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DIET FOR IMPAIRED KIDNEY FUNCTION
(LOW SALT, POTASSIUM, FLUID, AND PHOSPHORUS DIET)
Purpose: This diet is designed to provide information on foods that are high and low in potassium, sodium and phosphorus in effort to minimize complications, and maintain acceptable blood chemistries, blood pressure, and fluid status in people with impaired kidney function.
Use: The impaired kidney function diet is used for persons with chronic renal failure who are on hemodialysis or will be on hemodialysis soon. This food guide can be used as a guide to help plan nutritious meals.
Generally, a person who has impaired kidney function should follow a diet with controlled intake of protein, potassium, sodium, phosphorus and fluid. Additional modifications of fat, cholesterol, triglycerides, sugar, and fiber may be necessary based on individual requirements.
One of the most important jobs of the kidneys is to rid the body of excess "waste" (such as sodium, potassium, protein, phosphorus, and fluid). When your kidneys are not working properly this extra "waste" builds up in the bloodstream and can make you very sick. Too much sodium, potassium, protein, phosphorus, and fluid in the diet can cause dangerous changes in the body. Dialysis is the process that removes a certain amount of these waste products. Another way is limiting your intake of the following nutrients:
Protein.
As protein breaks down, urea is formed. In kidney failure, urea accumulates in the blood. Protein intake should be controlled to avoid accumulation of blood urea nitrogen (BUN) and creatinine in the blood. A high BUN level may cause fatigue, loss of appetite, nausea, vomiting, bad breath, or a bad taste in your mouth. The amount of protein a person may eat depends on the degree of kidney failure. Following a diet will keep your BUN at a good level between dialysis treatments.
Sodium.
The kidney is unable to excrete large amounts of sodium. If sodium intake is not restricted, the body may retain sodium and water. This retention can cause edema, swelling of lower limbs, and congestive heart failure. The level of sodium restriction needed depends on the sodium content of urine and blood, and the degree of high blood pressure and edema.
Potassium.
Potassium is restricted to prevent a sudden rise of potassium in the bloodstream above normal levels. Excess potassium levels in the blood may cause diarrhea, nausea, weakness, breathing difficulty, numbness or tingling in your fingers and toes, irregular heart beat and even cardiac arrest (heart attack). The amount of potassium restricted is based on serum potassium levels, kidney function, drug therapy, and the type of dialysis received.
Phosphorus.
The kidney is unable to excrete large amounts of phosphorus. Increased intake of phosphorus disturbs calcium balance and can put one at risk for bone disease in the future. Phosphorus allowance depends on dialysis, phosphate binders, and phosphorus intake in foods consumed.
Fluid.
Excess fluids remain in the body since maintenance of proper fluid balance is one of the kidneys major functions. Too much fluid can cause you discomfort and raise your blood pressure. The amount of fluid restricted depends on urine output, the presence of edema, congestive heart failure, and diuretic therapy.
The foods in the following food guide are color coded according to their nutrient content:
- Phosphorus
- Sodium
- Potassium
- Phosphorus & Potassium
- Sodium & potassium
- Sodium, potassium & phosphorus
FOOD GUIDE
| "OK" FOODS |
FOODS TO BE USED IN MODERATION |
FOODS TO LIMIT &/OR AVOID |
| MILK & DAIRY
Cream
Cream cheese
Dessert topping, nondairy frozen
Dessert, nondairy frozen
Half and half
Light cream
Liquid nondairy creamer, polyunsaturated
Sour cream
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MILK & DAIRY
All milk and milk products
Cottage cheese
Hot cocoa
Ice Cream
Lo Pro
Ovaltine
Yogurt, plain or fruit flavored
Yogurt, frozen
Dairy Substitutes:
Meadow Fresh
Mocha Mix
Poly Rich
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MILK & DAIRY
Buttermilk, cultured
Cheese (Muenster, Colby, Cheddar, Blue, Gouda, American, Velveeta , low sodium cheese)
Cheese spreads
Chocolate milk
Commercial milk drinks
Commercially prepared pudding mixes
Egg nog
Goats milk
Ice creams containing nuts, custard and coconut
Instant Breakfast
Malted milk
Milk shakes
Sweetened condensed milk
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| VEGETABLES
The following vegetables should be no added salt or low salt canned vegetables:
Alfalfa sprouts
Bamboo shoots, canned
Bean sprouts, mung or soybean
Beans, yellow, green snap and wax
Cabbage, raw
Cauliflower, cooked
Celery, cooked or raw
Chard, raw
Chayote squash
Chinese cabbage, raw
Cucumbers, raw and peeled
Endive
Jicama, raw
Leeks
Lettuce, all varieties (1 cup)
Onions, green, red, white, yellow
Parsley, fresh sprigs
Peppers, green, sweet, jalapeno, canned, raw
Radishes, raw
Water chestnuts, canned
Watercress
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VEGETABLES
Artichoke hearts
Artichokes
Bamboo shoots, raw
Beets, canned
Broccoli
Cabbage, cooked
Carrots, cooked
Cauliflower, raw, frozen
Celery, raw
Corn, sweet, cooked
Dandelion greens, cooked
Okra, frozen
Eggplant, cooked
Greens, collard, mustard, kale
Hominy, cooked
Leeks, raw
Escarole
Mushrooms, canned, raw
Peas & carrots
Peas, green
Snow peas
Soccotash, frozen
Spinach, raw
Squash, summer
Turnip greens, cooked
Turnips, cooked
Vegetables, mixed (frozen)
|
VEGETABLES
Asparagus, canned, Asparagus spears, frozen
Avocado
Bamboo shoots, fresh, cooked
Beans, pinto, kidney, lima, white, garbonzo, chili, navy (chickpeas)
Beet greens, cooked
Beets, cooked
Brussels sprouts
Carrot, raw
Catsup
Celery, cooked
Chinese cabbage
Chard, cooked
Chile peppers
Cow peas
Frozen vegetables with seasoning and sauces
Kohlrabi
Mushrooms, cooked
Okra, fresh, cooked
Parsnips, cooked
Pickle relish, sweet or sour
Pickled vegetables
Pickles and others prepared in brine
Potato, cooked, baked, mashed, hash browned
Pumpkin, boiled
Rutabagas, cooked
Sauerkraut
Spinach, cooked
Squash, acorn, butternut, winter
Sweet potato
Tomato juice, unsalted
Tomato, canned, cooked, paste, puree, sauce
Tomato, chili sauce
Vegetable juice, unsalted and regular
Vegetable or tomato juices, canned or bottled
Yam, cooked
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| FRUIT
Applesauce
Blueberries, fresh
Boysenberries, fresh, canned, frozen
Cherries, fresh
Cherries, canned
Coconut , grated
Cranberries, fresh
Cranberry juice cocktail
Grape drink, canned
Grape juice, frozen
Grapefruit, fresh
Grapes, green and purple
Lemon, peeled
Lime, peeled
Loganberries, fresh
Lychees, fresh
Orange/apricot drink
Papaya nectar
Peach nectar
Pear nectar
Pears, canned, and fresh
Persimmon
Pineapple, fresh
Pineapple/grapefruit juice
Pineapple/orange juice
Plums, canned, fresh
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FRUIT
Apple juice, nectar
Apple, fresh
Apricot, nectar, juice
Blackberries, canned or fresh
Currants
Cherries, sweet or sour
Figs, canned, or fresh
Fruit cocktail
Gooseberries
Grape juice, bottled, canned
Grapefruit juice
Kumquats, fresh
Lemon juice
Lime juice
Mandarin oranges, canned
Peach, fresh and canned
Persimmon, fresh
Pineapple juice
Pineapple, canned, fresh
Plums, damson, canned, fresh
Plums, prune type
Quinces, fresh
Raspberries, fresh
Strawberries, fresh, frozen
Watermelon
Tangerine
Papaya, fresh
Raisins, dried
Rhubarb, cooked
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FRUIT
Apricots, fresh, frozen, dried and canned
Avocado
Bananas, fresh
Cantaloupe melon
Casaba melon
Dates, dried, canned
Figs, dried
Guava, fresh
Honeydew melon
Kiwifruit, fresh
Mango
Maraschino cherries
Melonballs, fresh and frozen
Nectarine, fresh
Orange juice
Orange, fresh
Pickled Fruits
Pears, fresh
Pomegranate
Prune juice
Prunes, canned, cooked and dried
Tangelo
Tomato juice
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| BREADS & GRAINS
Bread and rolls (unsalted) such as French, Itlaian, light rye, sourdough white
Bagels
English muffins
Dinner roll or hard roll
Muffins, no nuts, bran, or whole-wheat
Tortillas, corn
Pita or "pocket" bread
Danish pastry or sweet roll, no nuts
Buns, hamburger or frankfurter type
Dry and cooked cereals, (most types except those under "avoid/limit" foods), such as Puffed rice and puffed wheat
Cream of Rice or Wheat , Farina , Malt-O-Meal
Corn meal, cooked
Grits, cooked
Salt-free pretzels
Noodles, spaghetti, macaroni and other pastas
Unsalted crackers
Oyster crackers, unsalted
Graham crackers
Melba toast
Tortilla chips, unsalted
Unsalted popcorn, plain
Low-protein products:
Low protein bread
Imitation pasta
Rusk
Semalino hot cereal, cooked
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BREADS & GRAINS
Food made with large amount of baking powder or baking soda: baking powder biscuit
Tortillas, flour
Rice and barley
Cherrios
Doughnut
Pancakes, waffles, from mix
|
BREADS & GRAINS
Breads and rolls with salted tops
Pumpernickel, dark rye, whole wheat, and oatmeal breads
Nut breads and rolls
Bran muffins
Whole-wheat cereals
Bran cereals
Grape nuts, granola cereals granola bars
Raisin bran
Oatmeal
Bran Flakes
Instant Food Products (e.g., cereals, pasta mixes, potatoes, rice, etc.)
Chow mein noodles
Seasoned stuffing, rice, pasta mixes
Seasoned bread crumbs
Cracker crumbs
Popcorn, prepackaged microwave
Salted popcorn
Saltines, potato chips, pretzels, snack chips
Potato chips
French fries
Wheat germ
Whole wheat crackers
Biscuit, from canned dough
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| MEATS & MEAT SUBSTITUTES
All fresh and fresh frozen meats (poultry, fish, shellfish, beef, pork, lamb)
Canned unsalted tuna fish
Soups
Homemade soups, made with allowed ingredients
Unsalted broth or bouillon
Low sodium commercial soup, except for pea soup
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MEATS & MEAT SUBSTITUTES
Eggs
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MEATS & MEAT SUBSTITUTES
Cured, salted, canned or smoked meats, poultry, or fish. (Corned beef, ham, bacon, luncheon meats,
bologna, pork rinds, frankfurter, sausage, chorizo, canned tuna, sardines, anchovies, caviar, salted cod,
herring, sardines, lox, dry fish, kippered salmon, beef jerky)
Organ meats such as beef liver
Oysters
Breaded fish and meats
Soybeans, tofu
Dried Fish, Assorted (e.g., dried shrimp)
Frozen pizza
Dried peas and beans
Beans: kidney, pinto, chili, navy, lima
Black-eyed peas
Chick peas
Split peas
Lentils
Baked beans
Unsalted nuts and regular nuts
Regular peanut butter and low sodium peanut butter
Sunflower seeds
Nut butters
All commercially prepared and convenience foods
such as TV dinners, box mixes, canned entrees, Hamburger Helper, meat pies, Chinese dinners, pizza, Shake'n Bake mixes Kosher meats
Pickled Meats
Soups
Broth and soups with added salt
Regular canned soup
Regular bouillon cubes
Pea soup
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| FAT & MISC
Butter, margarine, oils and lard
Mayonnaise, sour cream
Salt-free salad dressings such as Italian, French, Thousand Island
Homemade salad dressings, made without added salt
Shortening or vegetable oil
Whipping cream
Mocha mix
"Cool whip"
Corn syrup
Cranberry sauce or relish
Honey, jelly, jam, marmalade, syrup
Imitation maple syrup
Sugar, white, or powdered
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FAT & MISC
Cream cheese
Sour cream
Sugar, brown
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FAT & MISC
Commercial salad dressings
Cheese-based dressings
Bacon fat
Salad dressing mixes
Olives, green and black
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| SNACKS
Hard candies, gum drops, lifesavers , cough drops, sour balls
Butter mints, candy corn
Butterscotch candy
Jelly beans (not licorice), spice drops, Peppermint patties
Candy canes, mints (not chocolate)
Chewing gum
Fondant, plain
Chewy fruit snacks, fruit chews, fruit roll ups
Popsicle�s, fruit ice, sherbet, fruit sorbet, marshmallows
Sweetened gelatin
Homemade cookies, pies, cakes made with allowed ingredients
Butter cookies
Fruit pie (apple, berry, cherry, peach)
Pound cake
Shortbread cookie
Vanilla wafer
Low protein cookies
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SNACKS
Ice Cream
Cake, angel food
Sugar cookies
Sponge cake
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SNACKS
Prepared frozen cream pies and cheese cake
Instant pudding mixes
Commercially prepared baked goods (cakes, cookies, pie)
Chocolate syrup
Sandwich cookie
Chocolate
Candy bars
Caramel
Carob
Cocoa powder
Imitation chocolate made from carob
Licorice
Coconut
Molasses
Fruit cake
Pumpkin pie
Custard
Eclairs
Cream puffs
Macaroons
Boston cream pie
Pizza
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| BEVERAGES
Lemonade (made from concentrate)
Limeade
Hawaiian punch
Hi-C� fruit drink, any flavor except orange
Tang
Kool-aid (made with sugar)
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BEVERAGES
Milk shakes
Hot cocoa
Egg nog
Ovaltine
Grape soda
Ginger ale
7-Up
Beer
Alcohol (with permission from your doctor):
Gin, rum, whisky, vodka
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BEVERAGES
Wine
Cola-based soft drinks
Thirst quencher beverages
Tea, bag
Fruit-flavored drinks with added vitamin C
Coffee, regular or decaffeinated
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| MISC.
Allspice
Anise
Almond Extract
Basil
Bay Leaves
Caraway Seeds
Cardamom seed
Celery seeds
Chervil
Chili powder
Chives
Cider Vinegar
Cinnamon
Cloves
Coriander leaves (cilantro)
Coriander seeds
Cumin
Curry Powder
Dill
Fennel
Flavor extracts such as vanilla, maple, peppermint
Fresh horseradish
Garlic Powder
Ginger
Lemon juice
Lime juice
Mace
Marjoram
Mustard (dry)
Nutmeg
Onion Powder
Oregano
Paprika
Parsley
Pepper
Peppermint Extract
Poppy seeds
Rosemary
Saffron
Sage
Savory
Tarragon
Thyme
Turmeric
Vanilla
Vinegar
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MISC.
Baking soda
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MISC.
Accent (MSG)
Alka-Seltzer
Baking powder, from phophate
BBQ sauce
Bouillon cubes, salted or unsalted
Brewers yeast
Catsup, salted or unsalted
Celery salt
Chili sauce, salted or unsalted
Dill pickle
Garlic salt
Horseradish, bottled
Kitchen Bouquet
Lemon pepper seasoning
"Lite" salt
Marinade sauce
Meat tenderizers
Monosodium Glutamate (MSG)
Mustard, bottled
Onion salt
Party spreads
Relish
Salt
Salt substitute
Sea salt
Seasoning salts
Sodium Benzoate
Sodium Caseinate
Sodium Citrate
Sodium Nitrate
Sodium Phosphate
Sodium Propionate
Sodium Saccharin
Soy sauce
Soy sauce, light
Steak sauce
Sweet pickle relish
Taco sauce
Tamari sauce
Tartar sauce
Teriyaki sauce
Vegetable salts
Worcestershire sauce
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The following are considered fluids:
- Beverages: water, milk, milk drinks, milk shakes, fruit drinks, fruit and vegetable juices, soft drinks, coffee, tea, cola, possum, Sanka, beer, wine, and other alcoholic beverages.
- Soups: cream soup, broth, and vegetable soup.
- Ices: ice cream, sherbet, iced milk, ice chips, ice cubes, and popsicles
- Gelatin: Jell-O, D-Zerta , Jell-O molded fruit salad.
- Creamers: cream, half-and-half, non-dairy creamer.
- Others: Liquid medicine, syrup of canned fruits, foods that contain large amount of juices such as oranges, grapefruit and watermelon.
Your dietitian should decide how many choices from each group you should have. The foods in the "allowed foods" list does not mean you can have unlimited portions of those foods.
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