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Why is nutrition important for someone with early chronic kidney disease (CKD)?
Controlling blood glucose, also called blood sugar, and blood pressure through healthy food choices is an important step toward slowing or stopping the progression of CKD. Diabetes and high blood pressure are the two leading causes of CKD in the United States. A person’s eating habits can increase or decrease diabetes and blood pressure risks.
What do the kidneys do?
The kidneys remove wastes and extra water from the blood and make urine. To keep the body working properly, the kidneys balance the salts and minerals—such as calcium, phosphorus, sodium, and potassium—that circulate in the blood. The kidneys also release hormones that help make red blood cells, regulate blood pressure, and keep bones strong.
What are the effects of CKD?
CKD usually takes a long time to develop and does not go away. In CKD, the kidneys continue to work—just not as well as they should. Wastes may build up so gradually that the body becomes used to having those wastes in the blood. Salts containing phosphorus and potassium may rise to unsafe levels, causing heart and bone problems. Anemia—low red blood cell count—can result from CKD because the kidneys stop making enough erythropoietin, a hormone that causes bone marrow to make red blood cells. After months or years, CKD may progress to permanent kidney failure, which requires a person to have a kidney transplant or regular blood filtering treatments called dialysis.
Who is at risk for CKD?
Millions of Americans are at risk for developing CKD because they have diabetes, high blood pressure, or both. High blood glucose levels put people with diabetes at risk for heart disease, stroke, amputation, and eye and kidney problems. People with high blood pressure are at risk for damaged blood vessels, including tiny vessels in the kidneys.
What does a person with CKD and diabetes need to know about food and controlling blood glucose?
People with either type 1 or type 2 diabetes must choose foods carefully to control their blood glucose, the body’s main source of energy. Following a meal plan to keep blood glucose at a healthy level may prevent CKD from developing.
People with diabetes should talk with their health care provider about setting goals for maintaining healthy blood glucose levels and about how often to check their blood glucose level. The results from these blood glucose checks indicate whether a person’s meal plan is helping to keep diabetes under control. People with diabetes should also ask their doctor for an A1C test at least twice a year. The A1C number reflects a person’s average blood glucose level over the past 2 to 3 months.
Following regular, daily habits can help maintain healthy blood glucose levels:
- Eating about the same amount of food each day.
- Eating meals and snacks at about the same times each day.
- Not skipping meals or snacks.
- Taking medicines at the same times each day.
- Participating in physical activity every day.
What does a person with CKD and high blood pressure need to know about food and controlling blood pressure?
As blood pressure rises, the risk of damage to the arteries, heart, brain, and kidneys increases. Controlling blood pressure through healthy food choices and regular physical activity can delay or prevent the development of CKD.
Blood pressure is expressed as two numbers. The top number represents the force of the blood pushing against the artery walls when the heart beats. The lower number represents the pressure between beats. Normal blood pressure is below 120/80 millimeters of mercury (mmHg). People with CKD should try to keep their blood pressure below 140/90 mmHg.
Following a meal plan can help control blood pressure and protect the kidneys. The National Heart, Lung, and Blood Institute supported research that compared a typical American diet with the Dietary Approaches to Stop Hypertension (DASH) eating plan, which is lower in saturated fat, cholesterol, and total fat and emphasizes eating fruits, vegetables, and low-fat dairy foods. People who followed the DASH eating plan were able to reduce their blood pressure much more than those who ate a typical diet. The DASH eating plan also includes whole grain products, fish, poultry, and nuts. Limiting sodium, or salt, is another important feature of the plan. A dietitian can help find low-salt or salt-free alternatives to foods that are high in salt.
What is medical nutrition therapy (MNT)?
MNT is the use of nutrition counseling by a registered dietitian to help promote a medical or health goal. A doctor may refer a patient to a registered dietitian to help with the patient’s food plan. Many insurance policies cover MNT when recommended by a doctor. Anyone who qualifies for Medicare can receive a benefit for MNT from a registered dietitian or nutrition professional when a doctor provides a referral indicating the person has diabetes or kidney disease.
One way to locate a qualified dietitian is to contact the American Dietetic Association at www.eatright.org and click on “Find a Registered Dietitian.” Users can enter their address or ZIP code for a list of dietitians in their area. A person looking for dietary advice to prevent kidney damage should click on “Renal (Kidney) Nutrition” in the specialty field. Dietitians who specialize in helping people with CKD are called renal dietitians.
How can understanding and keeping track of lab reports help someone with early CKD make healthy food choices?
Learning how to read and understand lab reports lets a person see how different foods can affect the kidneys. A doctor should order regular blood tests for people with CKD. Patients can ask their doctor for copies of their lab reports and ask to have them explained, noting any results out of the normal range. Keeping track of these lab results can help people see whether they are making progress or getting worse. People with CKD should talk with their doctor or dietitian about how they can make healthier food choices. For example, a person who has a high A1C score should follow a diabetes meal plan to lower blood glucose levels.
Points to Remember
- Controlling blood glucose and blood pressure through healthy food choices is an important step toward slowing or stopping the progression of chronic kidney disease (CKD).
- The kidneys remove wastes and extra water from the blood and make urine.
- Millions of Americans are at risk for developing CKD because they have diabetes, high blood pressure, or both.
- People with either type 1 or type 2 diabetes must choose foods carefully to control their blood glucose. Following a meal plan to keep blood glucose at a healthy level may prevent CKD from developing.
- Controlling blood pressure through healthy food choices and regular physical activity can delay or prevent the development of CKD. People with CKD should try to keep their blood pressure below 140/90 mmHg.
- Medical nutrition therapy (MNT) is the use of counseling by a registered dietitian to help promote a medical or health goal.
- Dietitians who specialize in helping people with CKD are called renal dietitians.
- Learning how to read and understand lab reports lets a person see how different foods can affect the kidneys. Patients can ask their doctor for copies of their lab reports and ask to have them explained, noting any results out of the normal range.
The following fact sheets and brochures, as well as other information, are available on request from the organizations listed. Most of these resources can also be found online at the web addresses given.
Dining Out With Confidence: A Guide for Patients with Kidney Disease
Nutrition and Chronic Kidney Disease
National Kidney Foundation
30 East 33rd Street
New York, NY 10016
Phone: 1–800–622–9010 or 212–889–2210
Facts About the DASH Eating Plan
National Heart, Lung, and Blood Institute Health Information Center
P.O. Box 30105
Bethesda, MD 20824–0105
A Healthy Food Guide for People with Chronic Kidney Disease
Academy of Nutrition and Dietetics
120 South Riverside Plaza, Suite 2000
Chicago, IL 60606–6995
Kidney Beginnings: A Patient’s Guide to Living with Reduced Kidney Function
American Association of Kidney Patients
2701 North Rocky Point Drive, Suite 150
Tampa, FL 33607
Phone: 1–800–749–2257 or 813–636–8100
About the Nutrition for Chronic Kidney Disease Series
The NIDDK Nutrition for Chronic Kidney Disease Series includes three fact sheets:
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
What are clinical trials, and are they right for you?
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
What clinical trials are open?
Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.
This information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your health care provider for more information.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Lisa Murphy-Gutekunst, M.S.Ed., R.D., C.S.R., Cleve-Hill Dialysis; Marcy Bushman, M.P.H., R.D., L.D.N., Sigma-Tau Pharmaceuticals
This information is not copyrighted. The NIDDK encourages people to share this content freely.