Diet for End Stage Chronic Kidney Disease

White bread and fruits are good for end stage kidney disease diets.
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Your dietary needs change when your kidney disease progresses to stage five, and you need dialysis. The biggest dietary changes from your previous diet include an increase in your protein intake and a reduction in potassium. Salt and phosphorus intakes still need to be kept low, and you'll still need to monitor your fluid intake.

Eat More Protein

Protein is essential for building and maintaining muscles and immune system function.

You probably kept your protein intake low during the earlier phases of the disease because your kidneys couldn't handle the by-products of protein metabolism, but now that you're on dialysis, you'll need to eat more protein. According to the American Kidney Foundation, you'll need about 8 to 10 ounces of high-protein foods every day.

Choose meats, eggs, fish, and seafood or poultry for your protein intake. Vegetarian sources of protein such as peanuts, legumes, nuts, seeds, and peas are not so good for this diet because they're also high in potassium and phosphorus. If you're a vegetarian, you'll need to speak to your doctor or a dietitian who specializes in diets for kidney disease about protein supplements.

Keep Sodium Low

Eating too much sodium can mess with your fluid levels so you'll continue to follow a low-sodium diet. Watch for hidden sodium in things like breading, seasoning mixes, canned soups, meats, and vegetables.

Stay away from salty snacks.

Check the labels on everything even foods that claim to be "low-sodium." They may still have more sodium than you need per serving and they may contain potassium, which is also something you'll need to avoid.

Lower Phosphorus Intake

Phosphorus is one of the dietary minerals your body needs for strong bones and teeth and normal nerve and muscle function.

Your body likes to maintain a fairly specific level of phosphorus in your blood, and it's your kidneys' job to remove any excess phosphorus.

If a person has chronic kidney disease, the phosphorus levels can get too high because the kidneys can't function properly. This causes your blood's pH to rise. When the pH gets too high, your body releases calcium from your bones in an attempt to get the pH back down where it belongs. That can result in weaker bones, which isn't a good thing.

To reduce your phosphorus intake, restrict yourself to one 1/2 cup serving of milk or 1/2 cup of yogurt every day. Or, if you prefer, you can eat 1 ounce of cheese instead of the milk or yogurt. Some types of cream cheeses are lower in phosphorus so may be able to consume them if it's okay with your dietician. You should also stay away from whole grains, lentils and dry beans, peas, nuts, peanuts, cocoa, cola, and beer. It's okay to consume fruits, vegetables, refined grains, and rice. 

Medication may also be given with each meal or snack that limits the body's ability to absorb phosphorus.

Potassium Restriction

You may also need to keep your potassium intake low as well (your doctor will tell you) because high levels of potassium in your blood can cause problems for your heart.

Fruits and vegetables are often high in potassium, but these are acceptable:

  • Apples
  • Berries
  • Broccoli
  • Cabbage
  • Carrots
  • Cauliflower
  • Celery
  • Cherries
  • Cucumber
  • Eggplant
  • Grapes
  • Green beans
  • Lettuce
  • Onions
  • Peaches
  • Pears
  • Peppers
  • Pineapple
  • Plums
  • Radishes
  • Tangerines
  • Yellow squash
  • Zucchini

Carbohydrates and Fats

If you need to gain or maintain your weight, increasing your calories by adding carbohydrate-rich foods may help. Grains, cereals, and bread are excellent sources — you'll need 6 to 11 servings from this food group every day.

Choose refined grains rather than whole grains to keep your phosphorus intake down. If you have diabetes, you may need to follow a consistent carbohydrate diet.

Your doctor may want you to follow a low-fat diet if you're at risk for heart disease. Your dietitian will help you with any dietary fat restrictions

Sample Menu

Here's an example of a daily menu that will fit your restricted dietary needs:


  • Cranberry juice
  • 2 eggs
  • White toast with butter, margarine, jelly, or fruit spread.

Midmorning Snack

  • Carrot sticks


  • Tuna pasta salad white dinner roll with butter or margarine
  • Fresh or canned peaches
  • Apple juice or clear soda (not cola)

Afternoon Snack

  • Chicken sandwich on white bread


  • Salad with lettuce, cucumbers, carrots, and broccoli with oil and vinegar as dressing
  • Salmon fillet
  • Green beans
  • 1/2 cup milk

Nighttime Snack

  • Grapes or berries

Dietary Supplements

A diet for late-stage kidney disease might be deficient in certain nutrients, and your dietitian or nutritionist can help you with that. Be sure to speak with your healthcare providers before adding any new dietary supplements.


American Kidney Foundation. "Dietary Guidelines for Adults Starting on Hemodialysis."

Maher AK. "Simplified Diet Menu." Eleventh Edition, Hoboken NJ, USA: Wiley-Blackwell Publishing, October 2011.