Proper nutrition can slow the progression of chronic kidney disease (CKD), as well as help combat diabetes and hypertension, two of CKD’s greatest risk factors. Historically, nutrition therapy focused on limiting fruits and vegetables, legumes (beans, lentils), nuts, seeds, and whole grains because they are high in potassium and phosphorus. 

More recent research shows that potassium and phosphorus are not easily absorbed into the body from these specific foods, however, making them safer than previously thought, if eaten in reasonable amounts. What these items also have in common is that they are high in fiber. Learn how fiber can affect CKD progression, and why it’s necessary for overall good health.*

How does fiber benefit people with CKD?

Research shows that, while the recommended daily intake of fiber is 20-25g for women and 30-38g for men, most people with CKD only consume up to 12g per day. Increasing fiber intake to the recommended amount could help improve:

• Blood pressure
• Bowel regularity (reduction of constipation)
• Feelings of fullness (for weight control)
• Glucose (blood sugar) control
• Gut microbiota 
• Lipid (fat) panel  
• Risk for colon cancer

The DASH diet, recommended by the National Kidney Foundation for slowing CKD progression, incorporates whole grains; lean proteins; legumes, nuts, and seeds; and low-fat dairy, also includes a minimum of four to five daily servings of fruits and vegetables.

Gut health and CKD

Gut dysbiosis, an imbalance of ‘good’ and ‘bad’ microorganisms in the intestine, leads to a higher concentration of bacteria whose fermentation creates precursors to various toxins that can promote inflammation, oxidative stress, and fibrosis (scarring) of the kidneys. 

CKD increases levels of urea in patients’ systemic fluids, resulting in:

• The conversion of urea to ammonia and then to ammonium hydroxide, 
• A less favorable environment for beneficial bacteria, and 
• Damage to the intestinal barrier (which facilitates the absorption of nutrients and keeping out pathogens).

Adequate fiber intake can:

• Boost the growth of helpful bacteria
• Stimulate bowel movements
• Protect the intestinal barrier
• Reduce inflammation and oxidation
• Support renal function 

What research says about fiber and CKD

Various studies have indicated that:

• People with the highest fiber intakes had a 40%-50% reduction in occurrence of CKD. 
• For each 5g increase in daily fiber there was 11% less risk of CKD. 
• In 15,000 patients with CKD, eating fruits, vegetables, and whole grains was regularly associated with a lower risk of all-cause mortality.

In addition to eating a healthy diet, experts advise drinking at least 64oz of fluids daily unless your doctor or dietitian has placed you on fluid restriction. 

*Cochran, H. (2022, July 13). The Benefits of Fiber in Chronic Kidney Disease. Journal of Renal Nutrition 32(6): E1-E4.  https://www.jrnjournal.org/article/S1051-2276(22)00129-7/fulltext

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