Renal Diet for People with Kidney Failure or Disease

The kidneys keep fluids in our body at normal levels. When kidneys no longer work well, you can change your diet to help keep fluids and certain nutrients at normal levels. These nutrients include: protein, sodium (salt), phosphorus, potassium and fluid. You must watch the amount of these nutrients you get each day. That way, if your doctor tells you to cut back, you will know how much you were eating or drinking and about how much less to eat or drink.

In general, a renal diet is high in calories, low in fluids, protein, and sodium.

Balancing Salts, Fluids and Electrolytes

Nutrition LabelHealthy kidneys remove waste and fluids from the blood and balance the salts in our body. Once kidneys stop working, you need to limit the amount of certain nutrients you eat and drink. Too much of these nutrients in your blood can cause problems. Your doctor will set limits and restrictions for your diet based on how much kidney function you have. If you are on hemodialysis, when you go to the clinic for dialysis, they take blood for lab tests to measure how much of these nutrients are in your blood. If the lab tests results tell you too much of these nutrients are in your blood, then you are getting too much of them in your diet. Therefore, you need to change your diet to cut back on foods that contain those nutrients until your next lab work. It is a constant effort of monitoring, testing and balancing your fluids, electrolytes and salts. If the results of your blood work are good, then you can continue eating and drinking as you had been. There is usually a dietitian at the dialysis clinic that can help you adjust your diet to better control these nutrients.

It will also be helpful to understand food labels including nutritions facts and ingredient listings.

In addition to a special diet, you may be on medicines to help control these nutrients. There is usually a social services person at the clinic who can help you understand your medicines and tell you or your doctor (nephrologist) if your medicines need adjusting or changed.

Serving Sizes

  • 1/4 cup = a golf ball
  • 1/2 cup = a tennis ball
  • 1 cup = one fist
  • one small fruit = baseball
  • one pancake = the size of a DVD
  • one potato = the size of a computer mouse

5 Nutrients to Monitor

  • Protein
  • Sodium (Normal levels for serum sodium are 135-145 mEg/L)
  • Phosphorus (Normal levels for serum phosphorus are 1.8-2.6 mEg/L)
  • Potassium (Normal levels for serum potassium are 3.5-5 mEg/L)
  • Fluid


Protein is important to help build and maintain muscle mass and the immune system. Too much protein can cause nausea, vomiting, and more damage to the kidneys. Usually, protein is limited with renal failure. A low-protein diet reduces the end products of protein metabolism that the kidneys can no longer get rid of. However, protein may be increased once you start hemodialysis. Your doctor will tell you how many grams of protein you can have each day. (80 grams is a common daily limit for people on hemodialysis.) The protein should come from foods that contain all of the essential amino acids to prevent the breakdown of body protein (muscle). These foods include eggs, milk, poultry and meat. A high calorie diet will also help prevent the breakdown of body protein.

Vegetables, grains, meats, fish, poultry, and legumes (beans and peas) have protein. Most of the protein you eat should come from meats, fish, poultry (chicken) and legumes (beans and peas). Use the list below to plan your meals. g = grams, 1000 mg = 1 gram

  • 1 ounce cooked meat, fish, poultry = 7 g
  • 1 large egg = 7 g
  • 1/2 cup cooked dried beans, peas, lentils = 8 g
  • 1/2 cup tofu = 7 g
  • 2 tablespoons peanut butter = 7 g
  • 1 cup milk, soy milk, or yogurt = 8 g
  • 1/2 cup putting or custard = 4 g
  • 1 slice or 1 inch cubed cheese = 7 g
  • 1/2 cup cottage cheese or ricotta cheese = 7 g
  • 2 tablespoons Parmesan cheese = 7 g


Never add salt to your food—get rid of the salt shaker!Sodium makes us thirsty and want to drink more. As we drink more fluids, we retain fluid and our blood pressure goes up which puts a strain on our kidneys and heart. Avoiding foods high in salt and sodium  helps control fluid. You may eat 2000 mg (2 grams) of sodium per day. Table salt has sodium and chloride; 1 teaspoon of salt equals 2 g of sodium which is equal to your sodium allowance for the day. Salt substitute: does not contain sodium; is usually made from potassium; talk with your doctor before using a salt substitute.

High Sodium Foods to Avoid

  • canned vegetables and soups
  • packaged seasonings and meal starters
  • processed meats
  • seafood
  • ham, bacon, sausage
  • chips, pretzels, nuts, salty snack foods
  • pickled meats and vegetables
  • butter, garlic salt, seasoned salt
  • barbecue sauce, soy sauce, ketchup, mustard
  • processed cheeses and cheese foods

Tips to lowering sodium in your diet

  • leave the salt shaker in the cabinet—out of sight out of mind
  • seasoned with herbs and spices; garlic, onion, sage, rosemary, thyme, lemon juice, fruit
  • read medication labels and content talk with your doctor
  • beware of medicines that contain sodium such as antacids and laxatives
  • dining out: ask for meals made without salt or MSG (monosodium glutamate)
  • choose foods with less than 200 mg of sodium per serving
  • avoid foods with salt or sodium listed as one of the 1st 4 ingredients


Most foods have phosphorus in them. Too much phosphorus can cause calcium to come out of bones, making bones brittle and easier to fracture or break. Your doctor may prescribe a phosphorus-binding medicine to reduce the amount of phosphorus in your body. Tums is a phosphate-binding medicine.

Most people with kidney failure should limit phosphorus to 800-900 mg a day. It is recommended that you that you limit or avoid the following foods:

  • baking powder
  • beer
  • bran cereals
  • breads raised with baking powder
  • caramel
  • cheese (except cottage cheese)
  • chocolate
  • dark cola beverages
  • dried beans
  • dried peas
  • eggs
  • fish
  • milk and milk products
  • organ meats (brain and liver)
  • nuts
  • peanuts and peanut butter
  • poultry
  • whole grains, whole wheat bread


Potassium helps muscles including the heart muscles to contract and relax. Too much potassium can cause your heart to beat irregularly or even stop. Too much potassium in your blood can cause hyperkalemia and emergency treatment should be started. Unless your doctor tells you otherwise, limit potassium to 2000 mg each day. The following list will help you with lower potassium options. Choose fruits from the medium and low potassium groups.

Low potassium foods less than 150 mg per serving

Apples Cottage cheese Lemonade Raw cucumber
Applesauce Cranberry juice Onion Sliced cheddar or Swiss cheese
Bean sprout Diced turnips Parmesan cheese Sour cream
Bell Pepper Frozen pea Pears or papaya not nectar Strawberries
Black or green olives Grapes pineapple Summer squash
Blueberries Green beans Radishes Tangerine
Brewed tea Instant coffee Raspberries

Medium potassium foods 150 to 300 mg per serving

Apple juice Celery Hot cocoa Pears
Asparagus Corn Ice Cream (1/2 Cup) Pineapple Juice
Beets Dates (4) Kiwi Plums
Broccoli Eggplant Milk (1/2 Cup) Raw Cabbage
Carrots Grape juice Mushrooms Ricotta Cheese
Cauliflower Grapefruit (one half) Okra Turnip/Mustard Greens
Grapefruit juice Peaches Zucchini Squash

High Potassium Foods Greater Than 300 Mg per Serving

Apricots Honeydew Melon Prune Juice Tofu
Avocado Milk (1 Cup) Prunes Tomato Juice
Banana Molasses Pumpkins Tomato Sauce
Bran Cereal Nectarine Raisins Tomatoes
Buttermilk Orange Juice Salt Substitutes Vegetable Juice
Chard Oranges Spinach Watermelon
Dried Beans/Peas Papaya Sunflower Seeds Winter Squash
Figs Potatoes Sweet Potatoes Yogurt

Dialyzing Vegetables

You can prepare some vegetables in a way that reduces the amounts of sodium and potassium in them, called dialyzing vegetables. Follow these directions exactly. Be sure your doctors know you are using these methods.

  1. Use fresh potatoes, carrots, beets, rutabaga
  2. Peel and I, placing cold water new line
  3. Slice 1/8 inch thick slices
  4. Soak in warm water for 2 hours. Use 10 times the amount of water to vegetables.
  5. Rinse under warm water.
  6. Cook for 5 min. in 5 times the amount of water to vegetables.
  7. Serve only one portion
  8. You may freeze the left overs

Monitoring Your Fluid Intake

Because your kidneys can’t make urine, your body can’t get rid of fluids, you will need to limit the amount of fluids you take in. Your doctor will tell you how much fluid you can have each day, this amount may be adjusted based on your dialysis treatments. For instance, your limit may be 3 pints per day (6 cups). There are 16 fluid ounces (oz) in a pint, 8 oz in a cup, 2 tablespoons in an ounce.

Fluid is anything that is a liquid at room temperature. All fluids count towards your daily limit including foods that contain a lot of fluid.

  • juice
  • gelatin (Jell-O)
  • ice cream
  • ice cubes (one full cup of ice = 1/2 cup of water)
  • liquid medicines
  • Popsicle
  • water
  • pudding
  • beverages (clear soft drinks)
  • milk
  • soups

Fluid Formulas

  • 1500 mL = 50 ounces = 6 1/4 cups
  • 1000 mL = 33 ounces = 4 cups
  • 300 mL = 10 ounces = 1 1/4 cups
  • 240 mL = 8 ounces = 1 cup
  • 120 mL = 4 ounces = 1/2 cup
  • 60 mL = 2 ounces = 1/4 cup
  • 30 mL = 1 ounce = 1/8 cup = 2 Tbs

Recording Your Daily Fluid Intake

This table shows you how to break down your fluid intake throughout the day. Don’t forget to save enough fluid for taking your medicines; this fluid is counted in the “other” column.

Total Daily
Fluid Allowance
Breakfast Lunch Dinner Other

Measuring Fluid

Another way to keep track of your daily fluid intake is to fill a jar/jug with water with the total daily fluid allowance prescribed by your doctor.

  1. Measure each item you eat or drink that counts as liquid
  2. For each item, remove the same amount of water from the jar/jug
  3. When jar/jug of water is empty, you are finished with your fluid allowance for the day.

What You Can Eat

By now, I’m sure you’re wondering what can you eat? This table shows foods that may be OK for you to eat. You may have other health issues that keep you from eating some of these foods. For example, if you have diabetes or heart disease, some of these foods may have to be limited or cut out of your diet. Take this list to your doctor or dietitian and ask them if these foods are OK for you.

Protein Starches Fruits Vegetables Fats Sweets Drinks
beef bagels, muffins, English muffins apples, applesauce beets butter cake ginger ale, Sprite, 7-Up
pork yeast rolls, popovers blueberries, cherries cabbage margarine cookies (ginger snaps,
lemon or vanilla filled, sugar, shortbread)
chicken bread ( white, wheat, rye, pita) cranberries sauce carrots (cooked) cooking oil cheesecake weak tea
wild game crackers, unsalted fruit cocktail celery, cucumbers cream cheese cinnamon rolls, doughnuts
(glazed, jelly)
weak coffee
turkey dry cereal, no nuts or dried fruit grapes broccoli and cauliflower, cooked mayonnaise fruit tarts water
fish noodles, rice lemons, limes, tangerines corn nondairy creamer pies (apple, blueberry,
cherry, lemon, strawberry)
eggs pancakes, waffles pears, plums, pineapples eggplant salad dressing Popsicles
popcorn raspberries green beans, peas rice Krispie treats
tortillas, corn or flour strawberries onions honey, jam, jelly, syrup
peppers (green and red)
squash (yellow), zucchini
turnips, rutabagas

Sample Menus

Below are a couple of sample menus plans made from the list of foods you can eat. Use day 3 to come up with a menu plan of your own.

Day 1 Day 2 Day 3
Breakfast Breakfast Breakfast
Protein Egg Canadian bacon
Starch Bagel Cinnamon toast, jelly
Fruit Strawberries Fruit Cocktail
Fat Cream cheese Margarine
Drink/Fat Coffee w/nondairy creamer Coffee w/nondairy creamer
Lunch Lunch Lunch
Protein Tuna Salad made with Eggs Beef patty
Starch Bread Hamburger bun
Vegetable Celery Lettuce, onions
Fruit Pear Pineapple
Fat Mayonnaise Mayonnaise
Sweet Cookies Apple Pie
Drink Tea Lemonade
Dinner Dinner Dinner
Protein Fried chicken Grilled Fish
Starch Cornbread Yeast Roll
Vegetable Squash (yellow), Green Beans Grilled Asparagus and Corn on the Cob
Fruit Strawberries Blueberries
Fat Margarine Margarine
Sweet Pound cake Cheesecake
Drink Tea Tea


  1. catherine m montz says

    the diet of kidney disease is strange, what is good for you is now bad for you.

  2. catherine m montz says

    My husband had surgery and is living with 1 partial kidney. He was on Dialysis for 7 weeks and his kidney recovered. He has been off dialysis for almost 2 weeks. I would certainly follow the diet restrictions. No wheat bread only white. ON dialysis more protein , off Dialysis less protein. No chocolate, no ice cream. spinach is bad , phosorous is the worst . You can have pasta and I put that white sauce on it. String beans cooked in olive oil with garlic power and pepper. I cook a steak and he gets a little over a 1/4 of the steak. I was so so confused at first , but I have educated myself as I go. The diet is way different for people on dialysis verses off. The best thing is to follow and eat what your supposed to. I never thought he would be off dialysis , but his eating habits are perfect now.

  3. Maarilyn Kreitlow says

    Iam stage 3 kidney disease. According to the nutritionist that I see regarding what is ok to eat and what is not its quite strict. All that I always thought was healthy to eat turned out to not be ok for a renal diet….Its for example ok to eat white bread…white rice…little meat no red meat…so much protein a day….no potatoes of any kind….no greens….no tomatoes….no avocados… no dairy…..certain fruits and vegies…not easy…

  4. Susan Calise says

    I was just diagnosed with renal failure stage 3. Went in to see a renal specialist on Wednesday the day before Thanksgiving scared to death. He read my numbers and he said next time in a mthy when I see you you will have new blood work done next. Then you will get a sonagram of your kidneys then a week before you come back to see me I need a fasting blood work . I was like ok he goes any questions yes I said tomorrow is Thanksgiving what can I eat he said eat healthy so I said can I have one beer he said yes . Then he goes just keep eating healthy first time I ever meet this doc. I love salt and cola regular not diet my gp told me not to drink soda. One good piece of advice. But that’s it not how much I can drink. Water juice anything. I’m so confused. I need a lot of help.

  5. Ina Crone Nothing to be confused about. As my doctor once said to me, “Just stick with green lettuce after the age of 50, and you’ll be OK.” Those are the sober facts of chronic metabolic diseases.

  6. I love eating that putting, man.

  7. Will yes I just got on this but I am doing fine.I watch what I eat so for I am doing well .Just look up do what they say u will b ok.Because u can make it

  8. Ina Crone says

    James I am still confused about it all. I know it is so confusing and I struggle every day.

  9. Hi
    I ended up in the hsp (have CKD GFR 31) with no sodium in my body, I was so confused on how much sodium to eat a day it was driving me crazy.
    While eliminating what I thought was to much salt I was also washing what sodium I had left away with drinking 3 ltrs of wtr every day..
    Now how’s that for STUPIDITY. I know eventually I will be on dialysis one day (not looking forward to that). But trying to keep my wits about me, thinking positive and lucky to be alive every day.
    So a VALUABLE LESSON LEARNED here – and its a struggle still yes but will catch on. Hopefully I can find some good receipes from this website a dietiian in the hsp recommended to check out. Take care everyone out there your definitely not alone and I now know it to.

  10. James- I am with you. I have no idea what to eat anymore. I have CDK.
    I am going to see a dietitian. Its tough and I need to know wheat, white? What I think is good is bad……I am a mess trying to figure it out

  11. I am so confused, as to what I can eat. I have PKD / Polycystic Kidney Disease. I have to watch very closely , my potassium and phosorous and sodium levels and intake. Everyday, is a struggle! I absolutely LOVE chocolate, however it is suppose to be bad for my disease. Can I have chocolate cake or cookies every once in a blue moon? I need to know t his answer, please! !

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