Diet and Nutrition

If you have chronic kidney disease, diet and nutrition play an even greater role in managing your disease progression. This is because your kidneys become less effective at removing unwanted fluid and managing the correct levels of nutrients, such as calcium, phosphate and potassium. Planning a balanced and healthy diet becomes crucial.

Many foods that play an important role in a healthy diet contain potassium. Not everyone living with kidney disease needs to follow a low potassium diet. We recommend speaking with your care team if you are unsure whether you need to follow a low potassium diet.

A low potassium diet focuses on reducing the amount and how often we eat certain foods, instead of cutting them out completely. A good place to start is reducing the amount of ultra-processed foods, takeaways, and junk foods that you eat which often contain potassium-based additives. High blood potassium levels can trigger dangerous changes in our heart rhythm if left unchanged.

If you have kidney disease, it is very important that your calcium and phosphate balance is checked and managed correctly. Your healthcare team will request regular blood tests to check your calcium and phosphate levels.

Treatment of calcium and phosphate imbalance is designed to:

• prevent phosphate levels increasing in your blood
• maintain calcium levels
• reduce the hardening of our blood vessels making them less likely to get blocked
• prevent bone disease caused by loss of calcium

See our calcium and phosphate balance fact sheet for more information.

‘Fluids’ refers to any foods that are liquid when they’re at room temperature – that includes ice cream, yoghurt, and ice cubes. Fluid is also contained in foods like soups, stews and gravy.

Some people on dialysis may need to limit their fluid intake, whilst others can drink to thirst. It’s usually people who are on peritoneal dialysis or more frequent home haemodialysis that can enjoy more freedom with their fluids, but this can also change over time.

A renal dietitian or your healthcare team can help you manage your fluid intake, including advice on how much you should drink each day. Our Drink Water Instead factsheet contains more information on how to manage your fluid intake.

Keeping to a fluid allowance helps you to feel well whilst having dialysis treatment and may help you stay out of hospital. Speak with your healthcare team if you are unsure whether you have a fluid allowance.

People having dialysis treatment may need to make changes to the types of food and drinks they regularly enjoy to keep their phosphate levels within range. Making these dietary changes, and taking tablets called phosphate binders with all meals and snacks as prescribed your doctor will help with this.

Some people [having] dialysis [treatment] may need to follow a low potassium diet. This is more common for haemodialysis than peritoneal dialysis and may also change over time. Some people may even be advised to increase the amount of high potassium food they eat. Speak to your healthcare team to know what diet is right for you.

If you have received a kidney transplant, then you may be advised to reintroduce foods which were previously restricted. It is also important to maintain a balanced diet and regular physical activity as some of the medications you are required to take can make it easy to gain unwanted weight.

Getting a well-rounded balance of nutrients from the food you eat is important at any stage of your journey. If you are on dialysis, living with a transplant, (or struggling to eat enough) then you may have to pay closer attention to the food you eat. Eating a wide range of fruits and vegetables, wholegrains, lean meats and fish, and nuts and seeds is the best way to support your health.

It’s important that you only take supplements that are prescribed, as some can interfere with your treatment and be incredibly harmful. You may find extra vitamins and minerals helpful if you experience any of the following:

• chronically poor or erratic eating habits
• reduced appetite
• nausea
• vomiting
• changes in taste
• food aversions
• undesirable weight loss
• food insecurity
• vitamin loss during dialysis.

It’s important that you talk to your dietitian or healthcare team to formulate a plan that works best for you.

When living with chronic kidney disease, managing what you eat and drink can be a challenge; however, your diet can also positively influence how you feel, and what other treatments you might need.

It is important to recognise that as kidney disease progresses your dietary needs will more than likely change. It is also important to recognise that every person with kidney disease is different and has different food preferences and dietary needs.

A Renal Dietitian is a specialist who works with people living with kidney disease. They provide support around nutrition and which foods can help to keep you well during your kidney journey. Your GP or Nephrologist may make a referral to a renal dietitian. The Dietitians Association of Australia can provide names and contact details of local renal dietitians. Call 1800 812 942 or visit www.daa.asn.au and then ask your doctor to arrange a referral to your preferred dietitian.

For more information and to get the most out of your appointment with the Dietitian see our Nutrition and Kidney Disease fact sheet.