Smart Dietary Choices for Persons Managing Kidney Issues

When the kidneys are not working normally, waste products build up in the bloodstream. Making smart dietary choices will reduce the amount of waste that builds up in the bloodstream. The following information can help you make informed dietary choices to slow the progression of kidney disease.


People with kidney disease must limit the amount of fluid in their diets because when the kidneys are no longer functioning properly, fluids accumulate in the body, which can cause swelling of the hands, legs and feet and difficulty breathing.


Although protein is a necessary nutrient, when the kidneys are not functioning properly, excess protein starts to build up in the blood. People with kidney disease should consume no more protein than is needed by the body. When treatment was started early, a low protein diet and a balanced formula of essential amino acids at each meal has been shown to delay the time to dialysis and even reverse some kidney problems.

Vitamins and Minerals

People with kidney disease may require vitamin supplements to help avoid some common side effects of kidney failure, like bone disease or anemia, but these should be taken only as directed by a doctor.


Excessive amounts of sodium in the diet can cause the body to retain fluids, raise blood pressure and make the heart work harder. Sodium consumption should be limited to 2 grams per day. Avoid foods that contain large amounts of salt such as:

  • Canned food
  • Processed meat and smoked meat
  • Pickled foods like olives and pickles
  • Nuts
  • Chips, crackers or pretzels
  • High-sodium condiments like soy sauce, BBQ sauce or ketchup

WARNING! Be careful with salt substitutes and “reduced sodium” foods, as many salt substitutes are high in potassium.


Potassium is a mineral found in almost all foods. The body requires some potassium to make the muscles work, but during dialysis, potassium levels must be very closely monitored. Having too much or too little potassium can cause muscle cramps, irregular heartbeat and muscle weakness. A dietitian can help determine how much potassium is best for an individual.

EAT THIS… (lower-potassium foods)

  • Apples, cranberries, grapes, pineapples and strawberries
  • Cauliflower, onions, peppers, radishes, summer and zucchini squash, lettuce
  • Pita, tortillas and white bread
  • Beef and chicken
  • White rice

RATHER THANK THIS… (higher-potassium foods)

  • Avocados, bananas, melons, oranges, prunes and raisins
  • Artichokes, kale, plantains, spinach, potatoes and tomatoes
  • Bran products and granola
  • Beans (baked, black, pinto, etc.)
  • Brown or wild rice


Phosphorus, a mineral found in many foods, works with calcium and vitamin D to keep bones healthy. During dialysis, phosphorus can build up in the blood, and too much phosphorus can lead to weak bones that break easily. A dietitian can help determine how much potassium is best for an individual.

EAT THIS… (lower-phosphorus foods)

  • Italian, French and sourdough bread
  • Rice cereals and cream of wheat
  • Unsalted popcorn
  • Light-colored sodas or lemonade
  • White rice

RATHER THAN… (higher-phosphorus foods)

  • Whole grain bread
  • Bran cereals and oatmeal
  • Nuts and sunflower seeds
  • Dark-colored sodas
  • Brown or wild rice

WARNING! Potassium and phosphorus do not have to be listed on a nutrition facts label. Check the package ingredients list for other clues:

  • Foods high in potassium might list the ingredient potassium chloride or KCl.
  • Foods high in phosphorus might have the words phosphate or phosphoric somewhere in the ingredient list.

CareWorks Health Services understands the specific care and dietary needs of older adults with kidney disease, and can assist with chronic disease care and meals at home. Contact CareWorks Health Services today to learn more about the ways in-home care can help effectively manage kidney disease and other chronic illnesses.

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Sources: American Kidney Fund, Free MD, Walser M, Hill S Can renal replacement be deferred by a supplemented very low protein diet? J Am Soc Nephrol 1999 Jan;10(1):1106