From the Guidelines
A diet for patients with chronic kidney disease (CKD) should focus on controlling sodium, potassium, phosphorus, and protein intake while maintaining adequate nutrition, with a recommended daily protein intake of 0.8 g/kg body weight per day, as supported by the most recent evidence 1. The dietary recommendations for CKD patients aim to slow disease progression, reduce the risk of cardiovascular disease, and prevent electrolyte imbalances. Key aspects of the diet include:
- Limiting sodium intake to less than 2,300 mg/day to control blood pressure and reduce cardiovascular risk 1
- Restricting potassium intake to 2,000-3,000 mg/day, especially in advanced CKD, by limiting foods like bananas, oranges, potatoes, and tomatoes 1
- Reducing phosphorus intake by avoiding processed foods, dark sodas, and limiting dairy products
- Managing protein intake carefully, with a focus on high-quality protein sources like egg whites, fish, and chicken, and a daily intake of 0.8 g/kg body weight for most CKD patients not on dialysis 1
- Ensuring adequate calorie intake, typically 30-35 kcal/kg/day, to prevent malnutrition and muscle wasting
- Considering fluid restriction in advanced stages, typically 1-1.5 liters daily plus urine output It is essential to work with a renal dietitian to individualize the diet and address specific needs, as dietary requirements change with disease progression and may be influenced by comorbid conditions like diabetes or hypertension 1.
From the Research
Dietary Recommendations for CKD Patients
The recommended diet for patients with Chronic Kidney Disease (CKD) is based on several studies, including 2, 3, 4, 5, and 6. The key aspects of the diet are:
- Restricting phosphorus intake to between 0.8-1 g/day when serum levels of phosphorus and PTH are above the recommended range 5
- Restricting protein intake to approximately 50-60 g of protein per day 5
- Eating a balanced diet with:
- Animal proteins: 1 serving (100-120 g) per day
- Dairy products: 1 serving (equivalent to 200-240 mL of milk or 2 yoghourts) per day
- Bread, cereals, pastas: 1 cup of pasta, rice or legumes + some bread or cookies per day
- Vegetables and fruits: relatively freely, but with moderation
- Following a predominantly plant-based diet, which may have numerous mechanistic benefits for cardiovascular health in kidney disease 4
- Considering a Mediterranean diet, which may lower serum LDL cholesterol levels and have other beneficial effects on cardiovascular risk factors 6
Key Nutrients and Foods
The diet should focus on:
- Restricting sodium, potassium, phosphate, magnesium, and calcium intake, as these electrolytes are biologically vital molecules and their imbalance can contribute to CKD progression 2
- Increasing fruit, vegetable, and plant-based protein intake, which may have beneficial effects on cardiovascular health and gut health 4
- Choosing foods that are low in sodium, animal proteins, and phosphorus, and high in fiber, vitamins, and minerals
Lifestyle and Behavioral Changes
In addition to dietary changes, lifestyle and behavioral modifications are also important for managing CKD, including:
- Regular physical activity
- Stress management
- Getting enough sleep
- Quitting smoking
- Limiting alcohol consumption
Monitoring and Follow-up
Regular monitoring of biochemical parameters, such as calcium, phosphorus, and PTH levels, is crucial for adjusting the diet and preventing complications 5. Additionally, regular follow-up with a healthcare provider is necessary to assess the effectiveness of the diet and make any necessary adjustments.