Knowing what to eat, when to eat it, and why are some of the most frustrating aspects of living with chronic kidney disease (CKD). Online searches too often result in volumes of confusing and conflicting information. Renal dietitian, kidney expert, and director of Cukebook, Lauren Budd Levy recently sat down with Jessica Finch, Responsum’s Community Relations Manager, to help guide CKD patients through those murky waters. Here are her meal-planning guidelines for optimal nutrition with CKD.*

Nutrition goals

Nutritional goals can be different depending on whether you are on dialysis, not yet on dialysis, or post-transplant. If you are not yet on dialysis, then the goal is to practice a healthy lifestyle and prevent disease progression, avoiding the need to ever start dialysis. If you have already begun dialysis, then the goal is to maintain your remaining kidney function. The right diet can help you do that.

Understanding nutrition in CKD

When crafting your diet plan, some main considerations–besides your personal tastes and preferences–will be how much and what types of the following nutrients you consume:

• Sodium. Good for nerve function, muscle contraction, and fluid balance, but too much of it can raise your blood pressure to dangerous levels
• Potassium. Also good for nerve function and muscle contraction, as well as heart rhythm regulation, but too much can cause nausea, numbness, and weakness
• Protein. Necessary to build muscle, produce enzymes and hemoglobin, and maintain bones, hair, and skin, but too much in the wrong phase of CKD can stress your kidneys 
• Phosphorus. Helps build strong teeth and bones, but over the long term, high levels have been linked to CKD progression, bone disease, and hardening of the arteries

Planning ahead

Eating out

If you’re wondering whether or not you can still eat out when you have CKD, Budd Levy says, the answer is yes! She recommends taking one or more of these simple steps to ensure what will hopefully be both a safe and satisfying experience for you.

• If going to a restaurant:
  • Choose food made to order, rather than fast food.
  • Look up the menu online beforehand, to avoid hurried decisions.
  • Don’t eat the complimentary bread served before the meal.
  • Ask for sauce and gravy to be served on the side.
  • Opt for oil and vinegar for your salad.
  • Choose plain, steamed veggies or fresh fruit.
  • Drink plenty of water before you go, to control your appetite. 
  • Consider splitting an entrée with your dining companion, if you have one.
• If going to an event at a family member’s or friend’s house:
  • Bring a batch of something that you can eat.
  • Eat before you go, so that you’re less tempted to eat what’s served.
  • Bring a healthy snack that you can keep in your pocket or purse.

Eating at home

Budd Levy also has suggestions for simplifying meal-planning at home. First, she says, aim for a ‘balanced plate’. A balanced plate consists roughly of:

• 50% fruits and vegetables
• 25% protein
• 25% whole grains

To make the ever-present question “What can I eat?” easier to answer, Budd Levy recommends planning for the week by thinking in terms of batch-cooking, make-aheads, and freezables, of which a portion can be eaten right away and the rest put aside for meals later in the week, to give you some variety without anxiety. These might include:

• Overnight oats
• Rice and beans
• Falafel
• Veggie burgers
• Jar salads
• Hummus

The structure of planning ahead has many benefits, she says, but it’s best to not be too rigid.

“Give yourself some grace,” she encourages viewers. “Don’t forget to enjoy your food, and enjoy yourself.”

Watch the full interview for more tips and resources.

*Responsum Health. (2023, July 31). Navigating Nutrition for Chronic Kidney Disease [Video File]. YouTube. https://www.youtube.com/watch?v=fu9NvN1HeOQ

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