Plant-Based Diets, Dietary Approaches To Stop Hypertension (DASH) Diet, and Mediterranean Diet for Early Stages of Kidney Disease

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Submitted by Emily Campbell, RD CDE MScFN

The right foods can help you fight kidney disease.  Some well-known eating patterns that have been shown to preserve kidney function include plant-based, DASH (Dietary Approaches to Stopping Hypertension), and Mediterranean diets. These have added benefits such as lower blood pressure and cholesterol, a lower risk of diabetes and improved weight management. Since people with kidney disease have different needs, working with a registered dietitian can help you plan nutritious meals that meet your nutrient requirements.

Whether you look to adopt a plant-based diet, or follow the DASH or Mediterranean diet, each of these healthy eating patterns helps maintain proper kidney function by focusing on higher intakes of vegetables and fruit, legumes, nuts, whole grains, fish and low-fat dairy products, and lower intakes of red and processed meats, sodium, and sugar-sweetened beverages.  

You may have read or been told that many of the foods listed above should be avoided if you have chronic kidney disease (CKD). Based on current research, we now know that those associated with healthy eating patterns actually play an important role in slowing the progression of early kidney disease and improving heart health and blood pressure.

To help get you started with adopting a kidney-friendly diet, consider these strategies:

  1. Aim to fill half your plate with vegetables and fruit at each meal and snack. Enjoy them raw, or baked, stir-fried, boiled, or roasted. Choose low potassium vegetables and fruits if you follow a potassium- restricted diet.
  2. Set aside a quarter of your plate for whole grains, which are higher in fibre. These will not only help keep you full, but also control your blood glucose levels. Here is a comparison of brown rice vs white rice:  ½ cup brown rice has 81 mg potassium, 71 mg phosphorus, and 2 g fibre compared to ½ cup parboiled white rice, which has 52 mg potassium, 51 mg phosphorus, and 0.8 g fibre. Whole grains have slightly more potassium and phosphorous than refined grains, but the benefits outweigh the risk as they are higher in fibre and have less phosphorus absorption.
  3. Choose plant-based protein such as legumes, tofu, nuts, or seeds more often. Individuals following a Mediterranean Diet may want to include limited amounts of low-fat dairy items and fish or seafood twice a week. Those following a vegetarian diet may want to include low-fat dairy items in small quantities to help meet their nutrient needs. Limit consumption of beef, pork, chicken and eggs.  These foods should make up the smallest part of your meal – no larger than the size of the palm of your hand.
  4. Eat less butter, margarine, baked goods and processed foods as these are sources of saturated fat, which can be harmful for your heart.  Include heart-healthy fats such as olive oil, nuts/seeds and avocados.
  5. Make water your beverage of choice.
  6. Be physically active every day. (Note: Speak with your healthcare provider before starting any exercise routine.)

Making nutrition changes that you can stick to is important for delaying the progression of CKD. Get started by choosing one strategy above and work towards consistently healthier choices. Perhaps you want to find ways to include more vegetables and fruits in your diet when planning your meals. This simple and delicious recipe for Carrot and Apple Soup uses staple ingredients like onion, carrots, and apple to provide lots of fiber, flavor, and fullness. You can find this and more nutritious recipes to help preserve kidney in my book, The Complete Renal Diet Cookbook. For more resources and cookbooks check out the resource section on the Kidney Community Kitchen website. 

References:

Bach KE, Kelly JT, Palmer SC, et al. Healthy Dietary Patterns and Incidence of CKD. CJASN. 2019; 14(10): 1441-1449.
National Kidney Foundation. What is a Plant-Based Diet, and Is It Good for Your Kidneys? 2018. Available from: https://www.kidney.org/atoz/content/what-plant-based-diet-and-it-good-kidney-disease


Renal & Urology News. Mediterranean Diet Lowers Chronic Kidney Disease (CKD) Risk. 2014. Available from: https://www.renalandurologynews.com/home/news/nephrology/chronic-kidney-disease-ckd/mediterranean-diet-lowers-chronic-kidney-disease-ckd-risk/#:~:text=Mediterranean%20diet%20is%20associated%20with,Society%20of%20Nephrology%20has%20found.