Kidney Diet Tips

The Reality of Following Your Kidney Diet: Thoughts from the Renal Dietitian

I’ve noticed some confusion around what to include and exclude on the renal diet for dialysis and chronic kidney disease, especially when it comes to including some of the higher sodium, phosphorus or potassium containing foods. In today’s post I want to give you my thoughts on the realistic side of following a kidney diet and diet goals.Managing a chronic disease, whether it’s kidney disease, diabetes, celiac disease, cardiovascular disease or other conditions, means adopting necessary diet changes. Some changes are easy while others involve self-denial and are more difficult. Still, the kidney meal plan you follow must be practical and not take away all the pleasures associated with eating. If your plan is so restricted you cannot enjoy social events that include food, or enjoy a restaurant meal occasionally, it’s time to rethink what you are doing and why. If your plan is too restrictive it becomes impossible to follow and you may give up on it instead of managing your food intake over the long run.

The first goal of your kidney diet is to help manage minerals, fluid and waste that the kidney can no longer remove. How restricted depends on your stage of kidney disease. As a person approaches stage 4 (severe loss of kidney function) CKD or stage 5 CKD pre-dialysis (end stage kidney disease), diet management becomes more difficult with more limits than for earlier stages 1, 2 or 3 CKD. In earlier stages when the kidneys still have moderate to good function, it is not necessary to follow a ‘how low can you go’ diet. For example, if your prescription is for 50 grams of protein, dropping down to 30 grams may be doable but it may also rob you of important amino acids and other nutrients your body needs to function well. Your body may have to breakdown your own muscle and organs to supply the essential protein you are no longer getting from food.

In the case of potassium, if you have normal blood values and your kidneys still remove adequate potassium through the urine, a restriction below your prescribed 2000 or 3000 mg potassium diet may do your body more harm than good. Adequate potassium intake aids in blood pressure control; an unnecessary very low potassium diet can actually contribute to higher blood pressure and cause other problems. Potassium containing foods like fruits and vegetables also give your body vitamins, minerals and phytochemicals essential for preventing oxidation and inflammation. Eating a certain amount of potassium-containing foods is essential to good health, even with chronic kidney disease.

A second kidney diet goal for people with chronic kidney disease is to preserve kidney function for as long as possible. Limits on protein and phosphorus, keeping blood pressure controlled with a low sodium diet and medications, and managing blood glucose and fats all can help protect existing kidney function. Putting these items into a practical meal plan is work, but it if delays or keeps you off dialysis, it is worth the effort.

Thirdly, there are individual goals such as weight loss or gain, eliminating foods or ingredients that cause harm to the body, and managing conditions specific to you. The kidney diet becomes even more challenging when you combine it with these individual ‘non-kidney’ diet goals. In some cases you must decide which foods are most important to meet your goals and which ones just do not work for you to realistically follow your plan.

Food for thought this week as you think about your own kidney diet and which goals are important to you. Remember, regardless of the diet, food is meant for nourishment and enjoyment and you must have a plan that will provide both to be happy and healthy.

Check in next week to read my thoughts about the different mind sets that help you stay on track with your kidney or dialysis diet.

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.

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.