Some chronic kidney disease (CKD) patients believe following a CKD patient is the hardest part of having the disease. Some patients are taught that they must avoid some of their favorite foods completely, but this is not necessarily the case. Professional Chef Linda Blalock explains how moderation is key, what nutrients may need to be monitored, and tips on how to cook in a kidney-friendly way.* 

What nutrients will CKD patients monitor?

CKD patients typically have to monitor their intake of one or more of the following nutrients: sodium, potassium, phosphorus, and protein. Fluid intake is also something kidney patients often have to keep a careful eye on.

Sodium 

Sodium is a common mineral in the American diet, and it’s usually seen in the form of salt. No matter what stage of CKD you are at, it is recommended to restrict your sodium intake; it may negatively affect your kidneys and blood pressure. 

Here are some tips to help limit your sodium intake:

• Use kosher salt in place of standard table salt for roughly 500 mg less sodium per teaspoon.
• Rinse canned vegetables with water to help remove sodium.
• Use salt sparingly while cooking and avoid completely at the dinner table.
• Use an acid, like lemon juice, to trick your taste buds into thinking a food is salty.

Potassium 

Potassium can be used as an additive in many processed foods, while it is also naturally found in fruits and vegetables. Depending on your stage of CKD, you may not need to restrict potassium intake. 

If you are told to watch your potassium intake by your doctor or dietitian, here are a few tips to help you cut back:

• Keep an eye on salt-substitute labels as many will use potassium in place of salt. 
• Leech potatoes or root vegetables to remove potassium, which can easily be done by soaking vegetables in warm water for two to four hours.
• Should you choose fresh, frozen, or canned fruits and vegetables? Since most canned products are soaked in water, they tend to be lower in potassium.

Phosphorus 

Phosphorus is commonly heard by dialysis patients. As the dialysis machine does not clean phosphorus out as well as potassium, dialysis patients must monitor their intake. Some non-dialysis patients, especially those in a later stage of CKD, may also be told to restrict their phosphorus. 

The following are a few helpful tips:

• Phosphorus can be used as an additive and be detected on the ingredients list of the nutrition label by words that contain “phos.”
• Dairy and meat tend to be high in phosphorus and are fully absorbable by your body.
• Certain plant-based sources, like dried beans and corn, are high in phosphorus, but your body only absorbs about half the amount.

Protein 

Protein can be a tricky nutrient for CKD patients. Depending on your stage, you may be recommended a low-protein or high-protein diet. 

There are a couple of things to keep in mind when adding protein to your diet: 

• Protein can be found from animal-based and plant-based sources. 
• Unlike animal-based sources, plant-based sources (such as beans, rice, and tofu) will not contain all nine essential amino acids that your body needs. If you follow a plant-based diet, be sure to combine complementary foods together, like rice and beans. 
• Some plant-based protein sources will be high in either phosphorus and/or potassium, so be careful not to overdo them. 

Fluid restriction

Fluid restriction is typically required among dialysis patients, but it may be necessary for stages 3, 4, and 5 CKD, too. For patients who must follow a fluid restriction, following a low-sodium diet and maintaining good blood sugar control (if you have diabetes) are key to preventing excessive thirst.

Why is meal planning beneficial? How can I start?

Proper meal planning allows you to enjoy most foods in moderation and can help save you money. Being organized and planning time to grocery shop and meal plan will be needed. Other handy tools to have include:

• Dry erase marker
• Whiteboard
• Pen and notepad
• Calculator
• Storage containers

Once you have these tools, some tips to help you plan include:

• Take notes of ingredients that need to be used up, and plan recipes that will use those ingredients during the week.
• Choose recipes with similar ingredients for the week.
• Write down or print out the recipes you plan to use to help you plan what you need to buy at the grocery store.
• Decide what will be for breakfast, lunch, dinner, and/or snacks.
• Make larger portions, and use them for lunch the next day or freeze for later. 

What are some tips for reading a nutrition label? 

If you never looked at the nutrition label before, it is imperative to start now if you have CKD. A registered dietitian can fully explain the entire nutrition label, but there are a few things you can easily look out for:

• Note the serving size at the top of the label, which represents the amount of each nutrient listed. 
• On the ingredients list, limit or avoid foods that list potassium and phosphorus ingredients in the top half of the list.
• The nutrition label will always show the amount of sodium in a serving size. People with CKD should aim for meals to have less than 600 mg per serving and snacks less than 150 mg. 

Where can I find more nutrition tips and kidney-friendly recipes?

Understanding and implementing a kidney-healthy diet will take time and patience. The AKF’s Kidney Kitchen has a lot of great information on grocery shopping, dining out, and recipes to meet your cravings while keeping your kidneys happy.

*Blaylock, L. (2020, Feb. 19). Kidney-Friendly Cooking with Chef Linda. American Kidney Fund. https://www.kidneyfund.org/training/webinars/how-you-can-navigate-kidney-friendly-cooking.html