Diet and Lifestyle Changes

People with kidney disease can continue to live productive lives: working, enjoying friends and family, and staying physically active. You may need to make some changes to your diet and lifestyle to help you live a healthier and longer life. Because heart attack and stroke are more common among people with kidney disease, these changes are good for your heart and for your kidneys.

Lifestyle Changes

Following a healthy lifestyle is good for people with kidney disease, especially if you have diabetes, high blood pressure, or both. Talk with your dietitian, diabetes educator, or other health care professional about which actions are most important for you to take. As you will see, many of these actions are related.

• Keep your blood pressure at or below the target set by your health care provider. Aim for less than 1,500 milligrams (mg) of sodium each day.
• If you have diabetes, control your blood glucose level. Good blood glucose control may help prevent or delay diabetes complications, including kidney disease.
• Keep your blood cholesterol in your target range. Diet, being active, maintaining a healthy weight, and medicines can all help control your blood cholesterol level.
• Take medicines the way your provider tells you to.
• If you smoke, take steps to quit. Cigarette smoking can make kidney damage worse.
• Get or become more active. Physical activity is good for your blood pressure, as well as your blood glucose and blood cholesterol levels.
• Lose weight if you are overweight. Being overweight makes your kidneys work harder. Losing weight helps your kidneys last longer.

Diet Changes

What you eat and drink may help slow down kidney disease. Some foods may be better for your kidneys than others. Most of the salt and sodium additives people eat come from prepared foods, not from the salt shaker. Cooking your food from scratch gives you control over what you eat.

Your provider may suggest you see a dietitian. A dietitian can teach you how to choose foods that are easier on your kidneys. You will also learn about the nutrients that matter for kidney disease. See factsheets about sodium, protein, phosphorus, potassium, and how to read food labels.

The steps below will help you eat right as you manage your kidney disease. The first three steps (1-3) are important for all people with kidney disease. The last two steps (4-5) may become important as your kidneys become more damaged.

Step 1: Choose and prepare foods with less salt and sodium.

Why? To help keep your blood pressure at a healthy level. Aim for less than 1,500 milligrams of sodium each day.

• Buy fresh food more often. Sodium (a part of salt) is added to many packaged foods.
• Use spices, herbs, and sodium-free seasonings in place of salt.
• Check the Nutrition Facts label on food packages for sodium. A Daily Value of 20% or more means the food is high in sodium.
• Try lower-sodium versions of frozen dinners and other convenience foods.
• Rinse canned vegetables, beans, meats, and fish with water before eating.
• Do not use salt substitutes.

Look for Food Labels that Say

Sodium free l Salt free l Very low sodium l Low sodium l Reduced or less sodium l Light in sodium l No salt added l Unsalted l Lightly salted

Step 2: Eat the right amount and the right types of protein.

Why? To help protect your kidneys.

• Eat small portions of protein foods.
• Protein is found in foods from plants and animals. Talk to your dietitian about how to choose the right combination for you.

Animal-protein foods

Chicken, Fish, Meat, Eggs, Dairy

Plant-protein foods

Beans, Nuts, Grains

Step 3: Choose foods that are healthy for your heart.

Why? To protect your blood vessels, heart, and kidneys.

• Bake, roast, stew, grill, broil or stir-fry foods instead of frying
• Cook with nonstick cooking spray or a small amount of olive oil instead of butter.
• Trim fat from meat and remove skin from poultry before eating.

Heart-healthy Foods

• Lean cuts of meat, like loin or round
• Poultry without the skin
• Fish
• Beans
• Vegetables
• Fruits
• Low-fat milk, yogurt, cheese

As your kidneys become more damaged, you may need to eat foods that are lower in phosphorus and potassium. Your health care provider will use lab tests to watch your levels.

Step 4: Choose foods with less phosphorus.

Why? To help protect your bones and blood vessels

• Many packaged foods have added phosphorus. Look for phosphorus — or for words with “PHOS” — on ingredient labels.
• Deli meats and some fresh meat and poultry can have added phosphorus. Ask the butcher to help you pick fresh meats without added phosphorus.

Foods Lower in Phosphorus

• Fresh fruits and vegetables
• Breads, pasta, rice
• Rice milk (not enriched)
• Corn and rice cereals
• Light-colored sodas/pop

Foods Higher in Phosphorus

• Meat, poultry, fish
• Bran cereals and oatmeal
• Dairy foods
• Beans, lentils, nuts
• Colas

Step 5: Choose foods that have the right amount of potassium.

Why? To help your nerves and muscles work the right way—if potassium is too high or too low, your nerves and muscles will not work normally.

• Salt substitutes can be very high in potassium. Read the ingredient label for potassium chloride. If you need to limit potassium, choose foods that don't have added potassium chloride. Do not use salt substitutes. Drain canned fruits and vegetables before eating.

Foods Lower in Potassium

• Apples, peaches
• Carrots, green beans
• White bread and pasta
• White rice
• Rice milk (not enriched)
• Cooked rice and wheat cereals, grits

Foods Higher in Potassium

• Oranges, bananas
• Potatoes, tomatoes
• Brown and wild rice
• Bran cereals
• Dairy foods
• Whole wheat bread and pasta
• Beans and nuts

Having kidney disease also means you may need to change what you drink.

Water

Most people don't benefit from drinking when they are not thirsty unless they have kidney stones. Drink as much water as you normally do.

Soda and other drinks

If you are told to limit phosphorus, choose light-colored soda (or pop), like lemon-lime, and homemade iced tea and lemonade. Dark-colored sodas, fruit punch, and some bottled and canned iced teas can have added phosphorus.

Juice

If you are told to limit potassium, drink apple, grape, or cranberry juice instead of orange juice.

Alcohol

You may be able to drink small amounts of alcohol. Drinking too much can damage the liver, heart, and brain and cause serious health problems. Talk to your provider first.