Division of Nephrology

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Diet For Renal Patient


Fluid & Fluid Control

Kidneys help control the amount of fluid that leaves your body. If your kidney disease progresses, your kidneys may be unable to regulate the removal of fluid from your body and as a result your doctor may ask you to limit your fluid intake. Too much fluid may cause swelling, shortness of breath, or high blood pressure.

What exactly is a fluid? Fluids are any food that is liquid or anything that melts into a liquid. Examples of fluids include the following:

• Coffee
• Tea
• Sodas
• Soups
• Popsicles
• Ice cream, sherbet
• Ice cubes
• Gelatin
• Milk, liquid creamer
• Water
• Wine and beer

If your doctor advises you to decrease the amount of fluids you eat and drink each day these tips may help you.

• Drink only when thirsty. Do not drink out of habit or to be social
• Eat less salt so you will feel less thirsty
• Suck on ice chips. (Measure small units into a cup)
• Brush your teeth three to four times a day; this is to prevent your mouth from drying out
• Suck on a lemon wedge
• If you have diabetes, control your blood sugar
• Chew sugarless gum or suck on sugarless hard candy
• Take your medications with sips of fluid
• When dining out, ask your beverage to be served in a child-size glass
• Measure how much fluid your favorite cup or glass holds so you will be better able to monitor the amount of fluid you drink
• After measuring out the total amount of fluid you can drink for the day, place the water in a container. During the day drink only from this container so you can keep an eye on the amount of fluid you have consumed.


The Renal Diet- Phosphorus

Before making any changes to your diet, make sure you discuss them with your doctor or dietitian.

Phosphorus is a mineral that works with calcium to keep your bones healthy and strong. Phosphorus is needed by the body for building and maintaining bones and teeth and for normal nerve and muscle function. When kidney function declines, the body has a difficult time keeping phosphorus and calcium in balance. As a result of this imbalance, the body cannot get rid of excess phosphorus (phosphorus levels increase) and the body cannot take in enough calcium (calcium levels decrease). To try and correct this imbalance the body will “steal” calcium from the bones, which makes the bones weak. Problems associated with high phosphorus levels include itchy skin, bone and joint pain, and brittle bones.

Foods that are high in phosphorus include:

• Cola Drinks
• Peanut Butter
• Cheese
• Sardines
• Chicken/beef liver
• Nuts
• Caramels
• Beer
• Ice Cream

Lower phosphorus food substitutes include:

• Broccoli
• Non-dairy milk substitute
• Sherbet
• Non-cola soda
• Zucchini squash
• Hard Candy

A large serving size of a low phosphorus food can become a high phosphorus food.

If your phosphorus level remains high your doctor may prescribe a phosphate binder for you to take. This medication will bind with the phosphorus in the food you eat and prevent phosphorus from being absorbed in the body.

It is important that you take this medication exactly as instructed by your doctor.

The Renal Diet- Potassium

Before making any changes to your diet, make sure you discuss them with your doctor or dietitian.

Potassium helps to keep your nerves and muscles, especially your heart, working properly. Potassium is a mineral and can be found in many foods. The kidneys are responsible for helping to keep the correct amount of potassium in your body. It can be very dangerous if your potassium level is too high. Too much potassium can make your hear beat irregularly or even stop without warning.

Foods that are high in potassium include the following:

Fruits Vegetables Other Food
Bananas Broccoli Chocolate
Oranges Potatoes Coffee (limit to 2 cups per day)
Cantaloupe Tomatoes Salt Substitute
Prunes Mushrooms Bran & bran products
Raisins Greens (swiss chard, Nuts & dried fruit
Collard, dandelion,
Mustard, and beet)

Low-potassium foods include the following:

Fruits Vegetables Other Food
Apples Beans (green or wax) Rice
Grapes Cucumber Noodles
Pears Onions Cake
Watermelon Lettuce Cereal
Cranberries Carrots Bread & bread products

It is important to remember that almost all foods contain potassium. Serving size will determine whether foods are a low, moderate, or high potassium level.

A large serving size of a low potassium food can become a high potassium food.


The Renal Diet- Protein

Before making any changes to your diet, make sure you discuss them with your doctor or dietitian.

Diet plays an important role in the management of kidney disease. The diet your physician will ask you to follow will be based upon your level of kidney function, your body size, and any other medical conditions you may have. Your diet may be helpful in delaying the need for dialysis.

Protein is needed to maintain muscles, aid in building resistance to infections, and repair and replace body tissue.
As your body breaks down protein foods, waste products called urea are formed. As kidney function declines, urea builds up in the bloodstream.
Eating to much protein may cause urea to build up more quickly. This will make you feel sick.
Eating less protein may be helpful in reducing your blood urea levels.
Reducing protein intake must be monitored by your doctor and dietician.
Examples of foods high in protein are:
• Meat
• Poultry
• Milk Products
• Eggs

Foods low in protein includes the following:
• Fresh beans (pinto, kidney, navy)
• Grains
• Vegetables

You need both high quality and low quality protein in your diet. Your physician will determine how much protein should be in your diet.

The Renal Diet- Sodium

Before making any changes to your diet, make sure you discuss them with your doctor or dietitian.

Sodium is needed by the body for many functions such as controlling muscle contractions, balancing fluids, and controlling blood pressure. Healthy kidneys remove excess sodium in the urine. As kidney function declines, sodium and fluids may accumulate in your body. Fluid retention may cause swelling in your eyes, hands, and/or ankles. To keep your sodium level in balance, your doctor may ask you to limit the sodium in your diet.
Foods high in sodium include the following:
• Table salt
• Bouillon cubes
• Potato chips
• Nuts
• Bacon
• Cold Cuts
• Cheese
• Canned, dehydrated, or instant soup
• Canned vegetables
• Processed dinner mixes (such as Hamburger Helper, Rice-a-Roni)

Low sodium alternatives:
• Season with a variety of spices like garlic and oregano
• Use lemon

© 2014 Medical College of Wisconsin
Page Updated 03/05/2013