Renal Diet Basics

What type of food plan should I follow if I have kidney disease?

People with kidney disease may need to control these important nutrients: sodium, potassium and phosphorus. Please discuss your specific and individual diet needs with your healthcare provider or the registered dietitian at your dialysis center. Here are some tips to follow for a renal diet.

What should I know about sodium and salt if I follow a renal diet?

Sodium is a mineral found in salt (sodium chloride). It’s widely used to prepare foods.

Salt is one of the most commonly used seasonings. It’ll take time for you to get used to reducing the salt in your diet. However, reducing salt/sodium is an important tool in controlling your kidney disease.

Here are some suggestions.

1. Don’t use salt when cooking food.
2. Don’t put salt on food when you eat.
3. Learn to read food labels. Avoid foods that have more than 300mg sodium per serving (or 600mg for a complete frozen dinner). Avoid foods that have salt in the first four or five items in the ingredient list.
4. Don’t eat ham, bacon, sausage, hot dogs, lunch meats, chicken tenders or nuggets, or regular canned soup. Only eat reduced-sodium soups that don’t have potassium chloride as an ingredient (check the food label.) Also, only eat 1 cup, not the whole can.
5. Choose only canned vegetables that say “no salt added” on the label.
6. Don’t use flavored salts such as garlic salt, onion salt, or seasoned salt. Don’t use kosher or sea salt.
7. Be sure to look for lower salt or no salt added options for your favorite foods such as peanut butter or box mixes.
8. Don’t purchase refrigerated or frozen meats that are packaged in a solution or those that have been flavored or pre-seasoned. These items can include boneless chicken and bone-in chicken pieces, turkey breast, whole turkeys, steaks, roasts, burgers, pork tenderloin and pork chops.

What should I know about potassium if I follow a renal diet?

Potassium is a mineral involved in how muscles work. When your kidneys don’t work properly, potassium builds up in your blood. This can cause changes in how your heart beats and possibly even lead to a heart attack.

Potassium is found mainly in fruits and vegetables, as well as milk and meats. You’ll need to avoid certain fruits and vegetables and limit the amount of others.

Potassium-rich foods to avoid

These include:

• Melons such as cantaloupe and honeydew. (Watermelon is OK.)
• Bananas.
• Oranges and orange juice.
• Avocado.
• Prune juice.
• Tomatoes, tomato sauce and tomato juice.
• Dried beans — all kinds.
• Pumpkin and winter squash.
• Cooked greens, spinach, kale, collards and Swiss chard.
• Broccoli and Brussels sprouts.
• Nuts and nut butters.

You should also avoid:

• Bran cereals and granola.
• Salt substitutes or “lite” salt.
• Molasses.

Canned fruits

Canned fruits usually have lower amounts of potassium than fresh ones. Be sure to pour off the juice before you eat the fruit.

Potatoes and sweet potatoes

Potatoes and sweet potatoes need special handling to allow you to eat them in small amounts. Peel them, cut them into small slices or cubes and soak them for several hours in a large amount of water.

When you're ready to cook them, pour the soaking water off and use a large amount of water in the pan. Drain this water before you prepare them to eat.

What should I know about phosphorus in my diet if I follow a renal diet?

Phosphorus is another mineral that can build up in your blood when your kidneys don’t work properly. When this happens, calcium can be pulled from your bones and can collect in your skin or blood vessels. Bone disease can then become a problem, making you more likely to have a bone break.

Tips to limit phosphorus in your diet

Dairy foods are the major source of phosphorus in the diet, so limit milk to 1 cup per day. If you use yogurt or cheese instead of liquid milk, have only one container of yogurt or 1.5 ounces of cheese per day.

Some vegetables also contain phosphorus. Limit these to 1 cup per week:

• Dried beans.
• Greens.
• Broccoli.
• Mushrooms.
• Brussels sprouts.

Certain cereals should be limited to 1 serving per week. These are:

• Bran.
• Wheat cereals.
• Oatmeal.
• Granola.

White or Italian bread and low-salt crackers made with white flour have less phosphorus than whole-grain bread and crackers.

Soft drinks contain phosphorus, so only drink clear ones. Don’t drink Mountain Dew® (any kind), colas, root beers, Dr.Pepper® (any kind). Also, avoid Hawaiian Punch®, Fruitworks®, Cool® iced tea, and Aquafina® tangerine pineapple.

Beer also has phosphorus. Avoid all kinds.

A note from Cleveland Clinic

We all need to pay attention to what we eat. If you have kidney disease, following a renal diet gives you more control over how you feel. Work with your providers and dietitian because you’re the most important part of your healthcare team.