Kidney Diet Tips

“Limiting” Vs. “Avoiding” Foods

Diet recommendations for people with kidney disease can be confusing. Does everyone need to restrict potassium and phosphorus? What’s the right amount of protein and fluid? The most important thing to keep in mind is that every person has different diet needs. Diet varies with stage of kidney disease; however, there is not a one-size-fits-all solution for any one stage of kidney disease. Additional considerations include blood test results, appetite, number of meals or snacks eaten per day, and how much the kidneys are functioning.

In this post, we’ll look at two nutrients that have a significant impact in a kidney diet: potassium and phosphorus. We’ll also explore the difference between “limiting” and “avoiding” foods that are high in potassium or phosphorus.

“Limit” vs. “Avoid”

Many food lists created to help educate people on a kidney-friendly diet include an “avoid” list. It can be challenging when a person sees their favorite food on that list. Looking at these lists as “foods to limit” as opposed to “foods to avoid altogether” may reduce some anxiety around meal choices. After all, it seems unrealistic to think a person will never have cheese or a tomato again. 

Limiting Potassium and Phosphorus

Potassium is a mineral that plays an important role in muscle control. Monitoring potassium in kidney disease is important because if the blood levels are too high, it can cause cardiac arrest.

Phosphorus is a mineral that’s important for bone health. It also functions in how our body produces energy. When phosphorus gets too high, it can start to harden soft tissues like blood vessels over time.

However, you can still enjoy foods that are high in potassium and phosphorus by limiting them instead of avoiding them.

Tips for Limiting Instead of Avoiding

  • Kidney-friendly recipes may contain ingredients that are high potassium or phosphorus. This may cause you to wonder why it’s in the recipe. Including small amounts of “limit” food in a recipe can enhance flavor and enjoyment without exceeding goals for a kidney-friendly recipe.
  • Many foods are labeled as “limit.” This means that you can take a food that is high in potassium or phosphorus and slim the portion down. For example, if a recipe calls for 1 cup of cheese and makes 6 servings, the amount of cheese in one portion is only 1/6th cup of cheese—less than 1 ounce. This is an example of how a food high in a certain nutrient can be enjoyed in moderation.
  • Portion control and how often you eat the food is always important when choosing to have a higher-potassium or higher-phosphorus food.
  • Double-boil potatoes and other high-potassium vegetables to reduce potassium content.
  • Choose lower-potassium foods to balance out the higher-potassium food. For example, combine rice with beans.
  • With high-potassium foods, moderation is key. Choose one to two days in the week when you plan to eat a higher-potassium food or meal, then balance out the rest of the week with lower-potassium choices.
  • Instead of having a whole portion, split a higher-potassium or high-phosphorus food with a friend or family member.

Fruits to Avoid

There are certain foods that can be dangerous for people on a kidney diet to have.

  • Orange juice is very high in potassium. One cup has 443 mg of potassium. It is very easy to drink more than one glass, which is why dietitians generally advise against drinking orange juice. Another example of a very high-potassium drink is coconut water, with 404 mg potassium per 1 cup.
  • Grapefruit has interactions with certain medications, so it may be best to avoid this fruit altogether. Check with your pharmacist to find out if you need to avoid grapefruit because of any drugs you take.
  • Starfruit, also known as carambola, is a fruit that is on the list to avoid completely. This fruit contains neurotoxins that cannot be removed from the body when kidneys do not work.

If you feel like your care team’s diet recommendations are general and not individualized, talk with your dietitian or doctor. They can help you tailor your kidney-friendly diet to what you enjoy most.

For more information on limited foods read “Including High Phosphorus Foods in a Low Phosphorus Diet” and “Potassium Control Tips for a Healthy Life“.

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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.

Jackie Termont, RD

Jackie Termont, RD

Jackie has been a dietitian since 2007, and has been dedicated to renal nutrition since 2008. For two years she was the editor for the Renal Nutrition Forum, a publication for the Renal Practice group of the Academy of Nutrition and Dietetics. She enjoys baking, crafting, spending time with her sons and husband, and being active. She loves to experiment and come up with new recipes.