A meal plan for stage 3 kidney disease is just as unique as the individual behind the diagnosis. Kidney disease affects every person in a different way, making meal plans a personalized decision. On first glance, it might appear that someone with stage 3 kidney disease should eat differently than someone with stage 1 or stage 2 kidney disease, but I’d argue that the key factor is how well you are managing the symptoms of your condition.
Foods to Avoid for Kidney Disease
Chronic kidney disease, or CKD, is characterized by a progressive loss of kidney function over time.
Kidney disease is divided into five stages based on your estimated glomerular filtration rate (eGFR) and how well your kidneys can clear waste and extra fluid.
Your renal illness is in stage 3 if your eGFR is between 30 and 59. This suggests that there has been minor renal injury.
If you have kidney disease in stage 3, you might not notice any symptoms. However, you are now at risk for health problems as waste begins to build up in your body.
The good news is that you can change your diet to prevent the progression of renal failure.
We’ll cover foods to avoid if you have kidney disease in this article.
Maintaining a kidney-friendly diet is essential for preventing the advancement of renal illness. You should avoid foods high in potassium, salt, and phosphorus unless your doctor specifically recommends you to do otherwise.
The following foods should be avoided if you have stage 3 chronic renal illness.
Whole Grain Bread
Because it is high in fiber and other vital vitamins and minerals, whole grain bread is typically preferred over white bread for people without kidney disease.
However, because whole grain bread contains more potassium and phosphorus than white bread, it is typically advised to limit its consumption for those with moderate to advanced kidney disease.
For instance, the following is found in one slice (28 grams) of whole grain bread:
- About 69 milligrams of potassium
- 57 milligrams of phosphorus
In comparison, the same size slice of white bread contains:
- 32.8 milligrams of potassium
- 31.6 milligrams of phosphorus
Bran Cereals and Oatmeal
When shopping for cold and hot cereals, be sure to look at the food label. Many cereals that you find at the grocery store are filled with hidden:
Limit or avoid cereals with the word phosphorus or “phos” listed on the ingredient list. A 3/4 cup of bran flakes cereal contains about:
- 160 milligrams of potassium
- 135 milligrams of phosphorus
One cup of cooked oatmeal contains:
- 180 milligrams of phosphorus
- 164 milligrams of potassium
Nuts and Sunflower Seeds
Nuts and seeds are popular, healthy snacks for most people. However, for a person with kidney disease, they can be harmful.
A 1 ounce serving, or about 23 almonds, contains about:
- 208 milligrams of potassium
- 136 milligrams of phosphorus
Cashews contain about:
- 187 milligrams of potassium
- 168 milligrams of phosphorus
Consider combining nuts and sunflower seeds with other low-potassium and low-phosphorus meal alternatives if you love them. Alternately, select nuts with less phosphorous.
Given that they only have 104 milligrams of potassium and 53 milligrams of phosphorus per 1 ounce (28 grams) meal, macadamia nuts are a wonderful option for a kidney diet.
Most dark-colored sodas are high in phosphorus additives to help preserve shelf life and enhance the flavor. They are also high in calories and sugar and should be limited on all diets.
Most dark-colored sodas contain anywhere from 50–100 milligrams of phosphorus in a 200 milliliter serving.
Studies show that the absorption rate for phosphorus additives is higher than natural or plant-based phosphorus.
Root beer is an exception, with less than 1 milligram of phosphorus and potassium per serving.
The best beverages to drink on a kidney diet are water, cream soda, lemon-lime soda (such as Sprite or 7UP), lemonade, or root beer.
Important vitamins and minerals as well as heart-healthy fats can be found in abundance in avocados. They must be avoided when on a kidney diet, though, due to their high potassium content.
Approximately 690 mg of potassium are found in one avocado.
You should avoid or consume avocado or guacamole in moderation if your doctor has advised you to limit potassium.
Although avocados are heavy in potassium, a kidney-friendly diet can still include them in moderation. To keep your daily potassium consumption modest, keep the serving to one-fourth of a medium avocado.
Milk, cheese, yogurt, ice cream, and other dairy products are excellent sources of calcium, protein, and other vital nutrients. They contain a lot of potassium and phosphorus as well.
Protein, phosphorus, and potassium intake may need to be restricted in someone with stage 3 kidney disease.
According to one cup of 2% milk:
- 8 grams of protein
- 252 milligrams of phosphorus
- 390 milligrams of potassium
Consider dairy alternatives such as almond milk, soy milk, and rice milk. These options typically have less protein, phosphorus, and potassium compared to cow’s milk.
Brown rice is a whole grain that is high in fiber and is often recommended for healthy individuals to promote heart health.
However, like whole grain bread, brown rice has a higher phosphorus and potassium content than white rice.
For example, 1 cup of cooked brown rice contains about:
- 208 milligrams of phosphorus
- 174 milligrams of potassium
In comparison, 1 cup of cooked white rice contains:
- 69 milligrams of phosphorus
- 54 milligrams of potassium
White rice, wild rice, barley, and buckwheat have a lower potassium and phosphorus content than brown rice and are great alternatives.
One of the best food sources of potassium is bananas. There are an astounding 422 mg of potassium in one medium banana.
Limiting potassium intake when on a renal diet is crucial to prevent an excessive buildup in the blood that could cause heart issues.
Choose fruit options that are good for your kidneys instead of bananas, such apples and berries.
Oranges are rich in potassium, as is orange juice. Around 255 milligrams of potassium are found in one orange.
Orange juice has 443 milligrams of potassium per cup.
You should stay away from oranges and orange juice if your nutritionist or kidney doctor has advised you to limit your potassium consumption.
Choose a fruit like pineapple or pineapple juice if you want to avoid damaging your kidneys, rather than oranges or orange juice. Apple juice, cranberry juice, or grape juice are other kidney-friendly fruit juice possibilities.
Potassium levels in potatoes are naturally high. 610 mg of potassium are found in one medium potato.
There are, thankfully, techniques to lower the potassium level of potatoes. Leaching, or soaking potatoes in water before cooking, is one of the greatest methods for reducing the potassium level in potatoes.
Cutting the potatoes into little pieces and boiling them for around 10 minutes in water is the most efficient approach to remove potassium through leaching. By doing this, the potassium concentration can be decreased by at least 50%.
Leaching or boiling potatoes can reduce their potassium concentration by as much as 50% if you intend to include them in your kidney-friendly diet.
Fruits high in potassium, such as tomatoes, are frequently avoided or consumed in moderation by people with stage 3 renal disease.
Both tomato sauce and raw tomatoes fall under this category. For instance, around 910 milligrams of potassium are included in 1 cup of tomato sauce.
292 mg of potassium are found in one medium tomato.
Tomatoes and tomato sauce need to be avoided if your doctor has advised you to limit your potassium intake.
Choose a wonderful roasted red pepper sauce that has less potassium per serving than tomato sauce as an alternative.
Oats are the primary component in most granola recipes. Granola is generally a good choice, but because it contains potassium, it should be avoided when following a kidney diet.
Potassium content in two ounces of granola is about 306 mg.
Consider creating your own kidney-friendly homemade granola with less potassium instead of buying it from the store.
Beans are a fantastic source of fiber and plant-based protein. If ingested in significant amounts, they can also raise the levels of potassium and phosphorus in your blood, though.
According to recent research, people with chronic renal disease can get enough protein from beans and other legumes.
Nevertheless, due to their high phosphate and potassium levels, recommendations advise reducing bean consumption.
Take cooked pinto beans as an example, which include 251 milligrams of phosphorus and 746 milligrams of potassium per cup.
Before cooking, leaching beans and other legumes can help reduce their potassium concentration. However, be sure to discuss the recommended daily intake of leached, high-potassium vegetables with your kidney dietician.
Meats that have been fermented, smoked, salted, or cured in order to enhance flavor and increase shelf life are referred to as processed meats.
Pepperoni, beef jerky, corned beef, hot dogs, and sausage are a few examples of processed meats.
Consumption of red meat and processed meat is linked to an increased risk of developing chronic kidney disease.
In addition to being high in sodium, processed meat is also high in protein.
Choose skinless turkey or chicken, fresh fish, or eggs as an alternative to processed meats. Remember that these still include a lot of protein; thus, consult your nutritionist to determine how much protein you require.
Pickles and Relish
Curated foods include relish and pickles. They should be avoided on a renal diet since they are heavy in sodium.
One large pickle, for instance, has about 1,630 mg of sodium in it. A kidney-friendly diet typically advises someone to limit their daily sodium intake to 2,300 mg.
On a renal diet, pickles and relish should be avoided because they are high in sodium. To reduce your daily sodium intake, use low-sodium pickles if you’re in the mood for a pickle. It’s vital to study food labels to make sure low-sodium products stay within your recommended sodium intake because they still contain sodium.
Because of their potassium level, it is advisable to avoid apricots if you have stage 3 chronic renal disease. Potassium content in one cup of sliced apricots is 427 milligrams.
A cup of dried apricots also contains about 1,510 milligrams of potassium. Your recommended daily dose of potassium can easily be met with this.
A person on a potassium-restricted diet should typically keep their daily potassium consumption to under 2,000 mg.
Instead of apricots, choose a fruit that is good for your kidneys, like plums or peaches, to stay within the range of potassium you should consume each day.
Premade or Frozen Meals
Most processed foods, including premade or frozen meals, are high in sodium. Examples include
soups, frozen pizza, and premade frozen entrees.
On a kidney diet, it’s crucial to stay away from prepackaged meals as many of them might make up the majority of your permissible daily sodium intake.
Choose frozen or prepared meals with fewer than 600 mg of salt per serving.
As an alternative, you can prepare and freeze your own kidney-friendly, low-sodium meals, which can be prepared in a matter of minutes.
Swiss Chard, Spinach, and Beet Greens
Due to their high potassium level, the majority of leafy green vegetables, such as Swiss chard, spinach, and beet greens, are not suggested on a kidney diet.
One cup of cooked spinach, for instance, has 839 mg of potassium, or about half of the daily allowance for a person with stage 3 chronic renal disease.
To reduce your daily potassium intake, choose low-potassium green vegetables including green beans, asparagus, lettuce, and celery.
Prunes, raisins, and other dried fruits provide abundant sources of potassium, sugar, and calories.
One cup of prunes, for instance, has 1,270 milligrams of potassium in it.
However, the potassium is considerably diminished when it is in its unprocessed form. Only 259 milligrams of potassium are present in one cup of plums.
Fresh fruits are preferable to dried fruits with high potassium content. Pick fruits low in potassium, including figs, plums, or grapes.
Pretzels, Chips, and Crackers
Pretzels, chips, and crackers are common examples of snacks that are rich in salt. They also lack crucial nutrients that are necessary for your body to function correctly.
Given that they are made of potatoes, potato chips are likewise high in potassium and are to be avoided.
Around 150 milligrams of salt and 336 milligrams of potassium are included in one small bag of potato chips (22 chips).
Low-sodium foods should be used in place of pretzels, chips, and crackers. Pita chips, low-sodium crackers, and unsalted popcorn are all tasty kidney-friendly snack options.
IF YOU HAVE STAGE 3 KIDNEY DISEASE, THE RENAL DIET IS NOT FOR YOU
Imagine that you have recently received a new diagnosis of Stage 3 Chronic Kidney Disease and are leaving your primary care physician’s office (CKD). The news comes as a shock because you have been controlling your diabetes and high blood pressure reasonably successfully for the past ten years.
You make the decision that evening to alter your diet in order to assist your kidneys. With your diabetes and high blood pressure, you have already done this. You may have reduced your HgbA1c over the past few years by avoiding simple carbohydrates and choosing whole grain toast, oatmeal, and wheat pancakes in place of white bread, biscuits, and grits. And perhaps you’ve seen a decrease in blood pressure as well after adding a variety of fruits and vegetables to your daily diet. You now have more energy, a smaller frame, and you’re prepared to approach your kidney condition in the same manner.
When you Google “renal diet,” results appear.
Your brain begins to spin with just a cursory peek at the list.
White bread can be used in place of whole grain toast. Whoa, what?
No more oranges, tomatoes, collard greens, spinach, etc. Huh?
Throw out the banana and oats. You ask yourself, “What should I have for breakfast? cereal and milk?”
I can’t have that either, are you sure?
Despite your best efforts, it becomes impossible to strike a balance between the diabetic diet’s guidelines and the renal diet’s low potassium and low phosphorus requirements.
As a nephrologist, I encounter this situation every month. My patients frequently struggle needlessly with the renal diet and all of its paradoxes before I can help them because our clinic frequently has a three-month delay between a referral and the first office visit. How can I assist them? The best news I can deliver to them is, “The renal diet is not for you.”
Furthermore, the renal diet frequently does not apply to the majority of those with Stage 4 chronic kidney disease in addition to those with Stage 3 disease. In fact, attempting to follow a renal diet at these advanced stages of kidney disease is more likely to result in issues than it is to assist down the disease’s progression.
Not yet clear?
The conventional renal diet was created for a very specific group of people: those with kidney disease who have high blood levels of potassium and phosphorus and, typically, those who are receiving hemodialysis. You can limit your diet in ways that are unnecessary for you if you are not vigilant or visit a website with inaccurate advice. Your kidneys, for instance, might not filter everything properly, but they might still filter potassium and phosphorus effectively.
Don’t start a renal diet straight away if your primary care physician has diagnosed you with stage 1-4 kidney disease. Discuss your lab results with a dietician. To determine whether you need to restrict certain meals that contain high amounts of these elements, ask your nephrologist to examine your medications, your potassium level, and your phosphorus level.
Your heart function, medications, level of electrolytes in your blood, and other factors will all affect how you should eat to stop the progression of your chronic renal disease. You may also have diabetes or hypertension. When creating your ideal diet, your dietitian or doctor should also take into account your socioeconomic level, lifestyle, and likes and dislikes.
Don’t limit these foods unless your doctor has specifically instructed you to do so or unless your potassium level is excessive. It is unneeded and perplexing to add this amount of stress to an already challenging disease management. Additionally, avoiding items high in potassium, such as various fruits, vegetables, and nuts, which are frequently the foundation of a healthy diet, may be more detrimental than beneficial.
This is excellent news for most individuals. The renal diet is complicated, limiting, and demanding.
The advice to stay away from the renal diet, however, shocks and angers a small percentage of people. In fact, the only time a patient has dismissed me was because I insisted that she did not need the renal diet for her Stage 3 Chronic Kidney Disease. She firmly believed that it pertained to her and was enraged when I disagreed.
At the time, I felt vindictive because my patient believed she knew more about renal illness than I did and irate that she fired me. I now see that I handled the situation poorly since I didn’t appreciate her viewpoint.
Despite having a moderate case of renal illness, this woman was determined to manage it by changing her eating habits. I should have worked harder to influence her eating habits in the direction of the DASH diet (Dietary Approaches to Stop Hypertension), or at the very least, provided her with some recipes or advice for eating while suffering from early kidney disease, even though it didn’t fit with the conventional renal diet.
Foods to Avoid or Limit If You Have Bad Kidneys
Your kidneys are bean-shaped organs that serve a variety of crucial roles.
In addition to filtering blood and eliminating waste through urine, they also produce hormones, maintain mineral balance, and regulate fluid balance.
Kidney disease is accompanied by a number of risk factors. High blood pressure and uncontrolled diabetes are the most prevalent.
The causes of kidney illness also include alcoholism, heart disease, hepatitis C, and HIV.
Fluid can build up in the body and waste can gather in the circulation when the kidneys are damaged and unable to operate correctly.
However, cutting back on or eliminating specific foods from your diet may help to enhance kidney function, lower blood waste levels, and prevent additional harm.
Uncontrolled diabetes and high blood pressure are the most prevalent risk factors for renal disease. Learn which meals to limit or avoid if you have weak kidneys in this video.
Diet and kidney disease
Depending on the stage of renal illness, there are different dietary restrictions.
For instance, dietary limits for persons with chronic kidney disease in the early stages differ from those for people with end-stage renal disease, or kidney failure.
Dialysis patients with end-stage renal failure will also have a range of dietary limitations. Dialysis is a sort of treatment that filters waste and eliminates excess water.
Most people with end-stage renal disease will require a kidney-friendly diet to prevent an accumulation of specific chemicals or nutrients in the blood.
The kidneys are unable to efficiently eliminate too much salt, potassium, or phosphorus in those with chronic renal disease. They are therefore more likely to have increased blood levels of these elements.
A renal diet, also known as a kidney-friendly diet, often restricts salt intake to under 2,300 mg per day as well as potassium and phosphorus intake.
The most recent Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines from the National Kidney Foundation do not specify potassium or phosphorus intake restrictions.
People with kidney illness should still be cautious about their intake of potassium and phosphorus, but they should work closely with their doctor or dietitian to establish their individual limitations for these nutrients, which are typically based on lab results.
Kidney damage may make it more difficult to filter the waste products of protein metabolism. Therefore, unless they are on dialysis, people with chronic renal disease of any stage, especially stages 3-5, should reduce the quantity of protein in their meals.
However, those who are receiving dialysis for end-stage renal illness need more protein.
1. Dark-colored soda
Sodas contain phosphorus-containing ingredients in addition to calories and sugar, especially dark-colored sodas.
Phosphorus is a common ingredient used by food and beverage producers during processing to improve flavor, extend shelf life, and avoid discolouration.
This additional phosphorus is more readily absorbed by your body than natural, animal-based, or plant-based phosphorus.
In contrast to natural phosphorus, phosphorus found in additives is not protein-bound. Instead, it is present as salt and is readily absorbed by the digestive tract.
A product’s ingredient list will often contain additive phosphorus. The precise quantity of the phosphorus ingredient, however, need not be listed on the food label by the food maker.
While the amount of additive phosphorus in each brand of soda varies, most dark-colored sodas are thought to contain 50–100 mg per 200 mL serving.
A 12-ounce can of coke has 33.5 mg of phosphorus in it, according to the food database of the United States Department of Agriculture (USDA).
Sodas should be avoided while following a renal diet, especially those that are dark.
Dark-colored sodas should be avoided on a renal diet, as they contain phosphorus in its additive form, which is highly absorbable by the human body.
The numerous health benefits of avocados, including their heart-healthy fats, fiber, and antioxidants, are frequently praised.
A person with kidney disease may need to avoid avocados even though they are typically a healthy addition to the diet.
This is due to the high potassium content in avocados. One medium avocado has a whooping 690 milligrams of potassium in it.
People with kidney illness can still incorporate this food in their diets while lowering potassium, if necessary, by cutting the portion size to one-fourth of an avocado.
If you have been advised to control your potassium consumption while on a renal diet, avocados, especially guacamole, should be restricted or avoided. It’s important to keep in mind that everyone has different needs and that the most crucial factors to take into account are your overall diet and health objectives.
Consider avoiding avocados on a renal diet if your doctor or nutritionist has advised you to lower your potassium intake.
3. Canned foods
Because they are inexpensive and convenient, people frequently purchase canned goods including soups, vegetables, and beans.
However, because salt is added as a preservative to extend its shelf life, the majority of canned goods contain high levels of sodium.
It is frequently advised that persons with kidney illness avoid or limit their use of canned products due to the high salt content in them.
The best options are usually those with lower sodium content or those that say “no salt added.”
Additionally, depending on the product, draining and rinsing canned items like canned tuna and beans can reduce their salt level by 33-80%.
Canned foods are often high in sodium. Avoiding, limiting, or buying low sodium varieties is likely best to reduce your overall sodium consumption.
4. Whole wheat bread
Those with kidney disease may find it difficult to select the correct bread.
Whole wheat bread is frequently advised over refined, white flour bread for healthy people.
Due to its higher fiber content, whole wheat bread may be a more nutritive option. For people with kidney illness, white bread is typically advised above whole wheat variants.
This is as a result of its potassium and phosphorus concentration. The bread’s phosphorus and potassium contents increase with the amount of bran and whole grains it contains.
For instance, a serving of whole wheat bread weighing one ounce (30 grams) has 57 mg of phosphorus and 69 mg of potassium in it. White bread, in contrast, only has 28 mg of phosphorus and potassium.
Without having to completely give up whole wheat bread, eating one slice of whole wheat bread instead of two can help you reduce your potassium and phosphorus intake.
Be aware that most bread and bread products, whether they are made of white or whole wheat, also contain a lot of sodium.
It’s advisable to evaluate the nutritional information on different kinds of bread, select one with less sodium if you can, and keep an eye on your portion proportions.
White bread is typically recommended over whole wheat bread on a renal diet due to its lower phosphorus and potassium levels. All bread contains sodium, so it’s best to compare food labels and choose a lower sodium variety.
5. Brown rice
Brown rice is a whole grain with a higher potassium and phosphorus content than white rice, similar to whole wheat bread.
Cooked brown rice has 150 mg of phosphorus and 154 mg of potassium per cup, compared to 69 mg and 54 mg, respectively, in cooked white rice.
Brown rice might be acceptable in a renal diet, but only if the portion is moderated and balanced with other meals to prevent a daily potassium and phosphorus intake that is too high.
Brown rice can be effectively replaced with the nutrient-rich, lower phosphorus grains bulgur, buckwheat, pearled barley, and couscous.
Brown rice has a high content of phosphorus and potassium and will likely need to be portion-controlled or limited on a renal diet. White rice, bulgur, buckwheat, and couscous are all good alternatives.