Kidney Diet Tips

Salt: a hidden danger for people with kidney disease

A high salt intake is even more damaging to your health than eating too many calories, too much cholesterol or even smoking. That’s because eating too much sodium can cause high blood pressure and can interfere with the effectiveness of your blood pressure medications. Uncontrolled blood pressure is the leading cause of strokes and heart attacks. For kidney patients on dialysis, salt not only increases blood pressure, it contributes to thirst and makes removal of fluid from your body more difficult.

A recent article from Nutrition Action, health newsletter by the Center for Science in the Public Interest (CSPI), lists additional health dangers from eating too much salt. These include:

  • left ventricular hypertrophy, thickening of the left side of the heart that leads to heart failure
  • stiff arteries that contribute to early heart disease
  • increased protein in the urine for people who have kidney damage
  • osteoporosis linked to increased calcium loss in the urine

All of these are significant if you have kidney disease becaue people with chronic kidney disease (CKD) have much higher rates of both heart and bone disease.

Normal blood pressure is 120/80 or lower and high blood pressure is 140/90. Numbers in-between these ranges indicate pre-hypertension, a sign that a person is developing high blood pressure. Once you are diagnosed with high blood pressure, your treatment goal is to keep blood pressure as close to normal as possible. Following a low sodium diet will help you reach this goal.

On average, American women consume 3000 mg sodium a day and men consume 4000 mg. Studies show that high blood pressure medications are more effective if salt intake is reduced. How much? The new goal is 1500 mg or less sodium a day. Compare this to the old goal of 2400 mg or less and even dietitians start to question how you can achieve this level. The answer? Turn to the restaurants and food manufacturers and demand more accountability for the amount of salt and sodium added to your food. You get 75-80 % of your salt intake from what’s added to food during processing and preparation.

The desire for salt is acquired, and it’s easy to retrain your taste for salt. Pick some of these guidelines to start decreasing your salt intake along with lowering your risk for stroke, heart attack and further kidney damage.

  • Read labels and select the lowest sodium foods. Look for ‘No Salt Added’, ‘Low Sodium’, ‘Unsalted’ and ‘Reduced Sodium’ products.
  • Minimize the use of condiments, seasonings and flavorings added to food—often an additional 500 mg of sodium is added.
  • Experiment with herbs, spices and low sodium seasonings. In addition to salt, your taste buds respond to sweet, bitter, sour and savory (umami). Try lemon, vinegar, fruits, citrus zest and chilies to add flavor to food.
  • Expand your cooking skills and eat home prepared meals more often. In addition to giving you control over sodium, you will save money on your food bill.
  • If you order take-out or use a higher sodium packaged food, try adding fresh or frozen vegetables or unsalted pasta, couscous or rice to reduce sodium per serving and increase the number of servings.
  • Rework your favorite recipes to reduce high sodium ingredients and try new lower sodium recipes to add to your collection.
  • Ask for nutrition information for fast food, take out and restaurant meals so you are informed about how much sodium you are getting.

Instead of……………………………………………………. Try this
Ready to eat dry cereals                                                Farina, cream of rice, grits or puffed cereals
Regular canned vegetables                                           Unsalted canned, fresh or frozen vegetables
 Plumped or enhanced meats                                        Fresh meats without injected ingredients                              

Commercially made salad dressings                         Homemade salad dressings
Deli sandwich meats                                                         Fresh cooked chicken or roast beef
Processed cheese                                                               Natural, unprocessed cheese
Salted chips, pretzels                                                        Unsalted chips, pretzels,
Salted crackers                                                                    Low sodium crackers
Tuna canned in salt                                                            Unsalted canned tuna

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Sara Colman, RDN, CDCES

Sara Colman, RDN, CDCES

Sara is a renal dietitian with over 30 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 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.