National Institute of Diabetes and Digestive and Kidney Diseases
Do you have advanced CKD? Discover which nutrients are important to monitor to preserve your health.
A healthy diet and lifestyle can be important in preserving our health. For individuals with chronic kidney disease (CKD), your dietary needs may change as the condition progresses. Learn why calories, protein, fat, and fluids are important with advanced CKD (stage 4 or 5) and how your nutrition needs may change.
Foods and beverages provide us energy, which is measured in calories. Eating too many calories without burning them off can lead to becoming overweight or even obese, which can further complicate CKD and interfere with eligibility for a kidney transplant. Because of this, some patients restrict calories to help lose weight, but losing too much weight can also make you sicker.
Renal dietitians can provide you with an estimate of your caloric needs and teach you to find calories from kidney-friendly sources. They can also discuss appropriate kinds and amounts of calories for healthy weight loss.
Protein is a nutrient that is discussed on every health and wellness site and in every book and article about diet and nutrition. This is because protein serves many critical functions in our body, including:
After your body utilizes the protein it needs, metabolized and excess protein is then removed by the kidneys as a waste product. For people with CKD who are not on dialysis, restricting protein intake may be recommended to prevent protein waste products from building up and worsening your CKD. On the other hand, those on dialysis usually have higher protein needs as dialysis treatments remove protein.
By working with a renal dietitian, you can better understand the different types of protein sources, the benefits of each, and your protein needs based on your stage of CKD and other health conditions.
While fat tends to have a negative association with health, healthy dietary fats are essential nutrients. They:
Too much or the wrong types of fat can be detrimental to your heart, blood vessels, and kidneys. Since patients with CKD are already at higher risk for heart disease, limiting fat and understanding good sources of healthy fats is important.
In general, plant-based fats, like nuts, avocados, and certain oils, tend to have more unsaturated “healthy” fats, while fried foods and animal-based sources such as red meat and dairy tend to contain more “unhealthy” fats.
As kidney disease advances, damaged kidneys may be unable to properly remove extra fluid from your body. Fluid build-up can cause swelling, increased blood pressure, and strain on your heart. Too much salt (sodium) in your diet can also contribute to fluid build-up. Speak with your doctor about how much fluid you should drink daily to stay hydrated but not cause a build-up in your body.
In the second part of nutrition in advanced CKD, you will learn about which minerals are important and how to find a renal dietitian for more support.
Diet & Nutrition for Adults with Advanced Chronic Kidney Disease. (2023). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/eating-nutrition/nutrition-advanced-chronic-kidney-disease-adults
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