For people with chronic kidney disease (CKD), the biggest challenge often revolves around diet and nutrition. The renal (kidney) diet can be difficult to understand, as restrictions and recommendations often vary depending on the stage of CKD. At different times, your doctor may recommend restricting your intake of foods containing sodium, potassium, phosphorus, and/or protein. Learn more about common foods you may need to limit on a renal diet.* 

1. Dark-colored sodas contain phosphorus additives, which are absorbed more than natural sources of phosphorus from animals and plants. Limiting dark-colored sodas can help improve or maintain reasonable phosphorus control. 
2. While touted with heart-healthy nutrients, avocados, apricots, oranges, bananas, potatoes, tomatoes, and dried fruits can be worrisome as they contain a large amount of potassium. By reducing portion size, CKD patients following a low-potassium diet may still be able to enjoy these foods on occasion. 
3. Whether from a soup or vegetable source, canned foods are often higher in sodium, as salt is added to preserve shelf life. Many canned foods now come with low-sodium options. Draining and rinsing certain canned foods can further decrease the sodium content by 33-80%. 
4. While usually encouraged to promote strong bones and muscle strength, dairy products (milk, ice cream, cheese, yogurt, etc.) can lead to too much protein, phosphorus, and potassium in your diet. Consider dairy alternatives like unenriched rice milk and almond milk for a kidney-friendly diet. 
5. Processed meats like hot dogs, bacon, pepperoni, and sausage contain sodium and/or phosphorus additives, both of which are readily absorbed by the body, particularly in people with CKD, though they are linked with many types of chronic diseases.
6. Pickles, processed olives, and relish go through a curing or pickling process. During this process, large amounts of salt are usually added. Grocery stores now offer reduced-sodium varieties of these foods, but even with these, be mindful of your portions. 
7. Packaged and pre-made meals like frozen pizza, microwaveable meals, and instant noodles can be loaded with sodium preservatives. Many of these foods are chosen for their quick convenience and, fortunately, there are healthier versions available. If you are following a low-sodium diet (no more than 2300 mg of sodium per day), review the nutrition label and look for frozen meals with less than 700 mg of sodium per meal.
8. Swiss chard, spinach, and beet greens are leafy green vegetables rich in many nutrients including potassium. They are also high in oxalates, which can increase the risk of kidney stones in those sensitive to developing them.
9. Ready-to-eat snacks like pretzels, chips, and crackers are enjoyed for their salty taste, which is not helpful on a low-sodium diet. They also lack fiber (which provides a sense of fullness), making it easier to overindulge. Potato-based snacks can also be high in potassium. 

On a happy note, while whole grains such as oats, brown rice, and whole wheat bread used to be restricted on the renal diet due to their phosphorus content, they are now encouraged as healthy sources of fiber and nutrients since it was discovered that plant-based phosphorus is not easily absorbed.

Depending on your stage of CKD, you may not need to restrict all the nutrients mentioned above. If you are unsure of what to eat and when, speak with your healthcare team to learn more about what a kidney-friendly diet looks like for you. 

*Berkheiser, K. (2021, June 9). 17 Foods to Avoid or Limit If You Have Bad Kidneys. Healthline. https://www.healthline.com/nutrition/foods-to-avoid-with-kidney-disease