Kidney-Friendly Recipes

Diet and Nutrition Articles                                                      

Diet and Nutrition Videos

Kidney Smart® Virtual Classes

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.

Dawn Johnson, MS, RDN, LD

Dawn Johnson, MS, RDN, LD

Dawn Johnson MS, RDN, LD knew she wanted to be a dietitian when she was 18 years old. Now practicing over 20 years, Dawn has worked in various settings with a focus in renal nutrition over 12 years. She is passionate about addressing, examining and resolving people’s ambivalence for change. Dawn resides in Highland, Indiana with her husband and 2 young children. During her personal time, she likes to run, visit her local library and volunteer at church.