What should I eat with chronic kidney disease?

Eating the right foods is important for growth and health. However, this can be difficult when you have problems with your kidneys as you may feel sick and have a poor appetite.

Your dietitian may advise you to limit certain foods and drinks in your diet to help manage the potassium and phosphate levels in your blood, and to improve any symptoms you may be experiencing.

Please read the sections below to learn more about the specific dietary advice for kidney disease.

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Heathy eating advice for those with early stage CKD

This short video provides basic information about healthy eating for those with early-stage kidney disease. Please note that if you have been advised to follow specific dietary restrictions e.g. a low potassium or a low phosphate diet, then the sections below titled "Potassium" and "Phosphate" will be more suitable for you.

Energy

Everyone needs energy from food to grow and be active. We get energy from food. When a person is feeling unwell they may not be able to get all the energy they need. This can lead to feeling tired and losing weight. To stay strong and continue growing, a person with CKD may need to include high calorie foods, drinks and additional snacks to get enough energy. Your dietitian will help you know what's best for you.

Protein

Protein is found in foods such as meat, fish, eggs, cheese, milk, yogurt, nuts and beans. It is essential to eat enough protein to grow. But it is also important to not eat too much protein as this can put extra pressure on the kidney's. Your dietitian will help guide you on how much protein you need to eat.

Potassium

Potassium is a mineral we need from food to keep the heart beating and muscles working properly. If the kidneys aren't working well, potassium levels in the body can become too high and this is not healthy for the heart. Your dietitian will advise on what foods are low or high in potassium and how to follow a low potassium diet. For example, avoiding certain foods such as chocolate, or processed foods containing potassium additives, may be advised. Choosing low-potassium snacks such as apples or plain cookies may instead be encouraged.

What is a low potassium diet?

Getting Enough Fibre Following a Low Potassium diet

Phosphate

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Phosphorus is a mineral we need from food that has a role in controlling the amount of calcium in the bones. When phosphorus levels in the blood are measured, it is known as phosphate. If the kidneys aren't working well, phosphate levels in the body can become too high and this can cause weak bones, or affect blood vessels. This can also affect the blood vessels. Your dietitian will advise on how to follow a low phosphate (phosphorus) diet. Phosphate additives can also be added into many processed foods and drinks to keep products fresher for longer. The best way to reduce the intake of phosphate additives is to choose fresh foods over processed items. It may also be possible to find alternative products which do not contain phosphate additives. Reading and comparing labels and ingredient lists on packaging can help with this. Your dietitian will explain how to do this.

Dairy foods are high in phosphorus. If an individual is following a low phosphate diet and really loves milk, the dietitian may suggest a daily allowance. This includes all sources of dairy, including drinks of milk, milk added to tea or to cereal.

All food and drink contains some phosphorus. Even when high phosphorus foods are avoided, some phosphorus is still in your food and drink. To help keep blood phosphate levels under control, the doctor may prescribe a medication called a phosphate binder. This medication acts as a magnet and binds to the phosphorus you eat to reduce how much is absorbed into the blood. This is a very important medication that should be taken as prescribed by your health care team.

What is a low phosphate diet?

Getting Enough Fibre Following a Low Phosphate diet

Salt

Salt is in lots of foods.

As kidney function decreases, eating too much salt can lead to water building up in the body - most often the legs. This can become swollen and uncomfortable and is referred to as oedema. Your dietitian will advise on how to limit foods containing a lot of salt.

What is a low salt diet?

Fluid

If the kidneys can't remove excess fluid from the body, oEdema and high blood pressure may result. A daily fluid allowance may be advised to limit fluid intake and manage edema and fluid overload.

Managing a fluid allowance

Vitamin D and calcium

We get most of our vitamin D from the sun and some from our diet. Vitamin D helps the body to absorb and use calcium. One job of the kidneys is to activate Vitamin D in our body. If the kidneys are not working well, Vitamin D is not activated and this can lead to weak bones. Sometimes a Vitamin D supplement may be recommended by your healthcare team to help keep your bones strong and healthy.

Summary

Learning what to eat and drink with kidney disease can be a lot to take in! A specialist dietitian will help you to understand what changes can be made to the diet. Play our game to help you learn the dietary basics!

Want to learn more about the important work the kidneys do for you? Check out this video.

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Useful websites

Information sourced from:
National Kidney Foundation. KDOQI Clinical Practice Guideline for Nutrition in Children with CKD: 2008 Update. American Journal of Kidney Diseases. 2009;53(S2):S1-S124.
Royle J. Chapter 12: Kidney Disease. In: Shaw V, editor. Clinical Paediatric Dietetics. 4: John Wiley & Sons Ltd.; 2015. p. 242-81.
https://www.infokid.org.uk/
https://www.kidneyresearchuk.org/health-information/resources/the-kidneys-a-basic-guide