What’s the verdict on whole grains? Previously, whole grains were not recommended for kidney disease patients following a kidney healthy diet, due to the higher levels of phosphorus and potassium found in some whole grains.* Now, dietitians and medical professionals are saying otherwise, and DaVita Kidney Care explains why. 

What’s in whole grains?

Whole grains are unprocessed grains that contain the whole grain kernel, including the bran, endosperm, and germ. Nutritionally, whole grains are rich in:

• B vitamins, 
• fiber, 
• iron,
• magnesium, and 
• selenium. 

Depending on what type of whole grain you’re eating, the amount of the above nutrients varies. When grains are processed, or refined, however, you lose a lot of those good nutrients.

What are the health benefits of eating whole grains?

Including whole grains in your diet has a number of health benefits, such as:

• improve digestive health;
• help you feel full and improve weight control;
• prevent constipation;
• lower cholesterol (with decreased risk of heart disease and stroke); and
• cancer prevention, due to higher fiber intake. 

If I have kidney disease, can I eat whole grains?

Eating whole grains was previously discouraged, due to their higher levels of phosphorus and potassium. These two nutrients have an effect on kidney disease patients, because:

• Potassium can build up between treatments for dialysis patients, which can cause weakness, muscle cramps, tiredness, an irregular heartbeat, and, in some instances, heart attack. This is less of an issue for peritoneal dialysis patients, as daily treatments remove potassium from the body.
• Hemodialysis only removes a small amount of phosphorus from the blood.

However, medical professionals have seen an influx in the use of prepared and processed foods, as well as eating out, and the additives in these foods contain high levels of phosphorus, potassium, and sodium. 

Therefore, It’s better to eat foods, like whole grains, in which phosphorus and potassium occur naturally—as the mineral content of the nutrients you ingest also plays a big role in your overall physical health and wellbeing.

What types of whole grains should I eat?

Whole grains with a lower amount of phosphorus and potassium include:

• barley;
• buckwheat (kasha);
• bulgur
• popcorn; and
• wild rice.

The following whole grains are higher in phosphorus and potassium, and you should speak to your dietitian before including them in your kidney diet:

• amaranth,
• brown rice,
• millet,
• oats,
• quinoa,
• sorghum (milo),
• spelt,
• teff,
• triticale, and
• Wheat berries.

Another good way to intake whole grains is through grains that are high in protein, which will also help you tackle your protein goals. This is especially important for dialysis patients.

Examples of whole grains that are high in protein (some of which were mentioned above) are:

• amaranth,
• millet,
• quinoa,
• teff, and
• some whole-wheat pasta, as well as bread and cereals.

How do I find the right balance of whole grains for me?

The best way to determine what types of whole grains are okay for you to eat is to speak to your dietitian and care team. They will help you come up with a plan, such as how much of each you can and should include in your diet on a daily and/or weekly basis.

Further information on whole grains for kidney patients can be found in the American Society for Nutrition article, “Is it Time to Rethink the Traditional Renal Diet?,” and the Blood Purification journal article, “Whole Grains in the Renal Diet – Is It Time to Reevaluate Their Role?”

*Dolan, N. (n.d.). “Including Whole Grains in a Kidney Diet.” DaVita Kidney Care.