Published by PMR of NY & CT
Search for foods to avoid with kidney disease and you'll find lists so long they seem to rule out half the grocery store. The reality is more manageable. A few things are worth limiting for almost everyone with chronic kidney disease, while others matter only when your blood tests show a problem.
That difference is important, because cutting out too much can leave you short on calories, protein and the produce that supports your heart. Use this guide to understand the main categories, then ask your nephrologist or a renal dietitian which ones apply to you.
Why the list of foods to avoid with kidney disease is personal
What you need to limit depends on your stage of kidney disease, your latest blood tests, your medicines and whether you are on dialysis. Two people with the same diagnosis can get very different advice, and your own list may loosen or tighten as your labs change.
Some older advice told everyone with kidney disease to skip dairy, nuts and chocolate and cut back on activity. Current guidance is more individual, and plant-forward meals are often encouraged in early stages.
Salty packaged and restaurant foods
Too much sodium raises blood pressure, adds to swelling and puts extra strain on the kidneys. Limiting it is one of the few rules that applies at nearly every stage.
The saltiest foods don't always taste salty. Instant noodles and their flavor packets, boxed rice and pasta mixes, pickles, olives, sauerkraut, seasoning blends that list salt first, and most fast food tend to be high. Cooking from simple ingredients gives you the most control.
Phosphorus additives
Phosphorus builds up as kidney function falls, and high levels are linked to weaker bones and heart and blood vessel disease.
Not all phosphorus acts the same way. Your body absorbs only part of the phosphorus found naturally in beans, nuts and whole grains, but the National Kidney Foundation notes that phosphate additives are almost completely absorbed. That makes additives a smart place to start:
- Dark colas and some other bottled drinks
- Processed meats such as ham, sausage and chicken nuggets, and meat sold with an added solution
- Packaged baked goods, frozen meals and fast food
- Any ingredient list with "phos" in it, such as phosphoric acid, sodium phosphate or calcium phosphate
Dairy foods are naturally high in phosphorus as well. If your level runs high, your renal dietitian may suggest smaller portions or lower-phosphorus alternatives.
High potassium foods, only when your labs say so
Potassium is the clearest example of a limit that depends on your blood work. If your level runs high, often in later stages or with certain medicines, your care team may ask you to eat less of foods such as avocados, cantaloupe, honeydew, kiwi, winter squash, sweet potatoes and pumpkin.
Don't cut these on your own. Fruits and vegetables supply fiber and other nutrients, and research suggests they may benefit people with kidney disease when potassium levels allow.
Supplements, herbal products and star fruit
What you take can matter as much as what you eat. Check with your nephrologist or pharmacist before using:
- Herbal products and dietary supplements, which may contain potassium or phosphorus, harm the kidneys or interact with your medicines
- High-dose vitamin C, which can raise oxalate, a compound that may form crystals in the kidneys
- Protein powders and bodybuilding supplements, unless your care team recommends them
- Laxatives and enemas made with phosphate or magnesium, which damaged kidneys may not clear
Star fruit, also called carambola, deserves its own warning. It contains a toxin that damaged kidneys can't clear, and in people with kidney disease it has caused hiccups, vomiting, confusion and seizures. Avoid it completely.
Staying nourished, active and safe
Not every item on a list of foods to avoid with kidney disease will apply to you, and over-restricting has its own risks. Call your nephrologist if your eating plan leaves you losing weight without trying, too tired to eat or unable to keep to your limits.
Regular activity is generally good for people with kidney disease; in hot weather, follow your care team's fluid advice. If pain makes exercise hard, physiatry and pain management can help you find a starting point.
Call 911 for chest pain, trouble breathing, a seizure, sudden confusion or a heartbeat that feels very slow or irregular. Get emergency care for hiccups, vomiting or confusion after eating star fruit.
Frequently asked questions
Are eggs safe to eat with kidney disease?
Usually, yes. Eggs are a high-quality protein, and egg whites are especially low in phosphorus, which makes them a common choice in kidney-friendly meal plans. Most of an egg's phosphorus is in the yolk, so people with high phosphorus levels may be advised to use more whites than whole eggs. Your renal dietitian can show you how eggs fit your daily protein target.
Can I eat chocolate if I have kidney disease?
Often in small amounts. Chocolate contains potassium and phosphorus, and dark chocolate and cocoa powder contain more than milk chocolate. If your levels are in range, an occasional small piece may fit your plan. If your potassium or phosphorus runs high, ask your renal dietitian about treats that are lower in both minerals.
Is it safe to take ibuprofen with kidney disease?
Ask your doctor first. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can reduce blood flow to the kidneys and may worsen kidney function, especially with regular use, dehydration or certain blood pressure medicines. Your doctor or pharmacist can suggest safer options, which may include acetaminophen and non-drug care such as physical therapy or acupuncture.
Pain relief that fits your kidney care plan
Your nephrologist and renal dietitian decide which foods you should limit. If back or joint pain is part of your day and you've been told to avoid NSAIDs, Physical Medicine & Rehabilitation of NY & CT (PMR) can talk with you about non-drug options. Request an appointment and our team will contact you to schedule your visit.
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