Nutrition for chronic kidney disease (CKD) patients

Woman on a bike with healthy food in the basket

If you are diagnosed with CKD, following a well-balanced nutrition is of much higher importance and can even help in delaying the progress of the disease.

During the early stages of CKD, a healthy diet includes a variety of grains, especially whole grains, fresh fruits and vegetables. Remember, your body needs sufficient energy to function properly.

The main part of your energy supply should be derived from carbohydrates and fats, but please make sure to lower the ratio of saturated fat and cholesterol - choose unsaturated fat and oils instead (e.g. olive oil and fish).

One essential change to your diet may be the limitation of your protein intake. This will help to preserve your kidney function and reduce the amount of undesired substances in your blood. Especially high in protein are meat, fish, chicken, eggs and dairy products.

As long as your urine output is normal, you do not need to limit your fluid intake. Nevertheless the intake of sodium should be restricted. Salt binds water, and so your body also needs more liquids as a consequence. Sodium is mainly found in table salt and convenience food (e.g. sausages, canned food, frozen pizza), but also for example bread, cheese and ham contain salt. Try to replace table salt with herbs and spices and cook with fresh produce wherever possible.

As CKD progresses you may need to further adapt your diet: Later stages require a stricter reduction of your protein intake from a low protein to a very low protein diet. Eventually Amino-/Keto-Acid-supplementation can be useful for you, as the protein intake is not high enough to cover your body’s needs. Your nephrologist or dietician will inform you about your needs and prescribe the right supplement.

As soon as you notice a decrease in your urine output or swelling of ankles and feet it is time to also reduce your fluid intake. Your nephrologist or dietician will support you in calculating the right amount of your daily fluid intake. Remember: Salty food makes you thirsty!

Since potassium can now accumulate more quickly in your body, uptake should be reduced to prevent elevated levels that can lead to heart arrhythmias.

High in potassium are:

  • Fruit and fruit juice (bananas, dried fruits, grapes, avocado)
  • Vegetables (spinach, potatoes, broccoli, tomatoes and other dark green leafy vegetables)
  • Nuts/almonds  
  • Whole grain products  
  • Milk and milk products  
  • Salt substitutes 

Here are some simple tips to help you reduce your potassium intake:

  • You can remove some of the potassium from potatoes and other vegetables by peeling, cutting and soaking them in a large container of water for several hours. Replace the water before cooking!
  • Cooking reduces the potassium content of fruit and vegetables; use larger amounts of water
  • Use canned fruits (without the liquid) or frozen fruits and vegetables.  

If your phosphate levels are elevated, you should reduce your intake of phosphate rich foods.

High in phosphate are:

  • Dairy products  
  • Meat
  • Fish 
  • Whole grain products
  • Beans and lentils  
  • Nuts/almonds  
  • Dark chocolate/cocoa  
  • Soft drinks (e.g. Cola) and beer

Supplementation of certain vitamins or minerals might be useful. Please consult your physician or dietician to recommend a suitable product. Some over-the-counter preparations could be harmful for a person with CKD.

Please keep in mind that it is important to have your nutritional status checked regularly, particularly in the later stages of chronic kidney disease, when the risk of protein-energy-malnutrition and fluid overload increases. Consult your nephrologist or dietitian if you have any questions and follow their advice

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