I’m a survivor of kidney cancer, and when patients with renal disease are told they have to follow a low protein, low potassium low phosphorous and low sodium diet, it can leave them wondering what on earth they are going to eat. Eating to protect your kidneys generally means moving towards a plant-based, home cooked diet where protein is an accent rather than a staple.

While it is true that many convenient and familiar foods must be avoided on this diet, the good news is there are lots of tasty items you can eat which are both nutritious and enjoyable. As with any dietary change, the secret lies in doing your research and preparing in advance. To make it easy, we’ve created some notes on kidney friendly foods to stock your pantry with so that you can be prepared.

Grains
While whole grains are considered “healthier” due to their high fiber content, they are filled with potassium. If you’re trying to minimize potassium intake, keep your pantry stocked up with refined ‘white’ grains like those listed below so you can swap out wholewheat pastas, breads or brown rice in recipes for their white counterparts.

  • White flour foods like white sourdough bread, white pasta and couscous, white rice and rice noodles are all excellent low-phosphorous low-potassium sources of carbohydrates that will be easy on your kidneys.
  • Keep refined cereals like cream of wheat, cornflakes and farina on hand for quick meal or snack options.
  • Try to avoid refined salty baked goods and snacks like chips
  • When buying store bought treats like cakes or cookies read labels carefully. Avoid those containing dried fruits, nuts, coconut and, we’re very sorry to say, chocolate.

Fruits and Vegetables:

Although low in protein, many favorite fruits and veggies are high in phosphorous and potassium, including dark leafy greens like chard and spinach, sweet and white potatoes, winter squash, legumes including soy and soy products, nuts, nut butters and fruits like tomatoes, bananas, oranges, dried fruits. Even our beloved avocados can be tricky for a person trying to adhere to this diet. Don’t despair, because even though all of these foods should be avoided on a kidney protective diet, this still leaves a lot of delicious options to enjoy. Here’s the list.

  • Veggies:  asparagus, broccoli, cabbage, cauliflower, kale, watercress, peppers, zucchini and yellow squash, celery, corn, cucumber, eggplant, green or wax beans, green peas, lettuce, mushrooms, onion, radishes, parsley.
  • Fruits:     apples, pears, grapes, all berries (strawberries, blueberries, blackberries, raspberries, cranberries), peaches, plums, pineapple, tangerines, and watermelon.
  • Buy fresh where you can, and for your pantry choose plain frozen fruits and veggies – no sauces – rather than canned to avoid added sugars and sodium. And don’t pig out – a portion of F&V is ½ cup.
  • We recommend avoiding juices. A ½ cup of juice contains a lot more than ½ cup of fruits or veggies, concentrating the nutrients but also their potassium and phosphorous, plus juicing eliminates much needed fiber. Whether cooked or raw, it is safer and healthier to eat your fruits and veggies whole rather than juiced.

Leaching out unwanted minerals:  There are a lot of popular veggies that aren’t on this list – basically if it’s not there don’t eat it, but if you can’t do without carrots, potatoes, winter squash, beets or sweet potatoes, they can be thinly sliced with a sharp knife or mandolin and soaked in warm water for 2-3 hours to leach out some of the unwanted minerals before cooking. This can be done ahead of time and the veggies can be kept in the fridge for 2-3 days and ready for use. That said, keep portions small and make these veggies an occasional treat rather than an everyday thing.

Fabulous Flavorings
Since you’ll have to go easy on salt and avoid salt substitutes, flavor your food by using herbs and sweet spices.

  • Stock up on dried herbs like rosemary, thyme, oregano, bay leaves, and fennel seeds, and fresh herbs like ginger root, parsley, cilantro, basil and dill. The fresh leafy herbs can be blended with olive oil into a delicious pesto with that can be frozen in ice cube trays and used later melted into soups or to flavor steamed veggies. On its own, olive oil can add both healthy monounsaturated fats and delicious taste to your food.
  • Experiment with sweet spices like turmeric, cinnamon, cloves, star anise, cumin coriander and sweet paprika, smoked and/or plain. If you’re missing bacon, the smoked paprika will add a smoky almost meaty taste to food. If you like heat, make the paprika hot or add cayenne or smoky chipotle to taste.

Proteins
High protein foods can be eaten sparingly on this diet, but in small quantities only, and we mean small. On a normal diet, we should consume a maximum 4-6 ounces of protein daily. On low and very low protein diets this can drop to between 25-50% of the recommended daily portion, that’s around 1 ½ – 2 ounces (22 -28.5grams). This means that amounts of protein have to be watched carefully and used as accents to meals rather than the main event. This will mean cutting back in recipes on the protein rich foods below.

  • Proteins include seafood like shrimp and salmon, chicken, eggs, dairy, nuts, beans and legumes which include soy products like miso and tofu. In addition to being high in protein, certain protein sources can also be high in sodium and phosphates. If you are a vegetarian or vegan, check with your dietitian as to the amounts of legumes and veggie protein products you can safely consume.
  • Processed meats like bacon, salami and ham should be completely avoided. Protein aside, processed meats are heavy in sodium, phosphates and potassium. They have also been linked to several cancers.
  • When buying milk, choose non-dairy milk alternatives such as unsweetened soy or nut milks as they have less protein and less potassium than regular milk. Avoid creamers and half and half.
  • Do use cup measures and scales, and do read labels on processed foods. Labeling on all processed packaged foods and meals should be checked to make sure you’re not accidentally exceeding your daily protein limit and for phosphate content.

Beverages
You and your kidneys will need to stay hydrated, and plain water is your best bet. Commercially carbonated beverages, especially dark colas, should be avoided as they have been linked to chronic kidney disease and can contain a lot of phosphorous. Black tea and coffee can be drunk sparingly especially if you normally use half and half or creamers in them, which should be avoided. Some ideas:

  • Instead of soda, infuse water with frozen berries, herbs like mint or add a splash of cranberry juice to give it natural flavor. If you miss the bubbles, top up the last 1/3 of your glass with naturally sparkling mineral water.
  • If you enjoy coffee and tea, whether hot or iced brew it at home rather than drink readymade canned or bottled varieties. And go easy on the amounts. Keep it to 2-3 cups a day. Try getting into delicious fruit and herbal teas or infusions instead. They will provide you with the same warm pick-me-up.

We hope this information helps you. It will be important to partner with your medical team’s dietitian as this is a clinical diet and your renal health will depend on it. No two patients’ problems are alike, and your team dietitian can help you to navigate what will work best to keep you happy and well fed. With a good sense of the basics, a supportive medical team, and the recipe ideas on this site, you will grow to find this diet less daunting. You may even start to enjoy it!

References:

National Institutes of Health

https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/eating-nutrition/nutrition-advanced-chronic-kidney-disease-adults

National Kidney Foundation

https://www.kidney.org/atoz/content/vegetarian-diet-and-ckd

https://www.kidney.org/atoz/content/-how-much-plant-based-protein-can-you-eat-based-your-stage-kidney-disease

https://www.kidney.org/atoz/content/plant-based-diet-or-vegetarian-diet-difference

https://www.kidney.org/atoz/content/lowprotrecipes

Carbonated Beverages and Chronic Kidney Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3433753/

World Health Organization

https://www.cancer.org/latest-news/world-health-organization-says-processed-meat-causes-cancer.html

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