WHAT YOU NEED TO KNOW:

What is a renal failure diet? A renal failure diet controls the amount of protein and phosphorus in your diet. You may also have to limit calcium, sodium, and potassium. A renal failure diet can help decrease the amount of waste made by your body, which can help your kidneys work better. It may also help to delay total renal failure. Your diet may change over time as your health condition changes. You may also need to make other diet changes if you have other health problems, such as diabetes.

What kind of changes do I need to make on a renal failure diet?

• You will need to limit the amount of protein you eat to help decrease waste in your blood. Foods that are high in protein are meat, poultry (chicken and turkey), fish, eggs, and dairy (milk, cheese, yogurt). Your healthcare provider will tell you how much protein to eat each day.
  
  
• You may need to limit the amount of phosphorus you eat. Your kidneys cannot get rid of extra phosphorus that builds up in your blood. This may cause your bones to lose calcium and weaken. Foods that are high in phosphorus are dairy products, beans, peas, nuts, and whole grains. Phosphorus is also found in cocoa, beer, and cola drinks. Your healthcare provider will tell you how much phosphorus you should have in your diet each day.
  
  
• You will have to limit sodium if you have high blood pressure or extra fluid in your body. Limit your sodium intake to 1500 mg each day. Table salt, canned foods, soups, salted snacks, and processed meats, like deli meats and sausage, are high in sodium.
  
  
• You may need to limit potassium if your healthcare provider tells you that your potassium blood levels are too high. Potassium is found in fruits and vegetables. You may have to limit fruits and vegetables that are high in potassium.
  
  
• You may need to limit the amount of liquids you drink each day. If your body retains fluids, you will have swelling and fluid may build up in your lungs. This can cause other health problems, such as shortness of breath.

What foods can I include? Ask your dietitian how much potassium, phosphorus, sodium, liquid, and protein you should have each day. Your dietitian will tell you how many servings you can have from each of the food groups below. The approximate amount of these nutrients is listed next to each food group. Read the food label to find the exact amount.

• Starches: These foods contain about 2 grams of protein, 90 calories, 80 mg of sodium, 35 mg of potassium, and 35 mg of phosphorus.
  • 1 slice of bread (French, Italian, raisin, light rye, or sourdough white), small dinner roll, or 6-inch tortilla
    
    
  • ½ of a hamburger bun, hot dog bun, English muffin, or small bagel
    
    
  • ¾ cup of cereal
    
    
  • ½ cup of cream of rice, cream of wheat, farina, or cooked grits
    
    
  • ½ cup of cooked pasta (noodles, macaroni, or spaghetti) or cooked rice
    
    
  • 4 (2-inch) unsalted crackers
    
    
  • 1 ½ cups of plain popped popcorn
    
    
  • 10 unsalted pretzel sticks or 9 tortilla chips
    
    
  • 10 vanilla wafers or 4 sugar wafers, shortbread cookies, or sugar cookies
  
  
• Vegetables: A serving of these foods contains about 1 gram of protein, 25 calories, 15 mg of sodium, and 20 mg of phosphorus. The amount of sodium listed is for vegetables that are canned or prepared with no added salt. One serving is ½ cup, unless another amount is given.
  • Low potassium (less than 150 mg):
    • Green beans or bean sprouts
      
      
    • Raw cabbage, cauliflower, eggplant
      
      
    • Cucumber, onions, or canned corn
      
      
    • All varieties of lettuce (1 cup)
      
      
    • 1 small raw carrot or 1 stalk of raw celery
      
      
    • Fresh and canned mushrooms (Mushrooms have 40 mg of phosphorus or more per serving.)
    
    
  • Medium potassium (150-250 mg):
    • 5 spears of asparagus
      
      
    • Broccoli or celery
      
      
    • Mixed vegetables
      
      
    • Green or snow peas (Peas have 40 mg of phosphorus or more per serving.)
      
      
    • Summer squash or zucchini
  
  
• Fruits: A serving of these foods contains about ½ gram of protein, 70 calories, and 15 mg of phosphorus. Each serving is ½ cup, unless another amount is given.
  • Low potassium (less than 150 mg):
    • Apple juice, applesauce, or 1 small apple
      
      
    • Blueberries
      
      
    • Cranberries or cranberry juice cocktail
      
      
    • Canned pears
      
      
    • Grapes or grape juice
      
      
    • Canned peaches or pears
      
      
    • Pineapple or strawberries
      
      
    • 1 tangerine
      
      
    • Watermelon
    
    
  • Medium potassium (150-250 mg):
    • Fresh peaches or pears
      
      
    • Cherries
      
      
    • Mango or papaya
      
      
    • Small grapefruit or grapefruit juice
  
  
• Dairy: The following foods have about 4 grams of protein, 120 calories, 80 mg of sodium, 185 mg of potassium, and 110 mg of phosphorus.
  • ½ cup of milk (fat free, low-fat, whole, buttermilk, or chocolate milk)
    
    
  • ½ cup of plain or fruit-flavored yogurt, ice milk, or ice cream
    
    
  • 1 slice of cheese
    
    
  • Nondairy milk substitutes: These foods have ½ gram of protein, 140 calories, 40 mg of sodium, 80 mg of potassium, and 30 mg of phosphorus. A serving is ½ cup of nondairy frozen dessert, nondairy frozen dessert topping, or nondairy creamer.
  
  
• Meat and other protein foods: These foods have about 7 grams of protein, 65 calories, 25 mg of sodium, 100 mg of potassium, and 65 mg of phosphorus. Do not use salt when preparing these foods.
  • 1 ounce of cooked beef, pork, or poultry
    
    
  • 1 ounce of any fresh or frozen fish, lobster, shrimp, clams, tuna, unsalted canned salmon, or unsalted sardines
    
    
  • 1 ½ ounces of crab or oysters
    
    
  • 1 large whole egg or 2 large egg whites, or ¼ cup of low-cholesterol egg substitute
  
  
• Fats: These foods have very little protein and about 45 calories, 55 milligrams of sodium, 10 milligrams of potassium, and 5 milligrams of phosphorus. Include healthy fats, such as unsaturated fats, which are listed below.
  • 1 teaspoon margarine or mayonnaise
    
    
  • 1 teaspoon oil (safflower, sunflower, corn, soybean, olive, peanut, canola)
    
    
  • 1 tablespoon oil-based salad dressing (such as Italian) or 2 tablespoons mayonnaise-based salad dressing (such as ranch)

What foods should I limit or avoid?

• Starches: The following foods have added sodium and phosphorus.
  • 1 small biscuit or muffin
    
    
  • 2 x 2-inch square of cake
    
    
  • 1 (4-inch) pancake or waffle
    
    
  • ½ cup of oatmeal
    
    
  • ½ cup of whole-wheat cereal or bran cereal
    
    
  • 1 piece of cornbread
    
    
  • ¾ ounce of salted pretzel sticks or rings
    
    
  • 4 sandwich cookies
  
  
• Meat and protein foods: The following meats and cheeses are high in sodium.
  • 1 ounce of deli-style meat, such as roast beef, ham, or turkey
    
    
  • 1 ounce of canned salmon or sardines
    
    
  • ¼ cup of cottage cheese
    
    
  • Processed cheese, such as American cheese and cheese spreads
    
    
  • Smoked or cured meat, such as corned beef, bacon, ham, hot dogs, and sausage
  
  
• Vegetables: The following vegetables are high in potassium. Each serving has more than 250 mg of potassium. A serving is ½ cup, unless another amount is given.
  • Artichoke or ¼ of a whole avocado
    
    
  • Brussels sprouts or okra
    
    
  • Potatoes
    
    
  • Spinach
    
    
  • Sweet potato (Sweet potatoes have 40 mg of phosphorus or more per serving.)
    
    
  • Tomatoes, regular and low-sodium tomato juice, or ¼ cup of tomato sauce
    
    
  • Winter squash
    
    
  • Fresh beets
  
  
• Fruit: The following fruits are high in potassium. Each serving has more than 250 mg of potassium.
  • 1 cup of canned or fresh apricots, or 5 dried apricots
    
    
  • 1 small nectarine (2 inches across)
    
    
  • 1 small orange or ½ cup of orange juice
    
    
  • ¼ cup of dates
    
    
  • ⅛ of a small honeydew melon
    
    
  • 1 small banana
    
    
  • ½ cup of prune juice or 5 dried prunes
  
  
• Fats: Limit unhealthy fats, such as saturated fats, which are listed below.
  • 1 teaspoon butter
    
    
  • 2 tablespoons coconut
    
    
  • 1 tablespoon powdered coffee creamer
    
    
  • 1 teaspoon solid shortening
  
  
• Other: The following foods are high in sodium.
  • Frozen dinners, soups, and fast foods, such as hamburgers and pizza (see the food label for serving sizes)
    
    
  • Seasoned salt, such as onion or garlic salt
    
    
  • Barbecue sauce, ketchup, mustard, and chili sauce
    
    
  • 2 medium green olives or 3 large black olives
    
    
  • Soy sauce, steak sauce, and teriyaki sauce

What other dietary guidelines should I follow?

• You may need to take a vitamin and mineral supplement (such as calcium). Take only the supplement that your healthcare provider suggests.
  
  
• Avoid using salt substitutes because they contain potassium. They may cause the potassium levels in your blood to become too high.
  
  
• Read the nutrition information on food labels when shopping. This information may also help you to follow the renal failure diet. Ask your healthcare provider for information on how to read food labels.

What are the risks of not following a renal failure diet? The renal failure diet may take some time for you to learn to follow. If you do not eat enough food, you may not get the calories, protein, and other nutrients that your body needs. You may lose weight. If you do not follow a renal failure diet, your kidneys will work harder. This may cause total renal failure to happen sooner. If you have total renal failure, you will need to get dialysis treatments.

When should I contact my healthcare provider?

• You are gaining or losing weight very quickly.
  
  
• You have shortness of breath.
  
  
• You have nausea and vomiting.
  
  
• You feel very weak and tired.
  
  
• You are having trouble following the renal failure diet.

CARE AGREEMENT:

You have the right to help plan your care. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.