Nutrition for Early Chronic 

Kidney Disease in Adults 

National Kidney and Urologic Diseases Information Clearinghouse 

U.S. Department 

of Health and 

Human Services 

NATIONAL 

INSTITUTES 

OF HEALTH 

Why is nutrition important 

for someone with early 

chronic kidney disease 

(CKD)? 

Controlling blood glucose, also called blood 

sugar, and blood pressure through healthy 

food choices is an important step toward 

slowing or stopping the progression of CKD. 

Diabetes and high blood pressure are the two 

leading causes of CKD in the United States. 

A person’s eating habits can increase or 

decrease diabetes and blood pressure risks. 

What do the kidneys do? 

The kidneys remove wastes and extra water 

from the blood and make urine. To keep the 

body working properly, the kidneys balance 

the salts and minerals—such as calcium, 

phosphorus, sodium, and potassium—that 

circulate in the blood. The kidneys also 

release hormones that help make red blood 

cells, regulate blood pressure, and keep 

bones strong. 

What are the effects of 

CKD? 

CKD usually takes a long time to develop 

and does not go away. In CKD, the kidneys 

continue to work—just not as well as they 

should. Wastes may build up so gradually 

that the body becomes used to having those 

wastes in the blood. Salts containing phosphorus and potassium may rise to unsafe 

levels, causing heart and bone problems. 

Anemia—low red blood cell count—can 

result from CKD because the kidneys stop 

making enough erythropoietin, a hormone 

that causes bone marrow to make red blood 

cells. After months or years, CKD may 

progress to permanent kidney failure, which 

requires a person to have a kidney transplant 

or regular blood filtering treatments called 

dialysis. 

Who is at risk for CKD? 

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

blood pressure, or both. High blood glucose levels put people with 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 tiny vessels in the kidneys. 
               

                 

             

             

                

               

             

             

           

               

              

             

              

             

                    

             

                

           

       

               

               

     

         

             

         

             

             

          

           

             

   

              

               

             

            

            

           

            

               

             

              

           

           

         

           

             

             

            

             

             

                  

             

            

             

                  

               

What does a person with 

CKD and diabetes need 

to know about food and 

controlling blood glucose? 

People with either type 1 or type 2 diabetes 

must choose foods carefully to control their 

blood glucose, the body’s main source of 

energy. Following a meal plan to keep blood 

glucose at a healthy level may prevent CKD 

from developing. 

People with diabetes should talk with their 

health care provider about setting goals for 

maintaining healthy blood glucose levels and 

about how often to check their blood glucose 

level. The results from these blood glucose 

checks indicate whether a person’s meal plan 

is helping to keep diabetes under control. 

People with diabetes should also ask their 

doctor for an A1C test at least twice a year. 

The A1C number reflects a person’s average 

blood glucose level over the past 2 to 

3 months. 

Following regular, daily habits can help 

maintain healthy blood glucose levels: 

• Eating about the same amount of food 

each day. 

• Eating meals and snacks at about the 

same times each day. 

• Not skipping meals or snacks. 

• Taking medicines at the same times
 

each day.
 

• Participating in physical activity every 

day. 

What does a person with 

CKD and high blood 

pressure need to know about 

food and controlling blood 

pressure? 

As blood pressure rises, the risk of damage to the arteries, heart, brain, and kidneys increases. Controlling blood pressure 

through healthy food choices and regular 

physical activity can delay or prevent the 

development of CKD. 

Blood pressure is expressed as two numbers. 

The top number represents the force of the 

blood pushing against the artery walls when 

the heart beats. The lower number represents the pressure between beats. Normal 

blood pressure is below 120/80 millimeters 

of mercury (mmHg). People with CKD 

should try to keep their blood pressure below 

130/80 mmHg. 

Following a meal plan can help control 

blood pressure and protect the kidneys. The 

National Heart, Lung, and Blood Institute 

supported research that compared a typical 

American diet with the Dietary Approaches 

to Stop Hypertension (DASH) eating plan, 

which is lower in saturated fat, cholesterol, 

and total fat and emphasizes eating fruits, 

vegetables, and low-fat dairy foods. People 

who followed the DASH eating plan were 

able to reduce their blood pressure much 

more than those who ate a typical diet. The 

DASH eating plan also includes whole grain 

products, fish, poultry, and nuts. Limiting 

sodium, or salt, is another important feature 

of the plan. A dietitian can help find low-salt 

or salt-free alternatives to foods that are high 

in salt. 

2  Nutrition for Early Chronic Kidney Disease in Adults 
               

               

             

                

               

              

             

            

               

           

             

            

                 

         

           

            

                 

                

             

             

            

           

 

             

               

              

             

              

                 

               

              

               

            

               

             

                

               

           

       

         

           

         

       

           

           

    

             

         

         

    

                 

       

            

             

           

     

       

         

         

          

           

         

           

             

           

      

           

           

           

             

           

          

             

           

             

What is medical nutrition 

therapy (MNT)? 

MNT is the use of nutrition counseling by 

a registered dietitian to help promote a 

medical or health goal. A doctor may refer 

a patient to a registered dietitian to help 

with the patient’s food plan. Many insurance 

policies cover MNT when recommended by a 

doctor. Anyone who qualifies for Medicare 

can receive a benefit for MNT from a registered dietitian or nutrition professional when 

a doctor provides a referral indicating the 

person has diabetes or kidney disease. 

One way to locate a qualified dietitian is to 

contact the American Dietetic Association 

at www.eatright.org and click on “Find a 

Registered Dietitian.” Users can enter their 

address or ZIP code for a list of dietitians 

in their area. A person looking for dietary 

advice to prevent kidney damage should click 

on “Renal (Kidney) Nutrition” in the specialty 

field. Dietitians who specialize in helping 

people with CKD are called renal dietitians. 

How can understanding and 

keeping track of lab reports 

help someone with early CKD 

make healthy food choices? 

Learning how to read and understand lab 

reports lets a person see how different foods 

can affect the kidneys. A doctor should 

order regular blood tests for people with 

CKD. Patients can ask their doctor for 

copies of their lab reports and ask to have 

them explained, noting any results out of the 

normal range. Keeping track of these lab 

results can help people see whether they are 

making progress or getting worse. People 

with CKD should talk with their doctor or 

dietitian about how they can make healthier 

food choices. For example, a person who has 

a high A1C score should follow a diabetes 

meal plan to lower blood glucose levels. 

Points to Remember 

• Controlling blood glucose and 

blood pressure through healthy food 

choices is an important step toward 

slowing or stopping the progression 

of chronic kidney disease (CKD). 

• The kidneys remove wastes and
 

extra water from the blood and
 

make urine.
 

• Millions of Americans are at risk 

for developing CKD because they 

have diabetes, high blood pressure, 

or both. 

• People with either type 1 or type 2 

diabetes must choose foods carefully to control their blood glucose. 

Following a meal plan to keep blood 

glucose at a healthy level may prevent CKD from developing. 

• Controlling blood pressure through 

healthy food choices and regular 

physical activity can delay or prevent the development of CKD. 

People with CKD should try to 

keep their blood pressure below 

130/80 mmHg. 

• Medical nutrition therapy (MNT) is 

the use of counseling by a registered 

dietitian to help promote a medical 

or health goal. 

• Dietitians who specialize in helping 

people with CKD are called renal 

dietitians. 

• Learning how to read and understand lab reports lets a person see 

how different foods can affect the 

kidneys. Patients can ask their doctor for copies of their lab reports 

and ask to have them explained, 

noting any results out of the normal 

range. 

3  Nutrition for Early Chronic Kidney Disease in Adults 
               

           

           

           

              

           

         

               

       

              

           

             

             

             

            

             

             

        

               

           

       

       

                

             

               

     

              

         

         

               

               

           

              

          

          

             

             

            

               

       

       

        

      

  

     

       

     

  

  

  

  

           

      

  

           

      

      

  

  

Hope through Research 

The National Institute of Diabetes and 

Digestive and Kidney Diseases (NIDDK) has 

many research programs aimed at slowing 

the progression of CKD. 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. 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 participants and following up at regular clinic visits 

with kidney function measurements, cardiovascular studies, and lab tests. In addition, 

participants will answer questionnaires to 

assess various demographic, nutritional, and 

quality-of-life factors. 

Participants in clinical trials can play a more 

active role in their own health care, gain 

access to new research treatments before 

they are widely available, and help others 

by contributing to medical research. For 

information about current studies, visit 

www.ClinicalTrials.gov. 

Additional Reading 

The following fact sheets and brochures, as 

well as other information, are available on 

request from the organizations listed. Most 

of these resources 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 

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 

Email: nhlbiinfo@nhlbi.nih.gov 

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 

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 

4  Nutrition for Early Chronic Kidney Disease in Adults 
5    Nutrition for Early Chronic Kidney Disease in Adults

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

Eating Right for Kidney Health: Tips for 

People with Chronic Kidney Disease (CKD) 

(online only) 

Your Kidney Test Results (online only)

National Kidney Disease Education 

Program

3 Kidney Information Way 

Bethesda, MD 20892 

Phone: 1–866–4–KIDNEY (1–866–454–3639) 

TTY: 1–866–569–1162 

Fax: 301–402–8182 

Email: nkdep@info.niddk.nih.gov 

Internet: www.nkdep.nih.gov

For More Information

American Kidney Fund 

6110 Executive Boulevard, Suite 1010 

Rockville, MD 20852 

Phone: 1–800–638–8299 or 1–866–300–2900 

Fax: 301–881–0898 

Email: helpline@kidneyfund.org 

Internet: www.kidneyfund.org

Food and Nutrition Information Center 

National Agricultural Library 

10301 Baltimore Avenue, Room 105 

Beltsville, MD 20705–2351 

Phone: 301–504–5414 

Fax: 301–504–6409 

Email: fnic@ars.usda.gov 

Internet: www.nal.usda.gov/fnic

Life Options 

c/o Medical Education Institute, Inc. 

414 D’Onofrio Drive, Suite 200 

Madison, WI 53719 

Phone: 1–800–468–7777 

Fax: 608–833–8366 

Email: lifeoptions@meiresearch.org 

Internet: www.lifeoptions.org

The information in this fact sheet should

not be used in the nutritional counseling of

infants, children, and adolescents with CKD.

Families of pediatric patients with CKD

should seek age-appropriate nutritional

counseling from a pediatric renal dietitian.

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 Advanced Chronic Kidney 

Disease in Adults

• Nutrition for Chronic Kidney Disease in 

Children 

For free, single, printed copies of this

series, please contact the National Kidney

and Urologic Diseases Information

Clearinghouse.

You may also find additional information about this

topic by visiting MedlinePlus at www.medlineplus.gov.

This publication may contain information about

medications.  When prepared, this publication

included the most current information available.  

For updates or for questions about any medications,

contact the U.S. Food and Drug Administration tollfree at 1–888–INFO–FDA (1–888–463–6332) or visit

www.fda.gov.  Consult your health care provider for

more information.
            

               

           

          

     

   

      

  

  

  

  

  

           

   

               

           

              

             

            

       

         

             

             

           

          

         

           

       

           

   

 

       

           

          

           

       

           

         

       

      

     

   

  

  

  

  

         

             

           

         

             

            

             

             

               

       

Acknowledgments 

Publications produced by the Clearinghouse 

are carefully reviewed by both NIDDK 

scientists and outside experts. This publication was originally reviewed by Lisa 

Murphy-Gutekunst, M.S.Ed., R.D., C.S.R., 

Cleve-Hill Dialysis, Buffalo, NY, and Marcy 

Bushman, M.P.H., R.D., L.D.N., Sigma-Tau 

Pharmaceuticals. 

National Kidney Disease 

Education Program 

3 Kidney Information Way
 

Bethesda, MD 20892
 

Phone: 1–866–4–KIDNEY
 

(1–866–454–3639)
 

TTY: 1–866–569–1162
 

Fax: 301–402–8182
 

Email: nkdep@info.niddk.nih.gov
 

Internet: www.nkdep.nih.gov
 

The National Kidney Disease Education 

Program (NKDEP) is an initiative of the 

National Institute of Diabetes and Digestive 

and Kidney Diseases, National Institutes 

of Health, U.S. Department of Health and 

Human Services. The NKDEP aims to 

raise awareness of the seriousness of kidney 

disease, the importance of testing those at 

high risk, and the availability of treatment to 

prevent or slow kidney disease. 

National Kidney and 

Urologic Diseases 

Information Clearinghouse 

3 Information Way 

Bethesda, MD 20892–3580 

Phone: 1–800–891–5390 

TTY: 1–866–569–1162 

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 of 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. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this publication to duplicate and 

distribute as many copies as desired. 

This publication is available at 

www.kidney.niddk.nih.gov. 

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 11–5571 

April 2011 

The NIDDK prints on recycled paper with bio-based ink.