Using the DASH Diet For Kidney Disease

Should you tweak the popular DASH diet if you have kidney disease?

Managing chronic kidney disease (CKD) usually involves both medical treatment and lifestyle changes. At home, that means watching your blood pressure and eating a kidney-friendly diet.

The Dietary Approaches to Stop Hypertension (DASH) diet has been found to lower the risk for heart disease as well as kidney disease. However, if you already have chronic kidney disease, talk with your doctor before starting. The DASH diet may require some changes if you have dietary restrictions.

This article discusses what the DASH diet is, when it should be modified, and how it affects chronic kidney disease.

Fresh fruit and vegetables
Sean Gallup / Getty Images

What Is the DASH Diet?

The DASH diet is a heart-healthy eating plan recommended by the National Heart, Lung, and Blood Institute (NHLBI). Studies have found that it lowers blood pressure, which helps to reduce the risk for kidney disease as well.

The DASH diet approach emphasizes eating fruits, vegetables, low-fat dairy, fish, poultry, beans, nuts, and vegetable oils. It limits sodium, sugar, and red meat. It is low in saturated and trans fats and high in calcium, potassium, magnesium, fiber, and protein.

Recap

The DASH diet lowers blood pressure and reduces the risk of kidney disease. It limits sodium, sugar, and fats in your diet.

DASH Diet and Chronic Kidney Disease

For those with chronic kidney disease, research shows that the DASH diet may help prevent it from getting worse.

A 2019 study found that the DASH diet reduced the risk of kidney failure for those with moderate chronic kidney disease. This was especially true for those who also had high blood pressure and diabetes.

However, if you have chronic kidney disease, it's important to check with your doctor before starting the DASH diet. Specifically, you may need to limit how much potassium and phosphorus is in your diet.

The DASH diet should not be used if you're on dialysis. That's because you'll have specific guidelines from your doctor for the type of foods to eat.

Recap

The DASH diet may help improve the outlook for chronic kidney disease. Before starting, check with your doctor if you have any dietary restrictions. Don't use the DASH diet if you're on dialysis.

Limiting Potassium

When you have kidney disease, your doctor may ask you to monitor how much potassium you eat. That's because if your kidneys aren't working correctly, potassium can build up in your blood. This can change how your heart beats and possibly cause a heart attack.

Potassium-rich foods include certain vegetables, fruits, milk, and meats. Ask your doctor if you should limit potassium-rich foods. These may include:

  • Cantaloupe
  • Honeydew melon
  • Bananas
  • Pumpkin
  • Dried beans
  • Tomatoes
  • Oranges
  • Grapefruit juice
  • Spinach
  • Kale
  • Bran cereals
  • Granola

Eating a variety of fruits and vegetables may help to ensure that you don't get too much potassium on a daily basis.

Limiting Phosphorus

Your doctor may also suggest limiting phosphorus, which can build up in your blood with kidney disease as well.

When your blood has too much phosphorus, your body pulls calcium from your bones to balance out your blood. This calcium loss can lead to bone disease and cause your bones to break more easily.

To help limit phosphorus, your doctor or dietitian may suggest the following:

  • Limit milk to one cup per day. Limit cheese or yogurt to one container or one ounce daily.
  • Limit vegetables with phosphorus to one cup per week. These include dried beans, broccoli, greens, mushrooms, and Brussel sprouts.
  • Limit bran, wheat cereals, granola, and oatmeal to one serving per week.
  • Choose white bread over whole grain bread.
  • Avoid soft drinks and beer.

Recap

With kidney disease, your body may build up high levels of potassium and phosphorus, which can cause heart and bone issues. Your doctor or dietitian can work with you to limit potassium and phosphorus in your diet.

DASH Diet Guidelines

The DASH diet focuses on healthy foods, particularly ones that are low in sodium. The National Kidney Foundation gives the following tips for eating on the DASH diet:

  • Limit salt when cooking. Instead, try cooking with more spices and herbs.
  • Buy foods that are low sodium (less than 140 mg per serving) or very low sodium (less than 35 mg).
  • Eat plenty of fruits and vegetables. Check with your doctor about which ones to choose if you're limiting potassium or phosphorus.
  • Choose low-fat dairy products. Check with your doctor if these need to be limited because of dietary restrictions.

The following table details what a DASH diet plan would look like for different calorie needs. The serving numbers may differ if you're limiting phosphorus and potassium. Always check with your doctor or dietitian about your specific dietary needs.

Food group 1,200
calories
1,400
calories
1,600
calories
1,800
calories
2,000
calories
2,600
calories
3,100
calories
Grains 4–5 5–6 6 6 6–8 10–11 12–13
Vegetables 3–4 3–4 3–4 4–5 4–5 5–6 6
Fruits 3–4 4 4 4–5 4–5 5–6 6
Fat-free or low-fat dairy products 2–3 2–3 2–3 2–3 2–3 3 3–4
Lean meats, poultry, and fish 3 or less 3–4 or less 3–4 or less 6 or less 6 or less 6 or less 6–9
Nuts, seeds, and legumes 3 per week 3 per week 3–4 per week 4 per week 4–5 per week 1 1
Fats and oil 1 1 2 2–3 2–3 3 4
Sweets and added sugar 3 or less per week 3 or less per week 3 or less per week 5 or less per week 5 or less per week 2 or less per week 2 or less per week
Maximum sodium intake 2,300 mg/day 2,300 mg/day 2,300 mg/day 2,300 mg/day 2,300 mg/day 2,300 mg/day 2,300 mg/day

Summary

The DASH diet can be beneficial for your kidney health. However, if you already have chronic kidney disease, you should check with your doctor before starting. You may need to limit the amount of potassium and phosphorus in the foods you eat. You should not follow the DASH diet if you are on dialysis.

A Word From Verywell

It can be tricky to know what to eat, especially when you have chronic kidney disease. The DASH diet can serve as a healthy guide, once you get the OK from your doctor. With its focus on limiting salt and increasing nutrients, it may help slow kidney disease and improve your overall health.

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