Diet for Chronic Kidney Disease (Before Dialysis): Care Instructions

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When you have chronic kidney disease, you need to change your diet to avoid foods that make your kidneys worse. You may need to limit salt, fluids, and protein. You also may need to limit minerals such as potassium and phosphorus. A diet for chronic kidney disease takes planning. A dietitian who specializes in kidney disease can help you plan meals that meet your needs.

These guidelines are for people who are not on dialysis. Talk with your doctor or dietitian to make sure your diet is right for your condition. Do not change your diet without talking to your doctor or dietitian.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Work with your doctor or dietitian to create a food plan.
  • Do not skip meals or go for many hours without eating. If you do not feel very hungry, try to eat 4 or 5 small meals instead of 1 or 2 big meals.
  • If you have a hard time eating enough, talk to your doctor or dietitian about ways you can add calories to your diet.
  • Do not take any vitamins or minerals, supplements, or herbal products without talking to your doctor first.
  • Check with your doctor about whether it is safe for you to drink alcohol.

To get the right amount of protein

  • Ask your doctor or dietitian how much protein you can have each day. Most people with chronic kidney disease need to limit the amount of protein they eat. But you still need some protein to stay healthy.
  • Include all sources of protein in your daily protein count. Besides meat, poultry, fish, and eggs, protein is found in milk and milk products, beans and nuts, breads, cereals, and vegetables.

To limit salt

  • Read food labels on cans and food packages. The labels tell you how much sodium is in each serving. Make sure that you look at the serving size. If you eat more than the serving size, you will get more sodium than what is listed on the label.
  • Do not add salt to your food.
  • Buy foods that are labeled "no salt added," "sodium-free," or "low-sodium." Foods labeled "reduced-sodium" and "light sodium" may still have too much sodium.
  • Limit processed foods, fast food, and restaurant foods. These types of food are very high in sodium.
  • Avoid salted pretzels, chips, popcorn, and other salted snacks.
  • Avoid smoked, cured, salted, and canned meat, fish, and poultry. This includes ham, bacon, hot dogs, and luncheon meats.
  • You may use lemon, herbs, and spices to flavor your meals.

To limit potassium

  • Choose low-potassium fruits such as applesauce, pineapple, grapes, blueberries, and raspberries.
  • Choose low-potassium vegetables such as lettuce, green beans, cucumber, and radishes.
  • Choose low-potassium foods such as pasta, noodles, rice, tortillas, and bagels.
  • Limit or avoid high-potassium foods such as milk, bananas, oranges, cantaloupe, potatoes, spinach, tomatoes, broccoli, and sweet potatoes.
  • Do not use a salt substitute or lite salt unless your doctor says it is okay. Most salt substitutes and lite salts are high in potassium.

To limit phosphorus

  • Follow your food plan to know how much milk and milk products you can have.
  • Limit nuts, peanut butter, seeds, lentils, beans, organ meats, and sardines.
  • Avoid cola drinks.
  • Avoid bran breads or bran cereals.

If you need to limit fluids

  • Know how much fluid you can drink. Every day fill a pitcher with that amount of water. If you drink another fluid (such as coffee) that day, pour an equal amount of water out of the pitcher.
  • Count foods that are liquid at room temperature as fluids. These include ice, gelatin, ice pops, and ice cream.

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.