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Diet for Chronic Kidney Disease (Before Dialysis): Care Instructions

Your Care Instructions

When you have chronic kidney disease, you need to change your diet to avoid foods that make your kidneys worse. You may need to limit salt, fluids, and protein. You also may need to limit minerals such as potassium and phosphorus. A diet for chronic kidney disease takes planning. A dietitian who specializes in kidney disease can help you plan meals that meet your needs.

These guidelines are for people who are not on dialysis. Talk with your doctor or dietitian to make sure your diet is right for your condition. Do not change your diet without talking to your doctor or dietitian.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Work with your doctor or dietitian to create a food plan.
  • Do not skip meals or go for many hours without eating. If you do not feel very hungry, try to eat 4 or 5 small meals instead of 1 or 2 big meals.
  • If you have a hard time eating enough, talk to your doctor or dietitian about ways you can add calories to your diet.
  • Do not take any natural health products without talking to your doctor first.
  • Check with your doctor about whether it is safe for you to drink alcohol.

To get the right amount of protein

  • Ask your doctor or dietitian how much protein you can have each day. Most people with chronic kidney disease need to limit the amount of protein they eat. But you still need some protein to stay healthy.
  • Include all sources of protein in your daily protein count. Besides meat, poultry, fish, and eggs, protein is found in milk products, milk alternatives, beans and nuts, breads, cereals, and vegetables.

To limit salt

  • Read food labels on cans and food packages. The labels tell you how much sodium is in each serving. Make sure that you look at the serving size. If you eat more than the serving size, you will get more sodium than what is listed on the label.
  • Do not add salt to your food. Avoid foods that list salt, sodium, or monosodium glutamate (MSG) as an ingredient.
  • Buy foods that are labelled "no salt added," "sodium-free," or "low sodium." Foods labelled "reduced sodium" and "lightly salted" may still have too much sodium.
  • Limit processed foods, fast food, and restaurant foods. These types of food are very high in sodium.
  • Avoid salted pretzels, chips, popcorn, and other salted snacks.
  • Avoid smoked, cured, salted, and canned meat, fish, and poultry. This includes ham, bacon, hot dogs, and luncheon meats.
  • Do not use a salt substitute or lite salt unless your doctor says it is okay. Most salt substitutes and lite salts are high in potassium.
  • Use lemon, herbs, and spices to flavour your meals.

To limit potassium

  • Ask your healthcare provider how to change your diet to eat the amount of potassium that's right for you.
  • Choose low-potassium fruits such as apples and applesauce, pineapple, grapes, blueberries, cherries, strawberries, watermelon and honeydew melon, and raspberries.
  • Choose low-potassium vegetables such as lettuce, green beans, cucumbers, asparagus, carrots, cauliflower, peas, squash, zucchini, and radishes.
  • Choose low-potassium foods such as hummus, spaghetti, macaroni, rice, tortillas, and bagels.
  • Limit or avoid high-potassium foods such as milk, and milk products (like cheese and yogurt), nuts and seeds, whole grains, legumes, bananas, oranges, cantaloupe, avocado, potatoes, spinach, tomatoes and tomato products (like sauce and paste), broccoli, cooked greens, and sweet potatoes.
  • Avoid processed foods that have reduced salt. Many of these foods replace salt with potassium, always check the ingredient list.
  • Do not use a salt substitute or lite salt unless your doctor says it is okay. Most salt substitutes and lite salts are high in potassium.

To limit phosphorus

  • Ask your healthcare provider how to change your diet to eat the amount of phosphorus that's right for you.
  • Follow your food plan to know how much milk and milk products you can have.
  • Limit nuts, peanut butter, seeds, all legumes and pulses, processed or organ meats, salmon and sardines.
  • Avoid drinks with added phosphate such as; cola, iced tea, root beer, drink crystals, some flavoured waters.
  • Avoid whole grains and whole wheat bread, bran breads or bran cereals.
  • Avoid processed foods where phosphate is added, always check the ingredient list.

If you need to limit fluids

  • Know how much fluid you can drink. Every day fill a pitcher with that amount of water. If you drink another fluid (such as coffee) that day, pour an equal amount of water out of the pitcher.
  • Count foods that are liquid at room temperature, such as gelatin dessert and ice cream, as fluids.

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