Diet for chronic kidney disease
Adapt your diet for kidney disease. Protein, sodium, potassium and phosphorus management.
Calorie calculation examples by profile
Sedentary woman, 60 years old, 143 lbs (CKD stage 3)
Active woman, 60 years old, 143 lbs (CKD stage 3)
Sedentary man, 60 years old, 176 lbs (CKD stage 3)
Active man, 60 years old, 176 lbs (CKD stage 3)
Kidney disease and diet
Chronic kidney disease (CKD) reduces the kidneys' ability to filter waste. Diet plays a crucial role in slowing disease progression and preventing complications. Restrictions vary by disease stage (1 to 5) and require personalized dietary management with your medical team.
Protein management
Proteins produce waste that kidneys must eliminate. In early CKD (stages 1-3), a moderate reduction to 0.8 g/kg/day may be recommended. In advanced CKD (stages 4-5), restriction may be stricter (0.6-0.8 g/kg). Favor high biological value proteins (egg, fish, poultry). In dialysis, requirements increase.
Sodium, potassium and phosphorus
These electrolytes accumulate when kidneys don't function well. Sodium (limited to 2000 mg/day) raises blood pressure and causes water retention. Potassium (variable limit) can become dangerous for the heart in excess. Phosphorus (800-1000 mg/day) affects bones and cardiovascular system. Exact limits depend on your blood tests.
Hydration: delicate balance
Unlike usual advice, CKD may require fluid restriction, especially in advanced stages. Too much fluid can cause edema and shortness of breath. Your nephrologist will indicate the appropriate amount based on your kidney function and urine output.
Important
Never go below 1200 kcal/day (women) or 1500 kcal/day (men) without medical supervision. Too aggressive a deficit can be dangerous for your health and counterproductive for weight loss.
Dietary guide for chronic kidney disease
IMPORTANT: This guide provides general information. Diet for kidney disease must be STRICTLY personalized according to your disease stage, blood tests, and treatment. Always work with a nephrologist and specialized dietitian. The recommendations below are indicative and do not replace personalized medical supervision.
Diet is a major pillar in managing chronic kidney disease.
Understanding CKD stages
| Stage | GFR (ml/min) | Kidney function | Dietary restrictions |
|---|---|---|---|
| 1 | >90 | Normal or high | Mild |
| 2 | 60-89 | Mildly reduced | Mild to moderate |
| 3 | 30-59 | Moderately reduced | Moderate |
| 4 | 15-29 | Severely reduced | Significant |
| 5 | <15 | Kidney failure | Strict (pre-dialysis) |
The 4 nutritional pillars
1. Protein management
Stages 1-3 (without dialysis)
- Goal: 0.8 g/kg body weight/day
- Example (154 lbs): about 55 g protein/day
Stages 4-5 (pre-dialysis)
- Goal: 0.6-0.8 g/kg/day
- Example (154 lbs): 42-55 g protein/day
On dialysis
- Increased needs: 1.0-1.2 g/kg/day
- Dialysis removes proteins
| Food | Portion | Protein |
|---|---|---|
| Egg | 1 | 7 g |
| Chicken | 3.5 oz | 25 g |
| Fish | 3.5 oz | 20-25 g |
| Tofu | 3.5 oz | 8 g |
| Yogurt | 5 oz | 7 g |
2. Sodium restriction
Goal: generally < 2000 mg/day (about 5 g salt)
| Avoid | Prefer |
|---|---|
| Table salt | Herbs and spices |
| Deli meats | Fresh meats |
| Ready meals | Home cooking |
| Salty cheeses | Fresh cheeses |
| Regular bread | Salt-free bread |
| Canned foods | Fresh or plain frozen |
3. Potassium management
When to restrict: according to your blood tests (potassium > 5 mmol/L)
| High potassium foods to limit | Lower potassium alternatives |
|---|---|
| Banana | Apple, pear |
| Orange | Grapes, blueberries |
| Potato | White rice |
| Tomato | Cucumber, zucchini |
| Spinach | Lettuce, endive |
| Legumes | Limited quantities |
Technique: soaking and double-cooking reduces potassium by 30-50%
4. Phosphorus management
Goal: 800-1000 mg/day maximum
| Avoid (high phosphorus) | Prefer (low phosphorus) |
|---|---|
| Cola and sodas | Water, herbal teas |
| Processed cheeses | Fresh cheeses in limited quantity |
| Organ meats | Lean meats |
| Nuts | Limited quantities |
| Phosphate additives (E338-E343) | Additive-free foods |
Note: food additives contain highly absorbable phosphorus.
Sample day (stage 3, 154 lbs)
Breakfast
- Salt-free bread with unsalted butter
- Jam
- 1 egg
- Apple compote
- Tea or coffee (1 cup)
Lunch
- 3 oz grilled chicken with herbs
- White rice (5 oz cooked)
- Steamed zucchini
- Olive oil and lemon
- Pear
Snack
- 1 apple
- 2 plain cookies
Dinner
- 2 oz white fish
- Pasta (5 oz cooked)
- Green salad (lettuce, cucumber)
- Salt-free bread
- Compote
Approximation: ~50 g protein, 1800 mg sodium, 2000 mg potassium
Practical tips
- Weigh your protein portions at the beginning
- Read labels (sodium, phosphorus, additives)
- Cook at home to control salt
- Keep a food diary to share with your dietitian
- Adapt according to regular blood tests
Mistakes to avoid
- Completely eliminating protein: risk of malnutrition
- Using salt substitutes (potassium chloride) without advice
- Drinking excessively “to clean the kidneys”
- Following internet diets not adapted to your stage
- Modifying diet without consulting your healthcare team
Why Voical can help you
Voical allows you to precisely track your protein, sodium, potassium, and phosphorus intake. This visibility is essential for following your nephrologist’s recommendations. You can share your data with your dietitian for precise adjustments.