Can a Dietitian Help with Kidney Disease?

Updated by: Ashley Petrie

With kidney disease affecting close to 15 percent of the US population (and thought to be rising), registered dietitians play a key role in supporting those with the condition.

While nutrition can’t cure kidney disease, it can be an important part of managing your symptoms and delaying disease progression.

Keep reading to learn how a Nourish dietitian can help you manage kidney disease. 

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Can a Dietitian Help with Kidney Disease?

When you have kidney disease, the kidneys can’t properly filter blood.

This can lead to problems balancing salts, minerals, and fluid in the body. 

Your diet can also influence the delicate balance of fluids and minerals, which is why it’s important to choose foods and drinks that help your renal system function as well as possible. 

How a Dietitian Can Help

Nutritional needs for kidney disease change as the disease advances, so it’s important to follow up with a kidney disease dietitian (also known as a renal dietitian) regularly. 

If you’re in the early stages of kidney disease, your renal dietitian will provide recommendations for how to eat to slow down disease progression.

These changes may include:

• Limiting table salt and high-sodium processed foods, like canned soups and deli meats, to help better control your blood pressure and reduce fluid retention.
• Monitoring protein intake to reduce kidney workload while still ensuring adequate nutrition. This is often achieved by choosing small portions of high-quality protein sources such as chicken, fish, eggs, and tofu.
• Adjusting potassium intake by limiting foods high in potassium, such as bananas, potatoes, and tomatoes.

If you’re on dialysis, your renal dietitian will provide recommendations for how much fluid to drink to minimize fluid buildup and weight gain between your dialysis treatments, as well as specific micronutrients like sodium, phosphorus, and potassium. 

Also, if you’ve had a kidney transplant, your renal dietitian will provide nutrition recommendations to help you keep your new kidney healthy.

Regardless of what stage your kidney disease is at, a renal dietitian is an important part of your care team.

Nutrients to Manage in Kidney Disease

Kidney disease can affect your diet in many ways, and special attention should be paid to key nutrients that are linked to renal function. 

Protein

Your body breaks down protein into waste that your kidneys remove from the blood.

With kidney disease, it’s important to strike the right balance of protein.

Too little protein could lead to malnutrition, while too much protein can put excessive stress on your kidneys. 

Your protein needs will differ depending on whether you have early-stage kidney disease, are on dialysis, or have had a kidney transplant.

A renal dietitian can help you determine how much protein is appropriate for your needs. 

Fat

While it’s important to include fat as part of a balanced diet, too much fat or the wrong kinds of fat (like trans fats, which are found in fried foods and hard margarine) can have a negative impact on your blood vessels, heart, and kidneys. 

Since people with kidney disease are at a higher risk of developing heart disease, it’s important to include the right amounts and types of fat in your diet.

A renal dietitian can help you determine ways to include healthier fats in your diet.

Sodium

Sodium is a mineral found in salt. Too much sodium causes your blood to retain fluids.

This can cause high blood pressure and put excessive stress on your heart and kidneys.

A renal dietitian can provide sodium recommendations and teach you ways to reduce the amount of sodium you eat.

Potassium

Too much or too little potassium in the blood can lead to heart and muscle problems.

Kidney disease can make it difficult for the kidneys to remove potassium from the blood, leading to high blood levels of potassium.

Your renal dietitian will look at your potassium blood work to provide a recommendation for how much potassium to include in your diet.

They will also teach you which foods are high in potassium so you know which foods to include and reduce.

Phosphorus

When you have kidney disease, your kidneys have trouble removing phosphorus from your blood.

Too much phosphorus in the blood can weaken your bones. 

Phosphorus is naturally found in many foods that are rich in protein.

A renal dietitian can help you eat enough protein without getting too much phosphorus.

Fluids

Your body needs enough fluids to function properly.

However, when your kidneys are damaged, they may have trouble removing excess fluid.

This can lead to swelling, high blood pressure and can place excess stress on your heart.

A renal dietitian can help you determine your fluid needs, as well as provide tips for how to manage thirst while reducing fluid intake.

Fluids can come from:

• Beverages such as coffee, tea, water, soda, milk, fruit juices, sports drinks, and smoothies.
• Soups and stews.
• Fruits and vegetables with a high water content like watermelon, oranges, celery, cucumbers, and lettuce. 
• Frozen desserts such as ice cream, sorbet, frozen yogurt, milkshakes, and popsicle sticks.

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Calories

Calories are not technically a nutrient, but they’re still an important element of your nutrition plan that should be monitored while managing kidney disease. 

Kidney disease may lower your appetite so that you don’t feel hungry.

It can also cause taste changes, further decreasing your desire to eat. 

If you don’t eat enough, you may become malnourished, which can severely impact your energy levels and quality of life. 

To help you get enough nutrition, a renal dietitian can recommend evidence-based strategies to help you maximize your caloric intake, such as adding more energy-dense foods to your diet. 

Benefits of Working with a Dietitian for Kidney Health

There are several benefits of working with a dietitian for kidney health.

Delay Kidney Disease Progression

Studies show that medical nutrition therapy provided by a registered dietitian can slow kidney disease progression and delay the need for dialysis.

It’s important to note that medical nutrition therapy should include frequent monitoring and reassessment of nutritional recommendations.

Prevent or Treat Complications

A renal dietitian can help manage many of the complications of kidney disease, including muscle loss, electrolyte imbalances (such as high or low levels of potassium in the blood), and bone and mineral abnormalities (such as phosphorus or calcium abnormalities). 

A renal dietitian can also provide recommendations for how to manage blood pressure and include healthy fats in your diet.

Address Changes to Appetite

As kidney disease advances, it can lead to appetite changes such as nausea, a reduced desire to eat, and sensitivity to food smells.

If you start noticing changes to your appetite, a registered dietitian can help you address these issues too. 

For example, your dietitian may suggest eating smaller, more frequent meals, choosing bland or easy-to-digest foods, and avoiding strong-smelling items. 

Improve Quality of Life

Studies show that health literacy (the ability to find, understand, and use health-related information) is associated with improved quality of life in people with kidney disease. 

Since dietitians are trained to explain complex nutrition information in a way that makes sense and is applicable to your individual needs, working with a renal dietitian could help improve your health literacy and quality of life.

Managing Comorbidities

Diabetes and high blood pressure are the most common causes of chronic kidney disease.

To delay the progression of kidney disease, these conditions need to be managed.

A dietitian can provide education about managing your blood sugars and blood pressure to help you maintain your kidney function.

Make Recipes More Kidney Friendly

A dietitian can help you make your favorite recipes more kidney-friendly by modifying ingredients to align with dietary restrictions for kidney disease.

Here are some basic tips and examples:

Vegetarian Tofu Stir-Fry:

• Reduce Sodium: Use a small amount of low-sodium soy sauce instead of regular soy sauce, and avoid adding extra table salt.
• Limit High-Potassium Vegetables: Avoid or reduce high-potassium vegetables like spinach, sweet potatoes, and Brussels sprouts. Instead, use bell peppers, green beans, and eggplant.
• Incorporate Kidney-Friendly Protein: Tofu is a great plant-based protein that is low in potassium, phosphorus, and sodium, making it a suitable option for kidney-friendly, plant-based meals.

Grilled Chicken with Roasted Vegetables and White Rice:

• Control Sodium: Use a homemade marinade or seasoning blend instead of a store-bought one to better control the sodium in your meal.
• Moderate Protein Intake: Stick to enjoying a moderate portion of grilled chicken breast (about 3-4 ounces).
• Serve with Kidney-Friendly Sides: Pair the grilled chicken with a serving of white rice, which is lower in phosphorus, and lower-potassium roasted vegetables like zucchini and carrots.

Salmon Tacos:

• Reduce Sodium: Use a homemade seasoning mix made with garlic powder, cumin, and paprika instead of pre-packaged taco seasoning, which can be high in sodium. Avoid adding extra salt.
• Opt for Low-Sodium Tortillas: Choose low-sodium whole wheat or corn tortillas.
• Use Fresh Vegetables: Top with low-potassium options like shredded red cabbage, carrots, or peppers. Add more flavor with fresh salsa made from pineapple, bell peppers, cucumber, cilantro, and lime juice.

How Renal Dietitians Approach Kidney Care

When you meet with a renal dietitian, they will provide you with information regarding specific nutrients to consume.

They may provide recommendations on how much potassium, phosphorus, or sodium to include in your diet.

They will provide you with resources on which foods contain high amounts of these nutrients and guidance on how to include these foods in your diet.

What to Expect at Your First Appointment

Your first visit with a renal dietitian will typically include an in-depth assessment of your food and nutrition habits, a review of your kidney blood work, and a review of your current medications and medical history.

The information collected by your dietitian during your visit will help shape your individualized nutrition care and kidney-friendly meal plan.

Follow-Up Appointments

Renal dietitians monitor your diet, kidney blood work, medications, blood pressure, and weight.

They will also listen to any concerns you have about the goals you set at the previous visit and will help you identify new goals based on this information..

How Do I Find a Dietitian for Kidney Disease?

If you’re looking for a dietitian for kidney disease, consider virtual options that allow you to meet with a dietitian from the comfort of your own home. 

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Takeaway

Your nutrition needs can change drastically when you’re living with kidney disease.

From delaying the progression to managing or preventing complications, nutrition can be a powerful tool in your kidney disease care toolbox.

Managing Kidney Disease with a Dietitian

Working with a registered dietitian trained in kidney disease management can make it easier for you to understand your unique nutritional needs, and provide you with ongoing support and guidance. 

Find a dietitian who accepts insurance through Nourish.