• Brussels sprouts
• Butternut squash
• Chinese cabbage
• Dried beans
• French fries
• Kohlrabi
• Legumes
• Lentils
• Lima beans
• Mushrooms, cooked
• Okra
• Parsnip
• Potatoes
• Pumpkin
• Refried beans
• Spinach, cooked
• Swiss chard
• Tomatoes
• Turnips
• Vegetable juices
*Serving size is ½ cup unless otherwise indicated.
Phosphorus
Phosphorus is another essential mineral that the body needs. Most of the phosphorus in our bodies is found in the bones. Phosphorus helps us build strong bones and teeth, create energy, and produce hormones.
In the later stages of CKD, you may need to limit your phosphorus intake since the kidneys are not able to filter excess amounts out. Too much phosphorus can lead to bone disease and increase your risk of cardiovascular events. However, just like all the other nutrients, everyone’s needs are different. You will want to closely monitor your labs and work with your dietitian and nephrologist to find out what your specific needs may be. A normal blood phosphorus level is between 2.7 and 4.6 mg/dl.
Phosphorus is found in almost all foods. We tend to absorb less phosphorus from plant-based than animal-based foods. Phosphorus used as a food additive is almost 100 percent absorbed by our bodies. Phosphate additives are commonly used in fast foods, ready-to-eat convenience foods, sodas, beverages, and enhanced meats—all of which are highly processed foods.
If your phosphorus levels are elevated, your doctor may prescribe a phosphorus binder that you need to take with meals to help you get rid of excess phosphorus.
PHOSPHORUS CONTENT IN COMMON FOODS*
LOW PHOSPHORUS
(< 150 mg/serving)
MEDIUM PHOSPHORUS
(151–250 mg/serving)
HIGH PHOSPHORUS
(> 251 mg/serving)
• Apple
• Bagel, 1 plain (4-inch diameter)
• Barley, pearled, cooked
• Beans, green
• Bread, pita, 1 (6.5-inch diameter)
• Bread, pumpernickel, 2 slices
• Bread, white, 2 slices
• Butter, 1 tablespoon
• Beans, black, 1 cup
• Beans, fava, 1 cup
• Beans, kidney, 1 cup
• Beans, pinto, 1 cup
• Beef, bottom round, 3 ounces
• Beef, chuck roast, 3 ounces
• Beef, eye round, 3 ounces
• Beef, ground, 70% lean, 3 ounces
• Beef, ground, 95% lean, 3 ounces
• Almonds, oil/dry roasted, 2 ounces
• Baked beans, 1 cup
• Beans, small white, mature, boiled, 1 cup
• Beef, liver, cooked, 3 ounces
• Beefalo, 3 ounces
• Buttermilk, 1 cup
• Calamari, fried, 3 ounces
• Cabbage
• Cauliflower
• Cereal, crispy rice, 1 cup
• Cheese, Brie, 1 ounce
• Cheese, feta, 1 ounce
• Cocoa, unsweetened, 2 tablespoons
• Cookies, shortbread, 4
• Cornflakes, 1 cup
• Cottage cheese, nonfat
• Couscous, cooked
• Cream cheese, 1 ounce
• Cucumber
• Duck, with skin, 3 ounces
• Egg white, 1 large
• Egg yolk, 1 large
• Eggplant
• English muffin, 1 plain
• Figs
• Gelatin, water base
• Ginger ale, 1 can
• Grapefruit
• Grapes
• Grouper
• Hominy grits
• Ice cream, 10% fat, vanilla
• Lettuce
• Milk, soy, 1 cup
• Oatmeal, cooked, 1 packet
• Onions
• Oysters, canned, 3 ounces
• Oysters, raw, Pacific, 3 ounces
• Beef, sirloin steak, 3 ounces
• Black-eyed peas, 1 cup
• Bread, whole-wheat, 2 slices
• Catfish, breaded/fried, 3 ounces
• Cheese, blue, 2 ounces
• Cheese, Cheddar, 1 ounce
• Cheese, mozzarella, 1 ounce
• Cheese, provolone, 2 ounces
• Cheese, Swiss, 1 ounce
• Chicken, breast, 3 ounces
• Chicken, dark meat, 3 ounces
• Chickpeas, 1 cup
• Chocolate, plain, 2 ounces
• Cod, Pacific, 3 ounces
• Cottage cheese, 1% fat
• Cottage cheese, 2% fat
• Crab, blue, cooked with moist heat, 3 ounces
• Crab, Dungeness, cooked with moist heat, 3 ounces
• Lamb, kebabs, domestic, 3 ounces
• Lamb, leg roast, domestic, 3 ounces
• Lamb, New Zealand, 3 ounces
• Lobster, cooked with moist heat, 3 ounces
• Macadamia nuts, 3 ounces
• Cashews, dry roasted, 2 ounces
• Cereal, bran, 100%
• Cereal, wheat-germ, ¼ cup
• Cheese, goat, 2 ounces
• Cheese, Parmesan, 2 ounces
• Cheese, ricotta, part skim
• Cheese, Romano, 2 ounces
• Chia seeds, 1 ounce
• Chicken, liver, cooked, 3 ounces
• Clam chowder, New England
• Clams, cooked with moist heat, 3 ounces
• Corn bread, 1 piece
• Crab, Alaska king, cooked with moist heat, 3 ounces
• Custard, flan, 1 cup
• Flounder, 3 ounces
• Halibut, Atlantic/Pacific, 3 ounces
• Lentils, mature, boiled, 1 cup
• Milk, 1%, 1 cup
• Milk, chocolate, 1 cup
• Milk, evaporated, nonfat
• Milk, nonfat, 1 cup
• Milk, whole, 1 cup
• Mussels, blue, cooked with moist heat, 3 ounces
• Nuts, Brazil, 2 ounces
• Nuts, pine, 2 ounces
• Pasta, 1 cup
• Peas, split, mature, boiled
• Plums
• Popcorn, air-popped, 1 cup
• Pork, spare ribs, 3 ounces
• Radishes
• Rice cakes, 1 cake
• Rice, white, enriched, cooked
• Sherbet
• Shrimp, cooked with moist heat, 3 ounces
• Sour cream
• Tofu, soft
• Wheat flour, white, 1 cup
• Milk, canned, sweetened, condensed, ¼ cup
• Mushrooms, cooked, 1 cup
• Mussels, raw, blue, 3 ounces
• Peanut butter, 2 tablespoons
• Pork, boneless loin chop, 3 ounces
• Pork, leg roast, 3 ounces
• Raisin Bran, 1 cup
• Raisins, seedless, 1 cup
• Rice, brown, cooked, 1 cup
• Shredded Wheat, 1 cup
• Shrimp, breaded/fried, 3 ounces
• Snapper, 3 ounces
• Spinach, raw
• Tortilla, 2 corn or flour (6-inch diameter)
• Turkey, breast, 3 ounces
• Turkey, dark meat, 3 ounces
• Veal, rib roast, 3 ounces
• Wheat flakes, 1 cup
• Oysters, Eastern, cooked with moist heat, 3 ounces
• Peanuts, boiled, 1 cup
• Peanuts, dry roasted, 3 ounces
• Peanuts, oil roasted, 2 ounces
• Pecans, oil/dry roasted, 3 ounces
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• Salmon, canned, pink/red, 3 ounces
• Sardines, canned in oil, 3 ounces
• Scallops, breaded/fried, 3 ounces
• Sole, 3 ounces
• Soybeans, mature, boiled
• Sunflower seeds, 1 ounce
• Swordfish, 3 ounces
• Tofu, raw, firm
• Tuna, light, canned in oil, 3 ounces
• Tuna, white, canned in oil, 3 ounces
• Veal, cubed, stewed, 3 ounces
• Walnuts, English, 2 ounces
• Wheat flour, whole-grain, 1 cup
• Yogurt, low-fat
• Yogurt, skim
*One serving = ½ cup unless otherwise indicated.
Eat More of the Good Stuff
The kidney-friendly diet requires that you pay attention to certain nutrients to avoid overworking your kidneys and causing more damage to the body. While you may have to monitor or be more mindful of certain nutrients, there are other foods that you can and should incorporate more of into your diet.
Healthy Carbohydrates and Whole Grains
Carbohydrates provide your body with the energy it needs to function properly. Glucose, which is a carbohydrate, is the preferred source of fuel for our brains. There are different types of carbohydrates—starches, sugars, and fiber—and all types can be a part of a healthy diet.
When including carbohydrates in your diet, it is important to include whole grains. In the past, whole grains were not recommended for those with kidney disease because of their high phosphorus content. However, newer research has found that the phosphorus in whole grains is not broken down and absorbed as easily in the human body. Whole grains are those that have been harvested in their complete form and includes the endosperm, bran, and germ of the grain. Because whole grains are minimally processed, they provide a ton of nutrients, including fiber, vitamins, and minerals. Examples of whole grains include oats, barley, quinoa, popcorn, and brown rice. When choosing your carbohydrates, be sure to read the back of the package where the food ingredients are listed to find the words “whole wheat” or “whole grain.” Be careful of the claims on the front of the package, because they can be misleading.
It is recommended that at least half of your carbohydrates come from whole-grain sources. If you are using the plate method to prepare your meals, a quarter of your plate should consist of healthy carbohydrates.
CARBOHYDRATES AND DIABETES
When you have diabetes, being consistent with your carbohydrate intake is very important. Many people think that having diabetes means that you have to cut out carbohydrates. However, this is far from the truth. As I mentioned, carbohydrates provide you with energy and they are essential for your body to work properly and efficiently. When you have diabetes, you still need carbohydrates to function. You will want to make sure to monitor how many carbohydrates you eat and be sure to include healthy whole grains in your diet. Remember that controlling your blood sugar is important when you have CKD. Work closely with your dietitian and doctor to figure out the specific amount of carbohydrates you should eat daily to meet your blood sugar goals.
Fruits and Vegetables
Fruits and vegetables are an important component of a renal diet. I’m sure your internet search so far on the renal diet has scared you into thinking you can’t eat a lot of them due to the potassium content. Remember, potassium is generally not restricted for those with CKD unless indicated. Work closely with your nephrologist and renal dietitian to ensure that you are following the plan that is best for you. Fruits and vegetables have so many health benefits—they provide fiber, vitamins, and minerals. They can also help with weight management and lowering your blood pressure. Because of their numerous health benefits, fruits and vegetables don’t put as much stress on your kidneys as other foods, such as animal proteins, so it’s a good idea to include them in your diet. Try to fill half of your plate with fruits and vegetables—a colorful plate indicates a wide variety of nutrients.
If you do need to watch out for potassium, pay attention to the high/low potassium foods list (here) and make sure to keep track of your intake using the daily food log tracker (here).
HIGH-FIBER FOODS
Fiber is especially important for those with CKD, because as kidney function declines, your ability to get rid of toxins decreases. Fiber helps with your gut health, which in turn can help you get rid of some of the toxins that are building up in your body. Low fiber intake is correlated with increased inflammation and an elevated risk of heart disease. The standard American diet is generally low in fiber, which is not good for your overall health. The recommended daily fiber intake for women under 50 years old is >25 grams per day and older than 51 years old is >21 grams per day. Men under 50 years old need >38 grams of fiber per day and older than 51 years old need >28 grams per day.
Whole grains, fruits, and vegetables are examples of high-fiber foods, so be sure to include these good things in your diet. Some kidney-friendly options include jicama, eggplant, kale, chickpeas, berries, plums, chia seeds, flaxseed, and whole-grain cereals.
FIBER CONTENT IN COMMON FOODS*
FRUITS
VEGETABLES
GRAINS
PROTEINS
• Apple, 1 medium, 4g
• Avocado, ½ medium, 4.5g
• Banana, 1 medium, 3g
• Blackberries, 4g
• Blueberries, 2g
• Cherries, 1.5g
• Grapes, 7.5g
• Jicama, 3g
• Pear, 1 medium, 6g
• Raspberries, 4g
• Strawberries, 1.5g
• Broccoli, cooked, 2.5g
• Brussels sprouts, cooked, 3g
• Cauliflower, cooked, 2.5g
• Collard greens, cooked, 2.5g
• Kale, cooked, 1.5g
• Mustard greens, cooked, 2.5g
• Peas, frozen, 7g
• Spinach, cooked, 2g
• Spaghetti squash, 1.5g
• Sweet potato, 1 medium, 4g
• Swiss chard, cooked 2g
• Zucchini, 1.5g
• Barley, pearled, cooked, 3g
• Brown rice, cooked, 2g
• Oats, dry, 4g
• Popcorn, air-popped, 3 cups, 4g
• Quinoa, cooked, 2.5g
• Wasa crispbread, 2 slices, 4g
• Whole-wheat bread, 1 slice, 2g
• Whole-wheat pasta, cooked, 3g
• Wild rice, cooked, 1.5g
• Almonds, 1 oz, 4g
• Black beans, 7.5g
• Broad beans, 4.5g
• Chickpeas, 6g
• Edamame, 3g
• Kidney beans, 8g
• Lentils, 8g
• Mung beans, 7.5g
• Navy beans, 9.5g
• Peanuts, 1 oz, 2g
• Pinto beans, 7.5g
• Pumpkin seeds, 3g
• Sunflower seeds, ¼ cup, 3g
• Walnuts, 1 oz, 2g
• White beans, 9.5g
*One serving = ½ cup, unless otherwise indicated.
Healthy Fats
Fat is another macronutrient that has a bad reputation. For many years, many people thought that eating fat makes you fat. However, this is not the case. Fat is a macronutrient that you need, and it should compose 20 to 35 percent of your daily calorie intake. Fat helps promote normal functioning of the brain and nervous system, maintain cholesterol levels, and reduce inflammation, all of which are important in CKD. When including fats in your diet, you want to limit your intake of “bad” fats (aka saturated and trans fats) and choose “good” fats (aka unsaturated fats).
Sources of saturated fats include hydrogenated oils, animal proteins, cheese, butter, and whole- or reduced-fat milk dairy products.
Sources of unsaturated fats include fatty fish such as salmon, walnuts, chia seeds, eggs, olive oil, avocadoes and avocado oil, and peanut butter.
It is recommended to use olive
oil or avocado oil when cooking or making dressings, sauces, and marinades. Also, unsalted nut butters or a proper serving of nuts as a snack is a delicious way to get some healthy fats in your diet. Fat is calorie dense, so a little goes a long way.
Other Things to Keep in Mind
While diet is a crucial component of managing your kidney disease, there are other factors that you should also pay attention to for your overall health and wellness.
Medications: Be sure to let your nephrologist know about all the medications you are taking. There may be some medications that are not compatible with your kidneys depending on what stage of CKD you are at. You also want to make sure that you are taking all appropriate medications as prescribed by your doctor. Any time you have a change in medications by any healthcare practitioner, it is a good idea to let your nephrologist and dietitian know.
Vitamins and minerals: There are some vitamins and minerals that are not appropriate for those with CKD and may build up to a toxic level in your body. What vitamin and mineral supplements you can or cannot take depends on what stage you are at and how well your kidneys are functioning. Be sure to tell your nephrologist and dietitian about what supplements you are taking so that they can make adjustments as needed.
Quit smoking: It is no secret that smoking is dangerous to the human body. For many years, the US surgeon general and CDC have warned the public about the negative effects that smoking has on every part of the body, including the kidneys and the advancement of CKD. Smoking damages the cardiovascular system, causes increases in blood pressure and heart rate, and reduces blood flow to the kidneys. If you smoke, it’s important to quit.
Exercise: It is recommended that adults partake in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week. Everyone should engage in regular physical activity unless otherwise indicated by a doctor or other healthcare professional. Exercise is very important especially if you have CKD. It can help you maintain a healthy weight, improve your blood pressure and blood sugar, build strength and endurance, and even aid your sleep. Choose exercise activities that you enjoy and are appropriate for your age, physical condition, and abilities.
Nutritional Needs by Stage
CKD nutritional needs usually vary based on a person’s current stage of kidney disease. Everyone is different, however, and your healthcare practitioner may adjust your needs based on your current age, weight, labs, and overall health condition.
Renal Diet Cookbook for Beginners: 75 Simple Recipes to Help Manage Chronic Kidney Disease Page 3
