Kidney failure : What are the causes and treatment?

Kidney failure and diet, what diet to adopt?

The kidneys are vital organs that perform a number of functions in our body.

When kidney failure occurs, the kidneys no longer filter the blood properly, causing adverse health effects.

Kidney failure

Photo carmen camacho in Pixabay

They unbalance the production of hormones and deregulate the water and mineral balance of the blood flow. The complications are then multiple. The most common are high blood pressure and uncontrolled diabetes.

Content (Click to view)
  1. Kidney failure and diet, what diet to adopt?
  • The impacts of food
  • Objectives and fundamental principles
    1. Calcium
    2. Iron
    3. Go out
    4. Proteins
    5. Fats
    6. Alkalinize the pH of the blood
    7. Alcohol and Tobacco
  • The different types of kidney failure and their dietary management
    1. Dialysis treatment
    2. Acute kidney failure
    3. Chronic renal failure
  • To summarize
  • In practice
    1. Foods allowed
    2. Cereals with gluten: wheat, rye, barley, oats, triticale, spelt, kamut.
    3. To be limited
    4. To avoid
  • Frequently Asked Questions
  • What is kidney failure?
  • What diet to adopt in case of kidney failure?
  • What products are prohibited?
    1. Other Options:
  • You may be interested:
  • The impacts of food

    The diet in kidney failure varies according to the different stages of the disease. Patients for whom dialysis is necessary will have more restrictions and recommendations from a dietary point of view.

    The diet in kidney failure consists of limiting the intake of certain nutrients, in order to regulate blood levels and limit the work of the kidneys during filtration. The kidneys cannot eliminate excess sodium, potassium and phosphorus.

    This can lead to their excessive concentration in the blood and the resulting pathologies. The malfunctioning of the kidneys also leads to the loss of proteins
    in the urine, a fact that indicates the worsening of kidney failure. 3‌4‌

    Objectives and fundamental principles

    The goals of a diet in kidney failure are multiple. Below is a list of nutritional goals by nutrient or food type.


    In view of the urinary losses of nutrients, it is advisable to increase calcium intake by 3 or even 4 dairy products a day: milk, yogurt, cheese, but also certain fruits and vegetables. Hydration based on mineral water (contrex, courmayeur) also helps to enrich calcium intake.


    Like calcium, most of the iron consumed is eliminated in the urine. The loss can have serious consequences, especially for menstruating women. Therefore, it is important to increase the intake of quality iron by eating meat and/or offal. Vitamin C optimizes iron absorption and can be taken as a dietary supplement.

    Go out

    On the other hand, sodium intake should be limited with the risk of oedema or worsening. Salt increases water retention. In this sense, it is advisable to limit or even eliminate table salt. All foods, such as salted bread, salted butter, sausages and mature cheeses, considered too rich in salt, should be avoided.


    Loss of protein in the urine is also a side effect of kidney failure. The consequences of a protein deficiency are multiple, but the most severe is malnutrition. In kidney failure, the diet must be rich in protein.

    The supply of quality proteins can be increased through animal products: fish, eggs, but also dairy products.


    First choose the right fats for cooking and seasoning, varying the vegetable oils. A diet rich in vegetable fats and limited in animal fats helps prevent cardiovascular complications.

    Alkalinize the pH of the blood

    The acidity induced by a high intake of industrial products tends to aggravate the disease. Hydration based on carbonated water such as Vichy Saint-Yorre allows the body to become alkaline from the bicarbonate it contains.

    Alcohol and Tobacco

    Alcohol is obviously a drink that should be avoided as much as possible. The same goes for tobacco, which should be reduced or even eliminated in view of the undesirable side effects it produces on health.

    This advice helps delay the complications of kidney failure and the switch to dialysis.

    The different types of kidney failure and their dietary management

    Dialysis treatment

    Dialysis is usually indicated when the glomerular filtration rate is low or when the first clinical manifestations of the terminal insufficiency syndrome appear. There are two types of dialysis: peritoneal dialysis and hemodialysis. The latter performs the work of the kidneys when these are dysfunctional.

    Weight gain

    Between two dialysis sessions, weight gain is most often observed, mainly reflecting a buildup of water in the body, reflecting intakes since the last session. To be normal during dialysis, this weight gain should not exceed 5% of body weight.

    The main objective of a diet in kidney failure remains, above all, to maintain an adapted diet, fight against complications and preserve a good quality of life. Regular blood tests should be performed to adapt the diet as much as possible.

    Increase protein intake

    Protein intake increases during dialysis, i.e., 1.2 to 2 grams of protein per kilogram of body weight per day, depending on the type of dialysis. Some dialysis procedures result in increased protein leakage and more frequent infections.

    Consumption of vegetable fats and oils

    Lipid intake remains the same as that of a healthy adult, ensuring a good use of fats and favouring vegetable oils for the prevention and/or treatment of cardiovascular complications. 1‌2‌3‌4‌

    The specificity of carbohydrates

    Carbohydrate intake usually represents between 50 and 55% of total energy intake. It must be well distributed throughout the day and the amounts must be adapted in the case of diabetes, as kidney failure sometimes causes insulin resistance.

    In the context of dialysis, carbohydrate intake is preferably in the low average because dialysate contains glucose which must be taken into account in the food ration. Therefore, the risk of diabetes increases with this technique.

    The role of fibres

    Fiber plays an important role in kidney failure. It is necessary to favor a diet rich in fiber.

    In fact, dialysis is often synonymous with frequent constipation. In addition, fibers help regulate blood sugar levels and improve blood lipid parameters.

    The importance of hydration

    Normal hydration is essential. In kidney failure, it is a function of diuresis, the amount of urine produced.

    When diuresis is normal, 500 ml of water should be added to the basic water ration for a healthy adult. In the case of anuria, i.e. absence of urine, water intake is increased by 750 mL.

    The water you drink for medicines, tea, coffee, juices, should be counted in your water ration every day. In case of edema, slight restrictions may be applied, not without medical and dietary advice.

    Potassium restrictions?

    Reduction of potassium intake

    As part of a diet related to kidney failure, potassium intake should be limited during hemodialysis treatment.

    Potassium is limited to 2 or 3 grams per day. For this, it is advisable to soak the vegetables and potatoes, which are very rich. It is recommended to repeat the cooking with water. 5‌6‌

    Foods to limit

    Here is a list of the few foods that are richer in potassium, which will be limited as part of the diet and kidney failure. 7‌

    • Soluble coffee
    • Tomato concentrate, tomato puree
    • Cocoa powder
    • Tin cans8
    • Dry vegetables
    • Dried fruits
    • Potatoes
    • Dark chocolate
    • Oil seeds
    • Tomato, avocado, banana, apricots, grapes, strawberries,
    • Spinach, mushroom, artichoke, leek, pumpkin, carrot, green beans...
    • Whole grain products 9


    The consumption of these foods is not prohibited, but limited. Precautions should be taken to improve their metabolism, such as allowing vegetables to soak well before cooking and encouraging cooking with water rather than steam.

    Limited salt consumption

    In peritoneal dialysis, salt intake is not routinely controlled. However, in hemodialysis, sodium intake takes into account preserved renal function, the presence of edema or possible high blood pressure.

    Medical advice should be taken into account, in your absence, do not exceed 5 g of salt per day. In practice, it is recommended not to salt when cooking or at the table, unless a small bag is provided. On the other hand, herbs and/or spices can be used to improve the taste of the dishes.

    Is any supplement needed?

    Due to diet-induced restrictions, people with kidney failure may be deficient. Supplementation can be introduced if necessary, with prior medical advice.

    Weight, an element to take into account

    Weight is an indicator to prevent malnutrition in case of loss of appetite or intestinal malabsorption. It also allows us to take into account the importance of edemas that induce rapid weight gain. In this context, weighing is an important step in medical and nutritional surveillance.

    Acute kidney failure

    Acute kidney failure is the rapid decline in the filtration capacity of the kidneys, it is reversible. The goals of the diet in this case are to improve blood balance and restore kidney function.

    Protein intake is established according to blood results, calculated on a daily basis. They are around 0.5g per kilogram of weight per day at least, on the days without dialysis. On days of dialysis, the needs increase from 20 to 50 grams per day due to losses of dialysate.

    Water intake is adjusted daily according to urinary, digestive, skin and respiratory losses. Approximately 500 to 1000 mL of water per day increased, in addition to 200 mL per degree of fever above 37°C.

    Sodium intake may be restricted in cases of anuria, edema or high blood pressure. As for potassium intake, it is recommended that it be less than 3000mg per day. A modified textured diet (mixed or chopped) and fractionated may be proposed in case of difficult oral feeding with nausea and/or vomiting.

    Chronic renal failure

    Chronic Kidney Failure is characterized by irreversible damage to the renal filtration system. In this context, the objective of nutritional management will be threefold. First, the important thing is to ensure the absence of water and/or mineral deficiencies. On the contrary, hyperkalaemia or water retention leading to oedema will be treated.

    Control of the diet for each stage of the disease

    Dietary management takes into account the stage of chronic kidney failure. Prior to the dialysis stage, the goal is to avoid aggravation of the disease by limiting nutrient absorption disorders.

    When kidney failure is moderate, a slight decrease in protein intake is recommended, that is, 0.8 grams of protein per kilogram of weight per day. On the other hand, in the dialysis stage, the objective is to limit protein losses and prevent or fight malnutrition. A high-protein diet can be established with 1.2 to 1.5 grams of protein per kilogram of weight per day.

    A high-calorie diet for all stages of the disease

    In all stages of chronic kidney failure before and after dialysis, caloric intake rises by 30 to 40 kcal per kilogram of body weight per day.

    To summarize

    • Avoid condiments (mustard, pickles)
    • Forget about sauces, industrial dishes
    • No salting at the table
    • Encourage unsalted bread
    • Rinse canned vegetables
    • It limits the potato. When cooking, cook it in water several times.
    • Soak the vegetables well before cooking them.
    • Favouring water cooking over steaming
    • Limit banana and fruit syrups
    • Reduce consumption of nuts and oil seeds
    • Avoid chocolate
    • Varying vegetable oils
    • Eliminate cold meats and limit salty cheese
    • Banish salted butter or half-salted butter

    Once diuresis is corrected and edemas are reabsorbed, it is possible to consume enough water again, to extend the low salt diet by consuming salty bread, salted butter, cheese, sausages in moderate amounts. Bananas and chocolate are again allowed in limited quantities. Be careful with canned vegetables.

    In practice

    Foods allowed

    Vegetables: asparagus, eggplants, beets, chard, broccoli, celery or celeriac, cabbage (cauliflower, Brussels sprouts, Romanesco, broccoli, green, white, red cabbage), cucumbers, zucchinis, chicory, fennel, turnips, onions, sorrel, peppers, radishes, salads, herbs: Dill, basil, chervil, chives, coriander, tarragon, mint, oregano, rosemary, sage, thyme.
    Fruits: Pineapple, Cherry, Lemon, Fig, Raspberry, Pomegranate, Redcurrant, Kiwi, Mango, Melon, Blueberry, Grapefruit, Watermelon, Peach, Apple.

    Cereals with gluten: wheat, rye, barley, oats, triticale, spelt, kamut.

    Gluten-free cereals: millet, amaranth, quinoa, rice, buckwheat, sorghum, teff, corn (flour, semolina, flakes).
    Seeds: Flax seeds, sesame seeds, sunflower seeds, poppy seeds, pumpkin seeds, pine nut seeds
    Algae: Sea lettuce, kombu, sea beans, wakame, sweetness with raw vegetables, sushi nori, spirulina.
    Condiments : Gum, cider vinegar, brewer's yeast, spices, mustard, pickles, capers.
    Omega 3 oils : walnut, hemp, rape, flax, camelina, wheat germ.
    Omega 6 oils: olive, sunflower, safflower, sesame.
    Sheep or goat cheese Lactofermented products: sauerkraut, miso, tamari, kombucha, fruit kefir.
    White meat: beef, pork, rabbit, poultry (chicken, hen, turkey, duck, guinea fowl, pigeon), white ham.
    Lean fish*: cod, hake, pollock, dab, sole, canned tuna.
    Medium fish: herring, mackerel, trout. Big fish: sardine, salmon.
    Crustaceans: oysters, mussels, scallops, squid, shrimp, lobster, prawns.

    *Fish containing too many toxins are not listed.

    To be limited

    Vegetable drinks: almond, oats, chestnut, coconut, hemp, sunflower or sesame milk, spelt, kamut, millet, hazelnut, walnut, barley, quinoa and rice milk.
    Vegetable creams: oatmeal, almond, rice, soybean, coconut.
    Concentrated vegetable proteins: seitan, tofu, tempeh, humus.
    Condiments: gum, cider vinegar, beer yeast, spices, mustard, pickles, capers.
    Seeds: linseed, sesame, sunflower, poppy, pumpkin, pine nuts.
    Red meat: beef, horse, lamb (2x/week maximum). Fats: animal fats, butter, fresh cream.
    Seasoning: salt
    Sweet products: honey, jam, jellies, maple syrup, agave syrup, cakes, pastries.
    Cocoa, dark chocolate Delicatessen: smoked, dried or salted meat, raw ham, bacon, dried sausages, Bündnerfleisch, as well as hot dogs and some sausages.

    To avoid

    Vegetables: spinach, artichokes, bananas, fresh peas, pumpkin, squash, butter, carrots, leek, green beans.
    Fruits: strawberries, grapes, blackcurrant, banana, apricots, avocado, tomato, tomato puree, tomato concentrate
    Mushrooms: porcine mushrooms, shiitake mushrooms, battered mushrooms, monsoon mushrooms...
    Dried fruits: dates, apricots, prunes, figs, grapes, bananas, mangoes, pineapples, apples, blueberries, goji.
    Oily fruits: Almonds, nuts (Brazil, walnuts, cashews...), hazelnuts, pistachios, peanuts...
    Legumes: beans (flageolet, azukis, red), lentils (green, coral), peas, beans, split peas, chickpeas.
    Tubers: potato, sweet potato.
    Sprouted seeds: legumes, cereals, alfalfa, radish, broccoli, leek, mustard, pumpkin, parsley, watercress, arugula, Chinese cabbage, turnip
    Sugar and sweet products (mostly white): refined sugar, brown sugar, brown sugar, cookies, candy.
    Breakfast cereals: corn flakes, puffed rice, Coconut Krispies...
    Drinks: sweet drinks (soft drinks, fruit juice (including 100% pure juice).
    Processed and industrial products: prepared foods, canned foods, sandwich bread, desserts, pizzas, mayonnaise and ketchup.
    Food additives: sweeteners, preservatives, flavor enhancers, synthetic fragrances.
    Fats: fried foods, peanut oil, refined oils, coconut oil, margarines, fats and oils heated to over 110 / 120 degrees.
    Low fat foods. Alcohols: Wine, beer, strong alcohols

    Frequently Asked Questions

    What is kidney failure?

    Kidney failure is a condition that causes destruction of the kidneys. The kidneys are no longer able to filter the blood optimally.

    What diet to adopt in case of kidney failure?

    - Increase calcium and iron intake - Limit calcium and iron intake
    salt - Promote
    a high-protein diet -
    Use vegetable oils - Avoid the
    alcohol and industrial products

    What products are prohibited?

    - Dry fruits and oilseeds
    - Potatoes
    - Salted bread - Meat
    and chocolate -
    Canned vegetables

    Other Options:

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