For people living with chronic kidney disease (CKD), nutrition plays a powerful role in protecting kidney function and maintaining overall health. Beyond taking prescribed medications, the choices made in the kitchen can either support or strain vulnerable kidneys. Among the many dietary options available, the DASH (Dietary Approaches to Stop Hypertension) diet is widely recognized for its heart health benefits and potential to reduce kidney disease risk. But for those already diagnosed with CKD, adopting this eating plan isn’t always straightforward. While the DASH diet encourages nutrient-rich foods, certain elements—like high potassium and phosphorus—may require modification to avoid complications.*

Basics and Benefits of the DASH Diet

Originally developed to help control blood pressure, the DASH diet has proven benefits for cardiovascular and kidney health. Recommended by the National Heart, Lung, and Blood Institute (NHLBI), it emphasizes whole foods rich in essential nutrients while minimizing unhealthy fats, sodium, and added sugars.

The diet includes generous portions of:

• Fruits and vegetables
• Low-fat dairy
• Lean proteins like fish and poultry
• Beans, nuts, and seeds
• Whole grains and healthy oils
  

It is designed to be high in calcium, magnesium, potassium, and fiber—all of which support cardiovascular function and can indirectly benefit the kidneys by lowering blood pressure. Some of these nutrients, however, particularly potassium and phosphorus, typically must be consumed in moderation by people in moderate to advanced stages of CKD.

The DASH Diet and CKD

While studies suggest that the DASH diet can slow CKD progression—especially in people who also have hypertension or diabetes—it’s not a one-size-fits-all solution. A 2019 study found that individuals with moderately severe CKD who followed the DASH diet saw reduced risk of kidney failure. Yet, the diet’s naturally high potassium and phosphorus content can be problematic when kidney function declines.

People with CKD often need to limit these minerals to avoid complications, because:

• Potassium overload can cause irregular heart rhythms or cardiac arrest, and 
• Excess phosphorus can lead to calcium depletion in bones, increasing the risk of fractures.
  

As such, healthcare providers often advise modifying the DASH diet to restrict high-potassium and high-phosphorus foods, especially for those not on dialysis. Patients undergoing dialysis require a completely tailored dietary plan and should not follow the standard DASH guidelines.

Nutrient Limits and Practical Tips

Adapting the DASH diet for CKD involves careful nutrient management. Potassium-rich foods like bananas, tomatoes, potatoes, spinach, and citrus fruits may need to be reduced or rotated. Similarly, high-phosphorus items such as dairy, meats, legumes, and processed foods are often limited.

Tips for a CKD-friendly DASH adaptation:

• Choose fruits and vegetables lower in potassium (e.g., apples, berries, green beans).
• Use herbs and spices instead of salt to flavor food.
• Select low-sodium and low-phosphorus products, and read labels carefully.
• Work with a registered dietitian to tailor food choices to your lab values and kidney function.
  

While the DASH eating plan offers a solid framework for improving heart and kidney health, individual adjustments are essential for those managing CKD. Partner with your healthcare provider to ensure that you reap the benefits without putting your kidneys at further risk.

*Chauhan, V. (2024, July 1). Using the DASH Diet for Kidney Disease. Verywell Health. https://www.verywellhealth.com/dash-diet-for-kidney-disease-does-it-work-part-1-of-2-2085845 

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