Eating well when you have kidney disease is very important to help you stay as healthy and strong
as possible.
Including the right kinds and amounts of foods each day recommended for healthy eating can help your
kidneys to work more easily and keep you well for longer.
Sometimes having kidney disease can make you feel unwell. Your appetite may not be so good and food may
taste different. This is because waste products produced from the foods you eat build up in the blood instead
of being removed by the kidneys.
The need to make changes to your diet depends on how well your kidneys are working.
What is right for others may not be right for you.
Chronic Kidney Disease and Nutrition
Chronic Kidney Disease and Nutrition
What about protein and kidney disease?
Protein foods are essential to help keep your body healthy, repair body muscle and tissues and heal wounds.
Beef, lamb, chicken, fish, eggs, milk and dairy foods are all examples of protein foods. When you have kidney
disease, eating too much or too little protein can make you feel unwell.
Eating moderate portions of protein can help to reduce the work load of the kidneys and reduce high levels of
waste products in your blood.
Choose palm sized portions of meats at meals.
Your doctor can refer you to a dietitian for advice on how much protein to eat.
0800 KIDNEY / 0800 543 639
www.kidneys.co.nz
Too much salt (sodium) affects the amount of fluid the body holds on to and this can cause problems such as:
High blood pressure
Puffy or swollen feet and ankles
You may be asked to have less salt in cooking and cut down on salty foods.
To help keep your salt intake down:
Use no more than a pinch of salt (iodised) in cooking
Avoid adding salt to food at the table
Avoid foods high in salt such as:
- Ham, bacon, sausages, corned beef, smoked fish
- Salted chips, crisps, salted nuts
- Instant noodles and soups, stock cubes, salty crackers
- Salty sauces and pickles
- Most takeaway foods
Chronic Kidney Disease and Nutrition
What about salt?
To help keep your salt intake down buy fresh foods and make
home prepared meals. Use fresh herbs, spices, flavoured
vinegars and lemon juice for extra flavour.
Your doctor can refer you to a dietitian for help with reducing
your salt intake.
Do not use salt substitutes like Losalt as these have potassium in them and are not suitable for people with
kidney disease.
Should I change how much I drink?
You should continue to drink your usual amounts of fluids
i.e. at least 6 8 cups/glasses per day. Examples of fluids
include water, tea, coffee, soft drinks and cordials. If you
are passing more urine you will need to drink more.
Your doctor will tell you if you need to start cutting down
how much you drink each day.
0800 KIDNEY / 0800 543 639
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Fruits and vegetables are important in your daily meals. They contain a mineral called potassium. As kidney
disease progresses, potassium in the blood may start to rise. This is because the kidneys are not able to
remove extra potassium. This can be dangerous.
You may be advised to limit or avoid certain types of fruits and vegetables that are high in potassium.
Fruit and vegetables high in potassium include:
bananas
pure fruit juices
dried fruit
potatoes
silverbeet, tomatoes
Your doctor regularly checks your blood potassium levels and
will tell you if you need to cut down on high potassium fruits and
vegetables in your diet. Your doctor can refer you to a dietitian
for help to choose suitable fruits and vegetables.
Chronic Kidney Disease and Nutrition
What about fruit and vegetables?
What is phosphate?
Phosphate is a mineral, which together with another mineral called calcium, helps to keep your bones strong.
When your kidneys are not working properly phosphate builds up in the blood instead of being removed by
the kidneys.
High phosphate levels can cause problems such as:
Itchy and dry skin
Hardening of your blood vessels
Painful joints
Weak bones
Phosphate is found in many foods:
Milk, cheese, yoghurt, and ice cream
Calcium enriched milk
Peanut butter
Sardines
Coco Cola, Pepsi
Your doctor may also want to give you tablets to help keep phosphate levels in your blood normal. Your
doctor can refer you to a dietitian if you need to reduce your phosphate intake.
0800 KIDNEY / 0800 543 639
www.kidneys.co.nz
Maintaining a healthy weight is important for everyone. Your
energy requirements may need to be met by increasing the
amount of carbohydrates (starchy) foods and healthy fats (oils
and margarines) you eat.
Starchy foods include:
- breakfast cereals, breads, crackers and biscuits
- rice, pasta,.
Healthy oils and margarines include:
- sunflower, canola, rice bran and olive oils.
Eating well can help you feel your best and to stay at your well
weight when you have chronic kidney disease.
If your appetite is not so good and you are not eating your usual quantities of food then try eating smaller
meals and snacks more often over the day.
Chronic Kidney Disease and Nutrition
Increasing Your Energy Intake
You can ask your doctor to refer you to a dietitian if you need further assistance with your meals and making
suitable food choices.
What if I have diabetes?
In some cases you may be asked to make a few changes to your diabetic diet to fit around managing your
reduced renal function. If you are advised to have smaller portions of protein you must be sure to get enough
calories from other foods. You can ask to be referred to a dietitian for review of your diabetic diet and how to
fit in any changes you may need to make to manage your kidney disease.
What if I am vegetarian?
If you are vegetarian you may need good advice from a dietitian. Vegetarian diets can be high in potassium
and phosphate because of all the vegetables, fruits and whole grains that make up your diet. The goal is to
eat the right combinations of plant proteins while keeping potassium and phosphate under control.
Will I have to take vitamins and minerals?
Vitamins and minerals come from a variety of foods in your diet. If you diet is limited you may need to take
certain vitamins and minerals. You must only take the vitamins and minerals your doctor prescribes for you.
Certain ones can be harmful for people with kidney disease
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REDUCING YOUR SALT INTAKE
This guide is intended for people with health problems, where salt restriction is an important part of their
treatment. Salt restriction is often prescribed for people with high blood pressure, heart, kidney or liver
disease, and diabetes.
Where Does Salt Come From In Our Diet?
10% comes from salt naturally occurring in foods (meats, fish, milk and certain vegetables)
15% comes from salt used in cooking and added to food at the table
75% of our salt comes from processed and packaged foods bought from the supermarket
and from fast food outlets.
How to Reduce Your Salt Intake
Minimise high salt processed foods and takeaway foods.
Choose foods canned and packet foods containing 450mg or less of sodium (salt) per 100g.
Use up to a pinch of salt in cooking
Avoid adding salt to foods at the table
Helpful Hints
Always use iodised salt, as iodine is an important trace element for health
Salt substitutes are not always suitable to use in place of salt.
Use onions, garlic, fresh/dried herbs, spices, pepper, vinegars, and lemon juice to flavour food.
Steaming vegetables helps to retain their flavour.
Other Names for Salt
NaCl
Sodium
Na
Sea salt
Kelp
sodium chloride
rock salt
Monosodium glutamate (MSG)
Flavoured salts, eg garlic, lemon
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How to reduce your salt intake
FOOD GROUP
FISH
SUITABLE
MINIMISE
Fresh fish
Fish canned in spring water
Canned salmon with no added salt
Smoked fish, Canned fish in brine or
sauce eg herrings in tomato sauce.
Fish paste, Shellfish, prawns, shrimps,
Ready-made fish dishes
MEAT & POULTRY
Fresh beef, mince, lamb, pork, chicken,
offal meats
Tinned, processed or smoked meats
bacon, ham, corned beef, sausage
meats, sausages, smoked chicken
Mince pies, pasties.
Ready made meat dishes
MILK
Milk, all types, Cream, Butter, margarines Cheese based dishes, eg macaroni
(salt reduced types), Yoghurts, Cheese,
cheese, Quiche, Pizza, Cheese sauce
(not more than 20g/ day), Cottage, edam
and Gruyere cheeses are lower in salt
EGGS
Eggs
VEGETABLES
Potatoes- baked, boiled, mashed, and
roasted.
Instant potato, croquettes, Salted fries
and chips. Canned vegetables, unless
labelled No Added Salt or reduced
salt.
Baked beans in tomato sauce
Dehydrated vegetables
All vegetables (fresh and frozen)
SOUPS
Home made soups using stock made
from vegetables and meats and adding
only a pinch of salt
Tinned packet or instant soups
Homemade soup with stock cubes or
powder
SAUCES & PICKLES
Beetroot, home- made fresh salsas
Worcester sauce (1tsp), Home made
savoury sauces.
Tomato puree
Prepared dried mustard. Lite bottled
sauces, Mayonnaise
Stock cubes
Marmite or Vegemite,
Soya sauce, Regular tomato sauces,
relishes and pickles including pickled
onions, olives and gherkins
Packet and canned instant sauces
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CEREALS & BISCUITS All breakfast cereals
All types of breads
Pasta, rice
Sweet and semi sweet biscuits
Salted porridge
Tinned pasta e.g. spaghetti, ravioli,
macaroni cheese
Salted cracker biscuits
PUDDINGS
All puddings
FRUIT
All fresh, tinned, dried, frozen
DRINKS
Water
Hot drinks including tea, coffee, cocoa
and drinking chocolate
Fruit juices, squashes and cordials
Fizzy drinks
Stock broth
Tomato juice
Mineral waters and sports drinks
TAKEAWAYS &
SNACKS
Unsalted nuts
Unsalted crisps
Unsalted popcorn
Most takeaways
Salted nuts, dry roasted nuts, crisps
and packet savoury snacks
Dehydrated meals instant noodles and
rice
Nutrition Services
Christchurch Hospital, P O Box 4710, Christchurch
Tel: (03) 364 0630, Fax (03) 364 0636
G/common/resources/Renal/How to reduce salt intake
This resource was written by New Zealand Registered
Dietitians, Christchurch Hospital
Review Date: 2009
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Managing Potassium Intake
FOOD GROUP
Fruit & Vegetables
Aim for 5 serves of fruit and
vegetables a day
e.g. 2 serves of fruit &
3 of vegetables
Cut, boil & drain your vegetables to
reduce the potassium.
Carbohydrate (Starchy) Foods
Keep to one fist sized serve of
boiled potato, taro, cassava or yam
each day.
LOW POTASSIUM FOODS
Apple, berries, canned fruit (drain
the juice), feijoas, passionfruit,
pear, persimmon, plum, tangelo.
Asparagus, beans green,
cabbage, capsicum, cauliflower,
carrot, celery, corn, cucumber,
lettuce, peas, mixed vegetables,
puha, watercress.
Meat, Meat Alternatives & Dairy
All dried fruit, apricots, avocado,
banana, coconut flesh, grapefruit,
grapes, kiwifruit, mango, melon,
nectarine, oranges, peach,
pineapple (fresh), rhubarb.
Broccoli, courgette, leek, okra,
parsnip, pumpkin, silverbeet,
spinach, taro leaves, tomato.
Couscous, dumplings, noodles,
pasta, rice, rice noodles, vermicelli, Green banana, hot chips, kumara.
potato, taro, cassava, yam.
Bread, cabin bread, chapatti,
You may need to top up your
Chinese steamed bun, crackers
plate with other low potassium
plain, Maori bread, pita bread.
carbohydrates such as rice or pasta.
Breakfast Cereals
HIGH POTASSIUM FOODS
Bread that contains dried fruit.
Breakfast cereals that contain dried
Frosties, Special K Forest Berries, fruit, bran, nuts or chocolate.
Honey Puffs, Just Right Tropical,
NB: Some cereals are ok and have
LightnTasty, Mini Wheats Golden
been listed in the choose list.
Honey, Porridge/rolled oats made
Examples of cereals to avoid: All
with water, Puffed Wheat, Weet-Bix. Bran, Coco Pops, Muesli, Sultana
Bran, Sustain.
Not too much, not too little you need to eat the right amount of protein
foods each day. Choose palm sized portions at each meal.
Beverages (Fluids)
Cordial & soft drink (choose diet
drinks if you have diabetes),
instant coffee tea, thriftee, water.
Fruit & vegetable juices, milky &
espresso coffees.
Snacks
Plain biscuits, cakes, muesli or
cereal bars, popcorn, unsalted
rice cakes that do not contain fruit,
nuts, chocolate or coconut.
Biscuits, cakes, muesli or cereal
bars that contain fruit, nuts,
chocolate or coconut.
Miscellaneous
Aioli, garlic, ginger, herbs, honey,
jam/marmalade, mayonnaise,
mustard, nutella, spices, vinegar.
Baked beans, marmite/vegemite,
peanut butter, salt substitutes
(Losalt), soup, tomato puree.
Reproduced with kind permission of Auckland Region Renal Dietitians
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PHOSPHATE
When your kidneys are not working properly the phosphate level in your blood can begin to rise.
You may be prescribed tablets that act as phosphate binders to help keep your blood phosphate lower e.g. Osteo
500, Alutabs. These must be taken at the start of your meals and snacks containing protein to work properly. Avoiding
excess phosphate in your diet can also help to reduce blood potassium levels.
FOODS HIGH IN PHOSPHATE
Try to reduce
Milk/Dairy Foods/Eggs
Milk, Calcium enriched milks
Milkshakes
Most cheeses cheddar, Edam, Gruyere, Cheese
spreads, cheese sauce
SUITABLE ALTERNATIVES
Milk/Dairy Foods/Eggs
Cottage cheese, Ricotta cheese, cream cheese,
Cream, sour cream
Tinned milk condensed milk, evaporated milk, dried Egg whites
milk.
Yoghurt, milk puddings and custards
Eggs
Meats
Liver, kidney, liver pate, duck and game birds.
Sausages and sausage meat products
Meats
Beef, lamb, pork, turkey, chicken, minced beef.
Fish
Fish
Sardines, salmon, prawns, mussels, scallops, oysters,
White fleshed fish eg cod, sole, terakihi, gurnard, etc.
crayfish, whitebait, herring, smoked fish, cod roe,
Tuna, shrimps, fish fingers, fish cakes,
mackerel.
Vegetables
Hot Chips
Vegetables
All fresh and frozen vegetables
Legumes (dried peas& beans), nuts
Baked beans, lima beans, red kidney beans, chick
peas, lentils (unless taken in place of meat)
All nuts
Peanut butter
Legumes (dried peas& beans), nuts
Nuts small handful (30g)
Fruit
Dried fruits
Fruit
All other fruits are suitable
Breads and flours
Dense rye and wholemeal breads, bran flakes
Breads and flours
All white breads and rolls. White flours. Pastry.
Biscuits and Cakes
Rye crispbreads, oatcakes, scones, bran muffins,
wholemeal muffins, full coated chocolate biscuits
Biscuits and Cakes
Cream crackers, water biscuits, digestives, plain
sweet biscuits, shortbread, crumpets, cream biscuits,
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FOODS HIGH IN PHOSPHATE
Try to reduce
SUITABLE ALTERNATIVES
Miscellaneous
Milk chocolate.
Malted milk drinks e.g. Horlicks Ovaltine,
Milk powders
Mineral Water
Coco Cola and Pepsi drinks
Miscellaneous
Plain chocolate (2-3 squares)
Filled chocolates. Gravy (made with weak Bovril),
gravy browning, Bisto.
Boiled sweets, chewy fruit sweets, jelly sweets,
pastilles, peppermints, Mars Bars, chewing gum,
Marshmallows, Popcorn.
Fats (oils, margarine, butter)
None
Fats (oils, margarine, butter)
All varieties
Sugars
None
Sugars
All sugars, jams, honey, golden syrup,
Cordials and soft drinks, (not cola, pepsi )
Sauces, Herbs & Flavourings
Sauces, Herbs & Flavourings
Herbs, spices, salad dressings, mayonnaise,
mustard, vinegar, tomato sauce,
Nutrition Services
Christchurch Hospital, Private Bag 4710
Christchurch
Telephone: (03) 364 0630 Fax: (03) 364 0636
G:\COMMON\PATIENT RESOURCES\Renal\phosphate.CRF
This resource was written by NZ Registered Dietitians, Christchurch Hospital
Review Date: December 2011
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