Renal Diet Grocery List ⋆ Dialysis Dietitian

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You have recently started on dialysis and it’s time to go grocery shopping. What are the best foods to buy when you’re on dialysis? Suddenly grocery shopping has become more complicated.

Don’t worry, I have you covered! This blog post will cover general renal diet recommendations and a downloadable grocery list which includes some of my own personal recommendations which will make your next shopping trip a little easier.

Table of Contents

Why Do You Need A Special List?

Once your kidneys are unable to adequately filter the waste from the foods you’re eating, what you eat becomes very important! Your nutrition needs are also different from someone who is in earlier stages of CKD.

Dialysis helps filter your blood, but often this is only happening for a few hours 3x/week. If you are doing dialysis more frequently (peritoneal dialysis) then your potassium and fluid needs are usually less restricted.

Everyone has individual needs, so it is important to follow the advice of your doctor and clinic dietitian.

Important Nutrients In A Renal Diet

Below is a general guideline of nutrients that need to be modified in your diet:

Potassium

If you have healthy kidneys you normally don’t have to worry about your potassium intake. In fact, eating more potassium rich foods is usually recommended as part of a healthy diet.

However, that all changes once your kidneys are no longer able to filter excess potassium in your body. A build-up of potassium in your blood can be dangerous and can lead to a cardiac arrest if levels become really high.

That’s why it’s important to ensure you keep your potassium in good control. For more specific information about how much you should have each day, check out this blog post which covers Potassium Balance.

Phosphorus

Another important mineral that serves as a building block for healthy teeth and bones, helps your nerves and muscles work, and supports energy production.

A build up of too much phosphorus in your blood however, leads to bone disease and other problems. For more information on phosphorus check out my blog on How To Lower Your Phosphorus Levels.

Sodium and Fluid

When you are in kidney failure your kidneys are unable to eliminate excess sodium and fluid from your body properly. This can lead to increased blood pressure, edema (swelling), shortness of breath, and heart failure.

This is why it is important to limit how much sodium you eat in your diet. A typical daily goal for sodium is 2000 mg or less a day. This isn’t necessarily easy as most foods contain added sodium. Look for Low Sodium, Unsalted, or Sodium Free on your labels.

High sodium foods include:

Salted snacks (chips, pretzels, popcorn, nuts, crackers)
Condiments and sauces (soy sauce, hot sauce, ketchup, mustard, salad dressing, BBQ sauce, gravy, marinara/pasta sauce, etc.)
Olives, pickles, sauerkraut
Processed meats (ham, bacon, hotdogs, sausage, pepperoni, salami, pastrami, corned beef, SPAM, sardines)
Convenience foods (frozen meals, packaged foods, pizza)
Fast foods
Cheese, cottage cheese (get the no salt added version!), salted butter
Soups
Cereals, breads, bagels, tortillas, rolls, biscuits, and sandwiches
Burritos
Canned vegetables

Your daily fluid goal usually ranges from 4 to 6 cups a day (32-48oz) depending on how much urine you are making. For more information about fluid read: Drinking To Support Healthy Fluid Gains.

Protein

Once you start on dialysis, your protein needs increase. Protein has many important functions in the body. To read up on everything protein check out the blog: How Much Protein Does A Dialysis Patient Need?

It’s important to know what are good sources of protein to include in your diet. The downloadable renal diet grocery list includes good protein options in addition to my free protein tips handout that can be found HERE.

Grocery Shopping Tips

We all know that it isn’t the best idea to go grocery shopping on an empty stomach (wow, those chocolate candies at checkout look amazing!), but what other important tips should you be aware of?

Shopping The Perimeter

We are usually told to shop the perimeter of the store, but what does that mean? You can usually find the produce section, fresh meats and dairy, the deli, and bakery/breads along the perimeter of the store.

On the interior shelves is where you will find the canned, processed, pre-packaged foods which you want to limit in your diet whether your have kidney disease or not.

This doesn’t necessarily mean that all foods along the perimeter are dialysis friendly. Dairy for example is high in phosphorus and potassium (and sodium if we are talking cheese, cottage cheese, buttermilk). For this reason, dairy is usually limited to 1-2 servings a day (a serving is 1/2 cup/4oz or 1 oz of cheese).

Whole Grains And Fiber

When buying grains and bread try to choose more whole grain options for additional fiber and protein. Fiber helps in many ways. Insoluble fiber keeps things moving and helps you better digest and transport waste out of your body preventing constipation.

Soluble fiber helps lower cholesterol and has “prebiotic” powers because they ferment in your gut helping to feed your good bacteria and reduce the bad bacteria.

Be adventurous and try including some ancient grains in your diet like Amaranth, Bulgur, Buckwheat, Kamut, and Quinoa. Ancient grains are unrefined whole grains packed with nutrients, fiber, antioxidants, and protein. For ideas on how to include them in your diet click HERE.

Go Produce!

A lot of the high fiber foods like fresh fruits and vegetables are also high in antioxidants which is a bonus! All fruit and vegetables contain potassium, but some contain a lot more than others. The vegetables and fruits listed on your renal diet grocery list are examples of lower potassium options (per serving). Aim for around 5 servings of fruit and vegetables a day.

Also, there is nothing wrong with buying frozen fruits and vegetables. They last longer and still provide you with good nutrition and fiber.

The Best Sources Of Meats

You know you should avoid buying processed meats, but what are healthier sources? When choosing beef, ideally buying organic grass-fed is the healthiest choice. Not only is it lower in fat and calories, but it contains a significant amount of omega-3 fatty acids and antioxidants such as vitamin E in comparison to conventional grain fed beef.

Other lean options include bison, pork loin, lamb, and venison. Skinless chicken breast and thighs, turkey, fatty fish (salmon, tuna, cod), and fresh steamed seafood such as shrimp, crab, and lobster are also healthy sources of protein.

When buying frozen or pre-packaged, look for no added phosphates or sodium nitrates.

Also, don’t be afraid to incorporate Meatless Mondays into your routine and try out some plant based sources of protein. Again, for more on good sources of protein and how to incorporate them into your diet check out my Protein Tips handout.

When Shopping The Interior Of The Store

Read Food Labels

Look for low sodium or unsalted options. Also, read the ingredients list and watch out for phosphorus additives. These are found in various forms such as:

Dicalcium phosphate
Disodium phosphate
Monosodium phosphate
Phosphoric acid
Sodium hexameta-phosphate
Trisodium phosphate
Sodium tripolyphosphate
Tetrasodium pyrophosphate

Most cereals are very processed, refined carbohydrates and are high in sodium and added sugars. You will often see cereals such as Fruit Loops, Apple Jacks, Corn Pops, and Trix on renal friendly cereal lists. While these may be lower in potassium, phosphorus, and sodium it doesn’t mean that they are healthy options.

Look For Added Sugars

This brings me to added sugars. The American Heart Association recommends that men should consume no more than 9 teaspoons (36 grams or 150 calories) of added sugar per day and for women only 6 teaspoons (25 grams or 100 calories) per day (1).

You will find added sugars in sugar sweetened beverages (including coffee and tea beverages), desserts, pastries, candies, breakfast cereals and bars, yogurt and different milks, salad dressings, and canned sauces and condiments. They also sneak sugar in processed meats and cheeses, and bread so make sure you read your labels.

Fat & Oils

It is also important to know what type of fat/oil is in your food. Most pre-packaged foods including salad dressings and margarine will use vegetable oils such as corn, soybean, safflower and sunflower oil. They are classified as omega-6 polyunsaturated fatty acids or PUFAs.

These oils are more processed using heat and chemical solvents to extract the oil. Since we tend to eat them in excess due to the overabundance in our food supply, they can be pro-inflammatory to our bodies. They aren’t necessarily bad for you, just be aware and try to limit their use.

Another type of PUFA is omega-3 fatty acids which are found in fatty fish, flaxseeds, and walnuts. These are known to be anti-inflammatory and are healthy choices to include in your diet.

Both avocado oil and olive oil are high in oleic acid, a heart healthy monounsaturated omega-9 fatty acid. Extra virgin olive oil should be your staple oil as there is plenty of scientific evidence backing up the health benefits. Avocado oil is great to use with high heat cooking as it has a higher smoke point than olive oil.

This brings us to saturated fat which has long been promoted as unhealthy for our arteries. But, incorporating good sources of saturated fat such as grass fed butter and unrefined virgin coconut oil in small amounts can be a part of a healthy diet.

For a breakdown of recommended oils and how to use them check out my Best Oils Guide HERE.