Chronic kidney disease (CKD) refers to kidney damage that occurs slowly over many years.

Diabetes and high blood pressure are two of the largest risk factors for developing CKD.

Managing the disease often requires medication and changes to your diet.

This article explains what CKD is, and provides a food list of what to eat and what to limit on a chronic kidney disease diet.

chronic kidney disease diet

What is chronic kidney disease?

CKD is the progressive deterioration of your kidney function over time.

Your kidneys remove wastes and extra fluids from your body, and help maintain a proper balance of minerals — such as sodium, phosphorus, potassium — in your blood.

These key functions, however, are compromised if you have CKD.

Based on the degree of damage, there are five stages of CKD, which can range from mild damage in stage 1 to total kidney failure in stage 5.

The higher the stage, the more changes you’ll have to make to your diet to manage the disease and prevent or reduce further health complications.

Nutrition for chronic kidney disease

You may be able to prevent or delay some health complications of CKD by limiting your intake of protein, sodium, phosphorus, and potassium.

Work with a registered dietitian to develop a meal plan tailored to your individual nutrition needs and preferences.

Protein and calories

While a high-protein diet is safe in people with normal kidney function, people with CKD may benefit from consuming less protein (1, 2, 3).

Consuming too much protein can put excess strain on damaged kidneys that healthy kidneys would otherwise be able to handle.

In people with moderate to severe CKD, limiting protein to 0.6-0.8 grams/kg of body weight per day may help delay further kidney decline (4).

This translates to 49-65 grams of protein for a 180-pound person.

Conversely, if you require dialysis due to stage 5 CKD, or end stage renal disease (ESRD), you should consume more protein to replace protein that is removed during dialysis (5).

In either case, make sure to consume enough calories each day to ensure protein isn’t being wasted and used for energy.

Consume high-quality sources of protein, but make sure to watch your portion size.

High-quality protein sources include:

  • Meat: Beef, venison, and pork.
  • Poultry and eggs: Chicken, turkey, goose, and duck.
  • Fish: Salmon, tuna, herring, cod, and tilapia.
  • Dairy: Milk, yogurt, and cheese.

Plant products such as grains, grain products, legumes, and vegetables also contain protein.

Sodium and fluids

Eating less sodium — otherwise known as salt — can help control your blood pressure, which when too high, can damage your kidneys.

Severe sodium restriction, however, is not necessary, and may actually cause more harm than good.

You should limit your daily sodium intake to 2,300 mg (2.3 grams) or less — the equivalence of one teaspoon of salt.

This is the same amount of sodium recommended for the general population.

Tips for reducing sodium in your diet include:

  • Buy fresh, frozen, or canned vegetables with no added salt or sauce.
  • Avoid cured, salted, smoked, and other processed meats such as hot dogs, lunch meats, and bacon.
  • Use alternatives such as garlic powder, citrus juice, or spices with cooking.
  • Limit sauces, mixes, and “instant” products, such as flavored rice and ready-made pasta.

In addition to sodium, fluids are also commonly restricted — typically to 1,500-2000 mL per day.

Fluids, however, should only be limited if you require dialysis or have hyponatremia, a condition that occurs when you have low levels of sodium in your blood (6).

Phosphorus and potassium

With advanced stages of CKD, you may need to limit the minerals phosphorus and potassium in your diet.

These minerals may build-up in your blood when your kidneys aren’t functioning properly, which may weaken your bones or cause heart problems.

Generally, you will want to limit phosphate to 800-1,000 mg and potassium to 2,400 mg per day.

Limit phosphorus in your diet by:

  • Choosing foods with low levels of phosphorus (limit or avoid foods that have “PHOS” listed in the ingredients).
  • Eating fruits and vegetables that are lower in potassium.
  • Avoiding dark-colored soda or switching to light-colored soda.
  • Limiting your portions of meat, poultry, fish, and dairy products.

Potassium is found predominately in fruits and vegetables.

Choose fruits and vegetables that are lower in potassium such as:

  • Fruits: Apples, berries, grapes, melon, lemons, limes, mangoes, pears, peaches, plums, pineapple, and watermelon.
  • Vegetables: Bell peppers, broccoli (fresh), cabbage, carrots, corn, cucumber, green beans, kale, lettuce, and mushrooms (fresh).

Fruits and vegetables that are higher in potassium that you will want to limit include:

  • Fruits: Apricots (fresh), bananas, cantaloupe, nectarines, kiwi, oranges, and raisins.
  • Vegetables: Avocado, baked beans, beets, broccoli (cooked), mushrooms (cooked), potatoes, pumpkin, spinach (cooked), sweet potatoes, and vegetable juice.

Your doctor may also prescribe you medications called binders that are taken with food to reduce the absorption of phosphorus or potassium from food, allowing for a more liberalized diet (6).

The bottom line

CKD is long-standing progressive decline in kidney health.

You can prevent or reduce some of the health complications of moderate to severe CKD by limiting the amount of protein, sodium, phosphorus, and potassium in your diet.

A registered dietitian can make individualized nutrition recommendations based on your specific needs and health status.

Gavin Van De Walle, MS, RD
Gavin Van De Walle, MS, RD

Gavin Van De Walle, MS, RD is a registered dietitian with a master's of science in human nutrition and bioenergetics. Gavin specializes in nutrition for older adults and regulations surrounding long-term care as they relate to food and nutrition.