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Nutrition and CKD Stage 1-4

Why is good nutrition important for people with chronic kidney disease?

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Making healthy food choices is important to us all, but it is even more important if you have chronic kidney disease (CKD).  Good nutrition can help to:

  • Provide energy to do your daily tasks
  • Prevent infection
  • Avoid muscle-mass loss
  • Help maintain a healthy weight
  • Slow down the progression of kidney disease

What are the basics of good nutrition?

A well balanced diet gives you the right amounts of protein, calories, vitamins, and minerals each day. Eating a healthy diet, staying physically active and taking all your medicines as prescribed are all important parts to keeping you healthy and feeling well.

Will I need to change my diet if I have kidney disease?

Your kidneys help to keep the right balance of nutrients and minerals in your body. But if you have kidney disease, your kidneys may not be able to do this job very well. You may need to make some changes to your diet.

Ask your doctor about meeting with a Registered Dietitian with special training in kidney disease.  A dietitian can teach you to make the best food choices based on your lab tests and personal lifestyle.  Making changes in your diet to better control diabetes and high blood pressure can also help to keep kidney disease from getting worse.  Meeting with a dietitian is a covered service by Medicare.  The service may also be a covered benefit by other types of insurance. You may need to call your insurance provider to find out if meeting with a dietitian is covered by your plan.

What kinds of changes will I need to make to my diet?

There is not one eating plan that is right for everyone with kidney disease. What you can or cannot eat may change over time, depending on how much kidney function you have and other factors. Also, if you are following a special diet for diabetes or heart conditions, you will need to continue to follow it as well.

People with kidney disease may need to control the amount of protein, sodium, potassium, phosphorus, and calcium in their diet.   If your kidney disease gets worse, you may need to limit other nutrients as well. Your dietitian or healthcare provider will tell you if you need to do this based on your blood test results.

Why might I need to control protein, sodium, phosphorus, calcium, or potassium?

Eating the right amount of protein, sodium, potassium or phosphorus may help control the buildup of waste and fluid in your blood. This means your kidneys do not have to work as hard to remove the extra waste and fluid.


Your body needs protein to help build muscle, repair tissue, and fight infection. If you have kidney disease, you may need to watch how much protein you eat. Having too much protein can cause waste to build up in your blood. Your kidneys may not be able to remove all the extra waste. It is important to eat the right amount of protein each day. The amount of protein you need is based on your body size, your kidney problem, and the amount of protein that may be in your urine. Protein intake should not be too low, or it may cause other problems. Your dietitian or healthcare provider can tell you how much protein you should eat.


Healthy kidneys control how much sodium is in your body. If your kidneys do not work well, too much sodium can cause fluid buildup, swelling, higher blood pressure, and strain on your heart. Your dietitian or healthcare provider can tell you the right amount of sodium you should have each day.


Potassium works with the muscles, including the heart. Too much or too little potassium in the blood can be very dangerous. The amount of potassium you need is based on how well your kidneys are working and medications you are taking. Your dietitian or healthcare provider can tell you about foods that have potassium and the right amount for you to eat each day.


As kidney function gets lower, extra phosphorus can start building up in the blood. High phosphorus levels can cause bones to get weaker. Your dietitian or healthcare provider can tell you if you need to limit goods that are high in phosphorus.


Foods that are good sources of calcium are often high in phosphorus. Your dietitian or healthcare provider will tell you if you need to limit calcium. Talk to your healthcare provider before taking any over the counter vitamin D or calcium supplements.

Will I need to limit fluid?

Most people in the early stages of kidney disease do not need to limit the amount of fluids they drink. If you do not know your stage of kidney disease, ask your healthcare provider.

If your kidney disease gets worse, your dietitian or healthcare provider can let you know if you need to limit fluids and how much to drink each day.

How many calories do I need?

Every person is different. Calories are like fuel. If you don’t eat enough calories, you body will use protein for energy.  This protein comes from your muscles. This can make you weak and may also cause damage to the kidneys. It is important to make sure you are getting the right amount of calories. The right amounts of calories are important to:

  • Help you stay at a healthy weight.
  • Give you energy to do your daily tasks.
  • Help your body use the protein in food to build muscle and tissues.

Too many calories can cause extra weight gain which can be a burden on the kidney. If you are overweight, some weight loss may be beneficial. If weight loss is desired or you have diabetes, you should meet with a dietitian to set up a plan based on your kidney blood tests, current food choices and daily activities.

Should I be taking any vitamin and mineral supplements?

Most people get enough vitamins and minerals to stay healthy by eating a variety of foods each day. You need to limit some foods because you have kidney disease that would have given you vitamins and minerals. If so, you may need to take special vitamins or minerals. You should only take the vitamins and minerals your dietitian or healthcare provider tells you to take because some may be harmful to people with kidney disease.

You should check with your healthcare provider before taking any medications you can buy without a prescription. Some over the counter medications may be harmful to people with kidney disease. You should also avoid taking herbal supplements.

Copyright by the National Kidney Foundation. All rights reserved.