Changes to your diet can often help to lower blood pressure, slow down your loss of kidney function and reduce your risk of heart attack and stroke.
Most people with chronic kidney disease can get all the vitamins and nutrients they need by following a healthy, well balanced diet. But if you are approaching end-stage kidney disease you may need a special diet, where some types of foods and drinks are restricted, especially if you are on dialysis.
How do I know if I need a special diet?
You should only restrict what you eat and drink if you’re advised to do so by your doctor. They should refer you to a specially trained renal dietitian for advice. They will work with you to create a plan which is tailor-made to your needs and lifestyle.
Restrictions will vary depending on the cause and stage of your kidney disease, the medications you are on, your blood test results and whether you have other conditions, such as diabetes.
Dietary advice will be different for everyone, even if you share the same medical condition, so don’t automatically assume that dietary information on some websites will be right for you. Some information may be unsuitable or inaccurate so always speak to your renal dietitian before making any changes to your diet.
Why do some kidney patients need to follow special diets?
Advanced kidney disease can upset the delicate balance of essential nutrients in the body so some people may have to:
- restrict amounts of some types of foods and drinks (for example those containing potassium and phosphate) to stop harmful build up in the blood
- modify their diets to help prevent muscle or bone weakening.
Others may have to avoid certain foods, such as fresh grapefruit or grapefruit juice because they can interfere with certain medications.
How can I help myself?
Whatever your stage of kidney disease, it’s important that you:
- Have a healthy diet (containing a wide variety of foods)
- Cut back on salt – as eating too much salt is linked with high blood pressure and heart disease, which can damage your kidneys
- If you want to observe a period of fasting e.g. as part of your religion, be sure to read our guidance on fasting
- Keep to a healthy weight and exercise regularly.
What is a healthy diet?
The eat well plate from the NHS gives you a visual guide to healthy eating and our own download suggests foods which can generally be eaten by people with more advanced kidney disease.
How can I cut back on salt?
Try not to add salt to food at the table or in cooking. Check with your kidney team before using salt substitutes: as these contain a lot of potassium as well as some sodium, so are not suitable for people with reduced kidney function. If you do need to use salt or salt substitutes, try to use the smallest amount possible.
The table in the PDF you can download below, lists some practical ways to reduce your salt intake:
Check your salt intake
Most of the salt we eat is contained in the food we buy – especially processed foods and ready-made meals – so:
- Use the traffic light food labelling system to help you choose healthier green-labelled options. The system highlights salt, fat and sugar content per 100g or per portion of food. But your portions may be different so try to estimate the overall salt content of your meal.
- Be wary of ‘reduced salt’ labels as some foods may still have higher than recommended salt levels or contain potentially harmful salt substitutes.
Post-transplant diets
Dietary restrictions aren’t usually necessary after a kidney transplant but it’s still worth following a healthy diet and watching your salt intake. However, if you are advised by your kidney consultant to make specific changes to your diet, ask to be referred to the renal dietitian and follow their advice.
You will probably be advised to avoid fresh grapefruit or grapefruit juice because they can interfere with certain medications. Also, because some of your medications suppress your immune system, it’s even more important to follow general food safety advice around storing, preparing, and cooking food – especially in the first few months after your transplant operation. For example, you may also be advised to avoid foods containing raw eggs (such as mayonnaise), unpasteurised milk and soft cheese made with unpasteurised milk, and undercooked or raw meat, fish and shellfish (as they could potentially increase your risk of food poisoning.)
Suggested links...
- NHS Choices - Healthy Weight Calculator
- Guidance for patients and healthcare professionals on CKD from the National Institute for Clinical Excellence (NICE)
Page written with Renal Clinical Lead and Research Dietitian Fiona Willingham, who reviewed and approved it on 12.10.18