Nutrition for Early Chronic 

Kidney Disease in Adults 

National Kidney and Urologic Diseases Information Clearinghouse 

National 

Institute of 

Diabetes and 

Digestive 

and Kidney 

Diseases 

NATIONAL 

INSTITUTES 

OF HEALTH 

U.S. Department 

of Health and 

Human Services 

Your kidneys do many things to keep you 

healthy. They filter wastes and extra water 

from your blood. To keep the body working properly, the kidneys balance the salts 

and minerals—such as calcium, phosphorus, 

sodium, and potassium—that circulate 

in your blood. The kidneys also release 

hormones that help make red blood cells 

and keep bones strong. 

If your kidneys abruptly shut down because 

of an accident, poisoning, or other sudden 

sickness affecting the kidneys, you would 

quickly experience nausea and swelling 

from the buildup of wastes and fluid in your 

body. You would need to be hospitalized 

immediately to treat the effects of kidney 

failure. 

When you have chronic kidney disease 

(CKD), however, you may not notice 

changes in your health. In CKD, the kidneys continue to work, they just don’t do 

their job as well as they should. Wastes 

may build up so gradually that your body 

even becomes used to the condition. Salts 

containing phosphorus and potassium may 

rise to unsafe levels, causing heart and 

bone problems. You may be low in red 

blood cells, a condition called anemia, 

causing you to tire easily. 

Millions of Americans are at risk of developing CKD because they have diabetes, 

high blood pressure, or both. High levels of 

blood glucose (sugar) put people who have 

diabetes at risk for heart disease, stroke, 

amputation, and eye and kidney problems. 

People with high blood pressure are at risk 

for damaged blood vessels, including the 

tiny vessels in the kidneys. 

Diabetes 

Whether you have type 1 or type 2 diabetes, 

what you eat affects your blood glucose, 

the body’s main source of energy. Following a meal plan to keep your blood glucose 

at a healthy level may prevent CKD from 

developing. 

Talk with your health care provider about 

your blood glucose targets and ask how 

often to check your blood glucose level. 

The results from your blood glucose checks 

will tell you if your diabetes care plan is 

working. Also ask your doctor for an A1C 

test at least twice a year. The A1C number 

reflects your average blood glucose for the 

past 3 months. 

Following regular habits can help keep your 

blood glucose at a healthy level. 

•	 Eat about the same amount of food 

each day. 

•	 Eat your meals and snacks at about 

the same times each day. 

•	 Do not skip meals or snacks. 

•	 Take your medicines at the same times 

each day. 

•	 Participate in physical activity every 

day. 

For more information about nutrition for 

diabetes, see What I Need to Know About 

Eating and Diabetes from the National 

Diabetes Information Clearinghouse (see 

contact information under “Additional 

Reading”), or contact a registered dietitian. 
High Blood Pressure 

Blood pressure is expressed as two numbers. The top number represents the force 

of your blood pushing against the artery 

walls when your heart beats. The lower 

number represents the pressure between 

beats. Normal blood pressure is less than 

120/80 mmHg. It is recommended that 

people with kidney disease keep their 

blood pressure below 130/80 mmHg. 

As blood pressure rises, the risk of damage 

to arteries, heart, brain, and kidneys 

increases. Controlling blood pressure 

through healthy food choices and regular 

physical activity can delay or prevent the 

development of chronic kidney disease. 

Medical Nutrition Therapy 

When treatment for a medical condition includes nutrition advice, health 

care providers use the term medical 

nutrition therapy (MNT). Your doctor 

may refer you to a registered dietitian 

to help with your food plan. Many 

insurance policies cover MNT when 

recommended by a doctor. If you 

qualify for Medicare, you can receive 

a benefit for MNT from a registered 

dietitian or nutrition professional when 

your doctor provides a referral indicating that you have diabetes or kidney 

disease. Medicare covers 80 percent of 

the Medicare-approved amount for 

MNT after you have paid the $100 

deductible for Part B services. 

One way to locate a qualified dietitian 

is to consult the American Dietetic 

Association website at www.eatright.org, 

which features a “Find a Nutrition Professional” page. Users can enter their 

address or ZIP code and a list of dietitians in that area will appear. Click on 

“Renal nutrition” in the specialty field. 

The National Heart, Lung, and Blood 

Institute (NHLBI) supported research 

that compared a typical American diet 

with an eating plan that is lower in saturated 

fat, cholesterol, and total fat and that 

emphasizes fruits, vegetables, and lowfat 

dairy foods. People who followed the 

lowfat plan were able to reduce their blood 

pressure much more effectively than those 

who ate a typical diet. This eating plan— 

known as the DASH eating plan—also 

includes whole grain products, fish, poultry, 

and nuts. Limiting sodium (salt) is another 

important feature of the DASH eating plan. 

Facts About the DASH Eating Plan is a fact 

sheet available from NHLBI (see contact 

information under “Additional Reading”). 

It provides detailed nutrition information 

and meal plans. 

Keep Track of Test Results 

If you have CKD, your doctor will order 

regular blood tests. Ask your doctor for 

copies of your laboratory reports and ask 

to have them explained. Note any results 

that are out of the normal range. Talk with 

your doctor or your dietitian about what 

you can do to make healthier food choices. 

When you learn how to read your reports, 

you will see how the foods you eat affect 

your kidneys. Remember that you are the 

most important member of your health 

care team. 

Hope Through Research 

The National Institute of Diabetes and 

Digestive and Kidney Diseases (NIDDK) 

has many research programs aimed at 

slowing the progression of chronic kidney 

disease. For example, the NIDDK is sponsoring the Chronic Renal Insufficiency 

Cohort study to determine the risk factors 

for rapid decline in kidney function and 

development of cardiovascular disease. 

2 Nutrition for Early Chronic Kidney Disease in Adults 
This study of about 3,000 patients with 

chronic renal insufficiency, another way 

of describing CKD, will reflect the racial, 

ethnic, and gender composition of the 

people in the United States who have permanent kidney failure. The data collected 

and specimens obtained will serve as a 

national resource for investigating CKD, as 

well as cardiovascular disease. Establishing 

this group of patients and following them 

into the future also provides an opportunity 

to examine genetic, environmental, behavioral, nutritional, quality-of-life, and health 

resource use factors in this population. 

The main part of the study will consist of 

monitoring patients and following up at 

regular clinic visits with kidney function 

measurements, cardiovascular studies, and 

laboratory tests. In addition, participants 

will answer questionnaires to assess various 

demographic, nutritional, and quality-oflife factors. 

Additional Reading 

The following fact sheets and brochures, as 

well as other information, are available on 

request from the organizations listed. Most 

of them can also be found online at the web 

addresses given. 

Dining Out With Confidence: A Guide for 

Patients with Kidney Disease 

Nutrition and Chronic Kidney Disease 

National Kidney Foundation 

30 East 33rd Street 

New York, NY 10016 

Phone: 1–800–622–9010 or 212–889–2210 

Email: info@kidney.org 

Internet: www.kidney.org 

Facts About the DASH Eating Plan 

National Heart, Lung, and Blood Institute 

Information Center 

P.O. Box 30105 

Bethesda, MD 20824–0105 

Phone: 301–592–8573 

TTY: 240–629–3255 

Fax: 301–592–8563 

Internet: www.nhlbi.nih.gov 

A Healthy Food Guide for People with 

Chronic Kidney Disease 

American Dietetic Association 

120 South Riverside Plaza 

Suite 2000 

Chicago, IL 60606–6995 

Phone: 1–800–366–1655 

Email: knowledge@eatright.org 

Internet: www.eatright.org 

Kidney Beginnings: A Patient’s Guide to 

Living with Reduced Kidney Function 

American Association of Kidney Patients 

3505 East Frontage Road 

Suite 315 

Tampa, FL 33607 

Phone: 1–800–749–2257 or 813–636–8100 

Email: info@aakp.org 

Internet: www.aakp.org 

What I Need to Know About Eating 

and Diabetes 

National Diabetes Information 

Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

Email: ndic@info.niddk.nih.gov 

Internet: www.diabetes.niddk.nih.gov 

The information in this fact sheet should not 

be used in the nutritional counseling of infants, 

children, and adolescents with chronic kidney 

disease. Families of pediatric patients with 

CKD should seek age-appropriate nutritional 

counseling from a pediatric renal dietitian. 

3 Nutrition for Early Chronic Kidney Disease in Adults 
For More Information 

American Kidney Fund 

6110 Executive Boulevard 

Suite 1010 

Rockville, MD 20852 

Phone: 1–800–638–8299 or 301–881–3052 

Email: helpline@akfinc.org 

Internet: www.kidneyfund.org 

Life Options Rehabilitation Resource 

Center 

c/o Medical Education Institute, Inc. 

414 D’Onofrio Drive 

Suite 200 

Madison, WI 53719 

Phone: 1–800–468–7777 

Email: lifeoptions@MEIresearch.org 

Internet: www.lifeoptions.org 

National Kidney Disease Education 

Program 

3 Kidney Information Way 

Bethesda, MD 20892 

Phone: 1–866–4–KIDNEY (454–3639) 

Email: nkdep@info.niddk.gov 

Internet: www.nkdep.nih.gov 

About the Nutrition for 

Chronic Kidney Disease Series 

The NIDDK Nutrition for Chronic Kidney 

Disease Series includes three fact sheets: 

•	 Nutrition for Early Chronic Kidney 

Disease in Adults 

•	 Nutrition for Later Chronic Kidney 

Disease in Adults 

•	 Nutrition in Children with Chronic 

Kidney Disease 

For free single printed copies of this 

series, please contact the National Kidney and Urologic Diseases Information 

Clearinghouse. 

National Kidney and 

Urologic Diseases 

Information Clearinghouse 

3 Information Way


Bethesda, MD 20892–3580


Phone: 1–800–891–5390


Fax: 703–738–4929


Email: nkudic@info.niddk.nih.gov


Internet: www.kidney.niddk.nih.gov


The National Kidney and Urologic Diseases 

Information Clearinghouse (NKUDIC) is a 

service of the National Institute of Diabetes 

and Digestive and Kidney Diseases (NIDDK). 

The NIDDK is part of the National Institutes 

of Health under the U.S. Department of Health 

and Human Services. Established in 1987, the 

Clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to 

their families, health care professionals, and the 

public. The NKUDIC answers inquiries, develops and distributes publications, and works 

closely with professional and patient organizations and Government agencies to coordinate 

resources about kidney and urologic diseases. 

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists 

and outside experts. This fact sheet was 

reviewed by Lisa Murphy-Gutekunst, MSEd, 

RD, CSR, Cleve-Hill Dialysis, Buffalo, NY; and 

Marcy Bushman, MPH, RD, LDN, Sigma-Tau 

Pharmaceuticals. 

This publication is not copyrighted. The 

Clearinghouse encourages users of this fact 

sheet to duplicate and distribute as many 

copies as desired. 

This fact sheet is also available at 

www.kidney.niddk.nih.gov. 

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 06–5571 

January 2006