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Eating Right with Early-Stage Kidney Disease: A Pathway to Preserving Kidney Function

By Dr. Alex Armitage There are no stringent dietary restrictions in early-stage kidney disease, but making thoughtful adjustments to your eating habits can potentially slow down the progression of the disease. In this article, I share with you the dietary adjustments that can be potent allies in maintaining kidney health.

Hand holding a model of a kidney

This week, I had the enriching experience of conversing with a vibrant 54-year-old woman who epitomizes good health — at least, that's what we initially presumed. She maintains a balanced diet, engages in regular physical activity, and has an optimal body weight. However, life sometimes presents unexpected hurdles; during her recent lab tests, we found that her Glomerular Filtration Rate (GFR) was 58, categorizing her in stage 3 kidney disease. It was indeed a surprising revelation. Most people with early stage kidney disease have no symptoms, and indeed she did not.

The pressing questions now are, how did we arrive at this point, and more critically, what proactive steps can we undertake to prevent further deterioration of her kidney health? It is well-documented that kidney function naturally diminishes as we age. During our meeting, we ventured into an in-depth discussion about the intricacies of kidney disease, identifying the primary causes and exploring strategies to manage potential decline effectively.

In this article, I am eager to share with you the salient points from our conversation, highlighting the dietary adjustments that can be potent allies in maintaining kidney health.

Embarking on a proactive approach to safeguard your kidney health is both a sensible and empowering choice, particularly when you find yourself in the early stages of chronic kidney disease (CKD), notably stages 2 and 3. In these initial stages, your kidneys are gently signaling the necessity for a little more attention, a little more care. The good news is, there are no stringent dietary restrictions at this point, but making thoughtful adjustments to your eating habits can potentially slow down the progression of the disease.

Gloved hand holding a tube of blood

What is Chronic Kidney Disease?

Chronic Kidney Disease (CKD) is akin to a slow, gradual hill, with your kidneys’ health potentially declining as you ascend the stages. To understand this journey better, it's essential to be acquainted with the different stages of CKD, characterized mainly by the Glomerular Filtration Rate (GFR). The GFR is a crucial marker that indicates how well your kidneys are filtering the waste from your blood. There are 5 stages of kidney disease. Roughly speaking the GFR can be viewed as the percentage of how well the kidney is working. So if your GFR is 58, then you can roughly say that your kidneys are functioning at 58% capacity.

In the medical community, a GFR below 60 serves as a significant marker, indicating that close attention is needed. It is at this juncture that individuals are diagnosed with chronic kidney disease, which, to be precise, categorizes them into stage 3 of the disease progression. This is a critical phase where proactive measures can make a substantial difference in managing the condition effectively. Patients with CKD stages 1-3 are generally asymptomatic.

Stages of Chronic Kidney Disease:

  • Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m 2)

  • Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m 2)

  • Stage 3a: Moderate reduction in GFR (45-59 mL/min/1.73 m 2)

  • Stage 3b: Moderate reduction in GFR (30-44 mL/min/1.73 m 2)

  • Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m 2)

  • Stage 5: Kidney failure (GFR < 15 mL/min/1.73 m 2 or dialysis)

What Causes Kidney Damage?

Man having his blood pressure taken

High Blood Pressure

High blood pressure, or hypertension, is a leading cause of CKD. This condition constantly forces the kidneys to work overtime, eventually causing wear and tear to the small blood vessels, or capillaries, within the kidneys. It's paramount to maintain a blood pressure within the normal range to avoid undue strain on these vital organs.

Management Tips:

  1. Medication Adherence: Regularly taking prescribed medications can help keep your blood pressure in check.

  2. Lifestyle Modifications: Incorporate regular exercise and stress management techniques to aid in controlling blood pressure.


Diabetes acts like a silent enemy, gradually impairing the kidneys' filtration system by damaging the small blood vessels within them. This can be mitigated by maintaining blood sugar levels within the recommended range.

Management Tips:

  1. Dietary Choices: Opting for foods low in glycemic index can prevent rapid spikes in blood sugar levels.

  2. Regular Monitoring: Keeping a close eye on blood sugar levels and adjusting medications as per healthcare provider’s advice.

Medications and Substances

Certain medications like non-steroidal anti-inflammatory drugs, aspirin and ibuprofen, can be detrimental to kidney health. NSAIDs and other similar medications can potentially cause inflammation of the kidneys, disrupting their function over time.

Management Tips:

  1. Review Medications: Spend some time reviewing your medications with your healthcare provider to ensure that the medications you are taking are kidney safe and dosed at the right levels.

  2. Alternative Therapies: Explore safer alternatives under the guidance of your healthcare provider.

  3. Awareness: Being knowledgeable about the potential side effects of medications can help in early identification of issues.

Foods to Sidestep: Protecting Your Kidneys in Early Kidney Disease

Sidestepping certain foods when you have early-stage kidney disease can be likened to avoiding potholes on a road, ensuring a smoother and safer journey. Let's navigate through the foods that are best kept at bay when your objective is to shield your kidneys from further harm.

Steak dinner

Excessive Proteins: A Heavy Burden

In the early stages of kidney disease, it is advisable to moderate your intake of high-protein foods. While proteins are indispensable, in large quantities, they can burden the kidneys with excessive waste products.

Proteins to Avoid:

  1. Red Meats: High in protein, red meats can tax the kidneys due to their high content of creatinine, a type of waste product.

  2. Dairy Products: Items like milk and cheese are protein-rich and might put additional strain on your kidneys.

  3. High Protein Drinks: High protein drinks and bars are everywhere these days, and touted as being healthy. Let’s talk about high protein drinks

In the setting of early-stage kidney disease, the topic of high-protein drinks can be a bit nuanced. As you well know, kidneys are responsible for filtering out waste products generated from the metabolism of proteins. Consequently, an increased intake of proteins could potentially amplify the workload on your kidneys, which isn't desirable, especially when the kidneys are not functioning at their optimum capacity.

At the early stages of kidney disease, it is generally advisable to avoid unnecessary stress on the kidneys, and this includes avoiding a high-protein diet. High-protein drinks, which are often used as meal replacements or supplements, can contain a significant amount of protein, which might pose a challenge to a kidney that's already showing signs of strain.

However, the context is key here. If someone is malnourished or has other medical conditions that warrant higher protein intake, they might still be considered, but under strict medical supervision. It is always a balanced approach that aims to preserve kidney function while meeting the individual’s nutritional needs.

Furthermore, it is essential to consider the source of protein. Plant-based proteins, for instance, might be a gentler option compared to animal-based proteins. Plant proteins usually contain fewer sulfur-containing amino acids which are known to produce more nitrogenous waste, a by-product of protein metabolism that kidneys need to eliminate.

That being said, it's a delicate balance to maintain, and decisions regarding the inclusion of high-protein drinks in one’s diet should be made in close consultation with a healthcare provider who is well-versed with the individual's medical history and the nuances of kidney disease. It's not a straight 'yes' or 'no' answer but rests heavily on individual circumstances and medical guidance.

French fried being salted

High Sodium Foods: The Stealthy Culprit

Sodium has a knack for sneaking into various food items, sometimes in surprisingly high quantities. Restraining sodium intake is crucial as it can help prevent swelling and high blood pressure, a formidable foe of kidney health.

Foods to Avoid:

  1. Processed Foods: A large portion of our sodium intake comes from processed foods. It would be wise to limit items like canned soups, frozen dinners, and snack foods.

  2. Table Salt: Curtailing the use of table salt in cooking and seasoning can significantly reduce your sodium intake.

High Potassium and Phosphorus Foods: A Delicate Balance

As kidney function declines, it becomes increasingly challenging for the body to maintain the balance of minerals like potassium and phosphorus. Hence, being cautious with foods rich in these elements is key.

Foods to Avoid:

  1. Bananas and Oranges: While nutritious, they are high in potassium and might be better replaced with other fruits that have a lower potassium content.

  2. Dairy Products: These are not only rich in protein but also high in phosphorus, which might be taxing for ailing kidneys.

Cupcakes with frosting

Sugary Treats: A Sweet Trap

Excessive sugar intake can impair the small capillaries in the kidneys. Reducing sugar in your diet is not only beneficial for kidney health but is a vital strategy in managing obesity and diabetes, which are substantial risk factors for CKD.

Why is sugar so bad for kidneys?

To delve into the impact of sugar on our bodily systems, especially in the context of kidney health, it's essential to comprehend the process of glycation, a significant chemical reaction that occurs when sugar molecules attach themselves to proteins or lipid fats without the controlling action of enzymes. This can be pictured as sugar “coating” these vital molecules, altering their functions and impeding their natural roles.

The Perils of Glycation

This adverse interaction, glycation, could be likened to a rust that gradually corrodes the machinery of our cells, particularly the nerve cells and capillaries. The glycation process forms advanced glycation end products (AGEs), which tend to accumulate in our body over time. AGEs could be seen as 'vandals', damaging the structure and function of our tissues. In the kidneys, this manifests as a damage to the tiny blood vessels or capillaries which are integral to kidney function, thus exacerbating kidney disease progression.

Management Tips:

  1. Smart Substitutions: Replace sugary beverages with water or herbal teas.

  2. Reading Labels: Become adept at reading food labels to avoid hidden sugars in processed foods.

Foods to Avoid:

  1. Sugary Beverages: Drinks laden with sugar like sodas and sweetened teas should be avoided to prevent a spike in blood sugar levels.

  2. Desserts: It might be a good idea to limit consumption of desserts and confectioneries to prevent the escalation of kidney issues.

Alcoholic Beverages: A Potential Aggravator

Summer cocktail

While enjoying alcoholic beverages in moderation might not be harmful, excessive consumption can pose a risk to kidney health.

Foods to Avoid:

  1. Liquor: Heavy consumption of liquor can potentially aggravate kidney problems.

  2. Beer: High in purines, beer can increase the burden on kidneys, especially when consumed in large quantities.

By steering clear of foods that might distress your kidneys, you pave the way for a healthier life ahead.

Salmon on toast with toppings

Eating Right with Early Stage Kidney Disease: Kidney-Friendly Foods

In the grand scheme of maintaining optimal kidney health, the role of nourishing, kidney-friendly foods cannot be underscored enough. As a healthcare provider, I often liken the kidneys to a sophisticated filtration system, tirelessly working to remove waste products and excess substances from our body. Just like a well-oiled machine, the performance of our kidneys can be remarkably enhanced by fueling it with the right nutrients. Let's embark on a culinary journey that not only satiates our taste buds but also showers our kidneys with the care they rightly deserve.

Lean Proteins: The Building Blocks of Life

Proteins are essential to our well-being, acting as the building blocks of life. However, in the case of kidney health, the adage 'less is more' holds true. Opting for lean proteins like poultry, fish, and legumes can meet your nutritional needs without overburdening your kidneys.

Choices to Consider:

  1. Fish: incorporating fish, a source of high-quality protein and omega-3 fatty acids, into one's diet can be a beneficial choice

  2. Chicken Breast: Skinless and boneless chicken breast is a versatile choice, which can be grilled, baked, or stir-fried with a medley of colorful vegetables.

  3. Legumes: Beans, lentils, and chickpeas are excellent plant-based sources of protein that are kidney-friendly.

Fruits and Vegetables: A Splash of Colors and Flavors

While navigating kidney-friendly diets, it's essential to embrace a palette of fruits and vegetables that are low in potassium. This vibrant array not only brightens up your plate but also showers your system with a plethora of vital nutrients. Now let's sprinkle in some magic, shall we?

Apples on a tree

Choices to Consider:

  1. Apples: A timeless choice, apples can be enjoyed fresh or as unsweetened applesauce. They bring the dual benefit of being low in potassium and a great source of fiber.

  2. Cranberries: These little red jewels are not only delicious but are also known to protect against urinary tract infections, a boon for kidney health.

  3. Beets: These red beauties contain a compound called betaine, which is shown to have nephro-protective properties. It's like adding an extra layer of armor to your kidneys. You can consume them roasted, juiced, or even in salads.

  4. Spinach: Rich in antioxidants like vitamin C and beta-carotene, spinach works to combat oxidative stress in your kidneys. However, spinach is also high in potassium, so moderation is key.

Hydration: The Elixir of Life

Staying hydrated is vital, and what better way to do it than with water? While it's not a 'food' per se, water plays a crucial role in helping kidneys flush out toxins from the body.

Choices to Consider:

  1. Water: It remains the best choice for hydration, aiding in the smooth functioning of the kidneys.

  2. Herbal Teas: Herbal teas can be a pleasant, warming option, but do consult with your healthcare provider to choose those that are compatible with a kidney-friendly diet.

Lemons and limes with glasses of water that are garnished

Spices and Herbs: The Symphony of Flavors

In the world of kidney-friendly cooking, spices and herbs are your allies, adding bursts of flavors without the need for salt.

Choices to Consider:

  1. Garlic: A powerhouse of flavor, garlic can be used generously to add zest to your dishes, minus the salt.

  2. Lemon Juice: A dash of lemon juice can lift the flavors of a dish, offering a tangy note that complements various recipes.


Making conscious choices to eat right in early stage kidney disease can be a powerful tool in safeguarding the intricate functions of your kidneys. Nourishing your body with kidney-friendly foods not only cultivates a sanctuary for these vital organs but also heralds a ripple effect of well-being throughout your entire system. Remember, your journey to optimal health is akin to nurturing a garden; it requires patience, knowledge, and a hands-on approach to flourish. Together, let's take proactive strides towards not just a life of longevity, but a life brimming with quality and vigor.


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