What to Eat When You Have Polycystic Kidney Disease

Although autosomal dominant polycystic kidney disease (ADPKD) does not have a cure, diet appears to have some influence on the condition by protecting the kidneys of individuals who have ADPKD.

By working closely with your kidney specialist and a nutrition expert, kidney-protective diets may help individuals with ADPKD slow the progression of polycystic kidney disease and damage to the kidneys.

Benefits

ADPKD is a progressive disease that, over time, will affect kidney function and cause permanent damage. Dietary modifications with this chronic kidney disease are important to preserve kidney function for as long as possible. 

One study specific to individuals affected by ADPKD showed success with a small number of participants in preparing and following a diet specifically designed for ADPKD. Many other studies have shown the correlation between dietary modifications and stabilizing kidney function as well.

In diseases like ADPKD in which kidney function is impaired, the kidneys are not able to filter fluid as well, which results in the body keeping more sodium, or salt, than needed. Increased sodium has been studied extensively. It directly affects blood pressure, often raising it so consistently that individuals with ADPKD also have a diagnosis of hypertension, or high blood pressure.

When dietary salt intake is decreased, the body maintains a better sodium balance and keeps blood pressure within acceptable ranges. This same effect occurs with potassium and phosphorus. So, following a diet containing foods lower in potassium and phosphorus can help the body maintain a proper balance and prevent a more rapid decline to total kidney failure.

Another dietary recommendation includes limiting animal protein. Doing so has been shown to restrict growth of the cysts and minimize deterioration of overall kidney function. How animal protein causes cyst growth is unknown, but there is enough research indicating a diet high in animal protein causes more cysts and hastens progression to full kidney failure. 

Drinking water, with the goal to balance water intake against kidney function to prevent fluid excess, helps the kidneys to maintain fluid balance more effectively. Minimizing dark sodas and caffeine is also important to maintain the fluid balance that allows the kidneys to work as optimally as possible.

How It Works

Following a recommended diet specific to chronic kidney disease like ADPKD is important to preserving kidney function and delaying kidney function decline.

Duration

Since ADPKD is a progressive disease with no known cure, developing a diet appropriate for maintaining kidney function for as long as possible is a lifestyle modification that should be lifelong. 

What to Eat

Other Foods to Consider

Other types of foods that you may want to add to your diet are those with low potassium or phosphorus. You may also want to avoid foods and beverages with high levels of these minerals. However, with good kidney function, avoiding foods with these minerals may not always be necessary. Your healthcare provider may recommend specific restrictions if needed.

By working with a qualified nutrition specialist, such as a registered dietician (preferably one trained in kidney disease diets), you will be able to appropriately modify your diet. A registered dietician can also teach you how to read labels, determine portion sizes, and target ideal daily caloric intake, as well. Below are key points for inclusion in an ADPKD compliant diet: 

Portion sizes:

• Animal-source proteins: Generally, portion size for chicken, fish, or meat is about 2–3 ounces, or about the size of a deck of cards. Portion size for dairy is 4 ounces of yogurt or milk, or one slice of cheese.
• Plant-source proteins: A portion size of cooked beans is about 4 ounces, whereas a portion size of nuts is about 2 ounces. Bread is usually a single slice for one portion, and cooked rice or noodles is about 4 ounces.

Sodium intake:

• Current recommendations for individuals affected by ADPKD are to limit sodium intake to 1,500 milligrams daily. When reading food labels, look for a percent daily value of 5% or less as this indicates low sodium. A percent daily value of 20% or more is high in sodium and should be avoided.

 Considerations

The 2020–2025 Dietary Guidelines for Americans, developed collaboratively by the departments of Agriculture and Health and Human Services, recognizes the importance of healthy food and beverage choices while allowing for flexibility and options. These guidelines enable adults to focus on establishing and maintaining a healthy eating pattern instead of dictating a rigid diet to follow:

• Follow a healthy diet pattern to meet nutrition needs, help achieve a healthy body weight, and reduce the risk of chronic disease.
• Create nutrient-dense food and beverage choices that reflect personal preferences, cultural traditions, and budgetary considerations.
• Focus on selecting nutrient-dense food and beverages from different food groups and stay within calorie limits. Core elements of a healthy dietary pattern include:
  All types of vegetables
• Fruits, especially whole fruits
• Grain with half being made of whole grain
• Dairy (including fat-free or low-fat milk, yogurt, and cheese and/or lactose-free versions and fortified soy beverages and yogurt as alternatives)
• Protein foods like lean meats, poultry, and eggs; seafood; beans, peas, and lentils; nuts, seeds, and soy products; and oils like vegetable oils
• Limit food and beverages higher in added sugars, saturated fat, and sodium. Daily recommendations for limits include added sugars comprising less than 10% of calories, saturated fats comprising less than 10% of calories, and less than 2,300 milligrams of sodium a day.

For individuals with ADPKD, the majority of the 2020–2025 Dietary Guidelines for Americans apply, with a few small exceptions to adjust for preserving kidney function and preventing worsening of the ADPKD disease process, including

• Limit sodium intake to 1,500 milligrams a day.
• Incorporate more plant-based proteins than animal-based proteins.
• Avoid saturated fats by substituting monounsaturated fats.

An ADPKD-focused diet does not mean higher food costs or decreasing flavor with food selections. A 2017 study, specifically looking at an ADPKD-focused diet plan, was reviewed by participants as being financially neutral and full of variety. 

Dietary Restrictions

ADPKD is an inherited, genetic disease that is progressive. About 60% of individuals diagnosed with ADPKD will experience total kidney failure in their 70s. There is a growing body of evidence indicating that implementing a kidney-healthy diet soon after ADPKD diagnosis can prolong kidney function and potentially avert total kidney failure.

Collaborating with a medical professional specialized in kidney diseases, such as a nephrologist, to monitor kidney function through laboratory tests and routine physical examinations, is an important component of adjusting dietary requirements for ADPKD. 

Further collaboration with an experienced renal registered dietician can help formulate an ADPKD-compliant diet that supports optimal kidney function is also important. An experienced renal registered dietician can also assist with ensuring an ADPKD compliant diet is budget and taste friendly.

A Word From Verywell

A disease diagnosis, particularly one such as ADPKD, might feel overwhelming or discouraging at first. Implementing lifestyle changes, like a different dietary plan, may seem like a challenge, but with the right mindset and with healthcare specialists to lean on, your disease progression may be slowed. 

ADPKD does not necessarily mean your dietary changes will be restrictive or hard to implement. With the right guidance, an appropriate ADPKD diet can be chosen that fits your lifestyle and optimizes your kidney health.