Understanding how to properly nourish yourself with chronic kidney disease (CKD) can be complex and difficult. For patients not on dialysis, a protein restriction is often encouraged, however recommendations should be individualized based on a person’s preferences and overall health. Read more about the effects of protein in CKD and which diets may help to prevent the progression of CKD.* 

How can too much protein affect CKD patients?

Foods rich in protein, such as beef, chicken, nuts, and fish, are necessary and encouraged for good health, but too much protein is a concern for CKD patients. 

Research shows high protein diets may increase blood pressure inside the kidneys and accelerate kidney function decline in pre-existing CKD. Higher consumption of red and processed meat may worsen kidneys even further, while protein from plant sources can promote good heart health and delay CKD progression.

Which types of diets are preferred in slowing CKD progression?

Numerous studies have been done on dietary patterns and CKD. Plant-based diets like vegan, Mediterranean, and the Dietary Approach to Stop Hypertension (DASH) diet, are popular approaches that could be beneficial to kidney health. These approaches have been associated with:

• Decreased risk of developing CKD, 
• Improvement in blood pressure/heart health, and 
• Lower risk of death. 

A vegan diet is 100% plant-based and avoids all animal derivitives, including eggs, fish, and dairy products. This approach may be favorable in the later stages of CKD. One study done in elderly, non-diabetic patients found that dialysis was delayed for about a year for patients following a vegan diet.

Traditionally, the Mediterranean diet includes high amounts of fruits, vegetables, whole grain bread and cereals, potatoes, nuts, seeds, and extra virgin olive oil. Low-to-moderate amounts of dairy, fish, poultry, and wine are allowed, with sweets and red meats to be consumed for special occasions only. 

The DASH diet is a food guideline that includes legumes, whole grains, vegetables, fruits, and low-fat dairy. It allows for moderate amounts of poultry, fish, and nuts and low amounts of sodium (salt), red and processed meats, and alcoholic and sweetened beverages. Interestingly, one study learned that participants who did not adhere to a DASH diet had a 16% higher chance of developing CKD. 

How does a plant-based diet help the kidneys? 

There are several ways in which plant-based diets can support overall health in kidney patients. They include:

• A decrease in acid load and metabolic acidosis, which has been associated with high blood pressure, heart failure, muscle wasting, and CKD progression. 
• Reduced intake and absorption of phosphorus, which is more easily absorbed from animal sources. Phosphorus is an important nutrient, but may negatively affect bone and overall health when its levels in the blood get too high. 
• Improved fiber intake, which supports gut and heart health and may help lower chronic inflammation in the body 

Before starting a specific diet, including a plant-based one, speak with your doctor to address any risks that diet may pose to your kidneys or other health conditions. A registered dietitian can help you to create the best approach for your overall health and lifestyle. 

*Apetrii, M., Timofte, D., Voroneanu, L., & Covic, A. (2021). Nutrition in Chronic Kidney Disease—The Role of Proteins and Specific Diets. Nutrients, 13(3), 956. https://doi.org/10.3390/nu13030956