Navigating diabetes and kidney disease can be overwhelming, especially if either one of those diagnoses is new to you.
Keeping your blood sugar levels under control directly benefits your kidneys.
Therefore, good blood sugar control should always be one of the main goals when treating kidney disease.
Adjusting your lifestyle to manage both your diabetes and kidney disease will help reduce your risk of developing other complications.
Keep reading to learn which foods you should avoid with kidney disease and diabetes, and what foods you should eat.
Diabetes and kidney disease
Your kidneys play an essential role in your health. They filter waste products from your blood, help regulate your blood pressure, maintain optimal electrolyte balances, and more.
Kidney disease occurs when your kidneys are damaged and can’t filter blood as efficiently as they should. Kidney disease is broken down into different stages or levels of severity.
Your stage of kidney disease is partially determined by your GFR (glomerular filtration rate). The GFR measures how much blood your kidneys can filter in a given time.
- Stage 1 with normal or high GFR (GFR > 90 mL/min)
- Stage 2. Mild CKD (GFR = 60-89 mL/min)
- Stage 3A. Moderate CKD (GFR = 45-59 mL/min)
- Stage 3B. Moderate CKD (GFR = 30-44 mL/min)
- Stage 4. Severe CKD (GFR = 15-29 mL/min)
- Stage 5. End Stage CKD (GFR <15 mL/min)
Stage 5 kidney disease always requires dialysis and/or a kidney transplant.
Around 13% of the world’s population is estimated to have chronic kidney disease (1). Having diabetes increases your risk of kidney disease because high blood sugar levels damage your kidneys.
Kidney disease from diabetes is called diabetic nephropathy. Around 20-30% of people with diabetes will get diabetic nephropathy (2).
Foods to avoid with kidney disease and diabetes
If you have advanced or end-stage kidney disease, you might need to follow a restrive renal diet. A renal diet restricts foods high in certain minerals, such as potassium and phosphorus, that can accumulate in your bloodstream if your kidneys don’t filter them out.
If you don’t need to limit potassium and phosphorus, you should still limit sodium to help preserve your kidney health.
Eating a moderate carbohydrate diet low in added sugars is also important to help control blood glucose levels. High blood glucose levels will continue to damage the delicate tubules and blood vessels in your kidneys, which can worsen your kidney disease.
Below, we share a list of the foods you might want to limit or avoid if you have diabetes and kidney disease.
High-sodium foods
Aim to keep your sodium intake below 2,000 milligrams per day if you have diabetes and kidney disease, or less if your healthcare provider recommends it.
Sodium is found in processed foods like frozen ready-to-eat meals, quick bread mixes, canned soups, and snack foods like chips, pretzels, etc. It’s also prevalent in prepared foods, including fast food and frozen entrees.
Some examples of high-sodium foods include:
- Smoked, cured, or canned meats – including bacon, deli meat, sausage, sardines, anchovies, etc.
- Frozen dinners like burritos, pizzas, and other “TV dinners”
- Canned meals like chili, soups, ravioli, etc.
- Canned beans and vegetables with salt added.
- Salty snacks like chips, microwave popcorn, pretzels, etc.
- Quick-bread mixes like pancakes, muffins, etc. due to the high sodium content of baking soda.
According to the Centers for Disease Control, 40% of the sodium in the typical Western diet comes from these ten foods, which can add up if you eat them often throughout the day:
- Bread and rolls
- Pizza
- Sandwiches
- Cold cuts and cured meats
- Soups
- Burritos and tacos
- Savory snacks (pretzels, jerky, chips, etc.)
- Chicken
- Cheese
- Eggs and omelets
High-phosphorus foods
If you don’t have advanced kidney disease and/or your blood levels of phosphorus are consistently normal, you don’t need to avoid high-phosphorus foods.
Otherwise, some high-phosphorus foods to avoid include:
- Dairy products like milk and yogurt
- Beans
- Lentils
- Nuts
- Bran cereals and whole-grain products that include the bran
- Oatmeal
- Colas and other drinks with phosphate additives
High-potassium foods
Like phosphorus, only limit potassium if you have high blood potassium levels or have been told to limit potassium.
Some high-potassium foods include:
- Apricots
- Bananas
- Cantaloupe
- Dried fruit
- Honeydew melon
- Kiwi
- Mango
- Nectarines
- Oranges and orange juice
- Papaya
- Pomegranate and pomegranate juice
- Prunes and prune juice
- Pumpkin
- Raisins
- Acorn squash, butternut squash, Hubbard squash
- Avocado
- Artichoke
- Beets
- Baked beans, black beans, refried beans
- Broccoli (cooked)
- Brussels sprouts
- Kohlrabi
- Lentils
- Okra
- Onions (fried)
- Parsnips
- Potatoes
- Rutabagas
- Spinach (cooked)
- Tomatoes, tomato sauce, and tomato paste
- Vegetable juice
- Bran products
- Chocolate
- Coconut
- Creamed soups
- French fries
- Granola
- Ice cream
- Milk (buttermilk, chocolate, eggnog evaporated, malted, soy and milkshakes)
- Miso
- Molasses
- Nuts
- Peanut butter
- Potato chips
- Salt substitutes
- Seeds
- Tofu
- Yogurt
Added sugar
Eating and drinking added sugar regularly can make it difficult to meet your blood sugar goals.
Sugary beverages are the leading contributor of added sugar in a typical Western diet.
Drinks like soda, sweetened teas, sugary coffee drinks, energy drinks, and many more are very high in added sugar.
Added sugar is also found in processed foods like cereal, granola bars, yogurt, pre-made fruit smoothies, and many more. Always check the nutrition facts label to see how much added sugar is in your favorite foods and drinks. Aim to keep your added sugar intake below 40 grams per day – the lower the number, the better.
What foods should you eat if you have diabetes and kidney disease?
Each person should tailor a diet for kidney disease and diabetes to promote blood sugar control and kidney health. Plant-based foods like fruits, vegetables, and whole grains can benefit diabetes and kidney disease.
If you need to limit potassium, disregard those in the lists below that are high in potassium. Otherwise, potassium promotes healthy blood pressure levels, which can benefit your kidneys, and shouldn’t be avoided.
Non-starchy vegetables
Non-starchy vegetables are low in carbohydrates, so they don’t raise your blood sugar levels much. They’re also naturally rich in beneficial nutrients like fiber, potassium, vitamin C, and many others.
- Artichoke
- Asparagus
- Beans (green, wax, Italian)
- Beets
- Brussels sprouts
- Broccoli
- Cabbage (green, bok choy, Chinese)
- Carrots
- Cauliflower
- Eggplant
- Green leafy vegetables (collard, kale, mustard, turnip)
- Jicama
- Kohlrabi
- Leeks
- Mushrooms
- Okra
- Onions
- Peapods
- Peppers
- Radishes
- Rutabaga
- Salad greens (chicory, endive, escarole, lettuce, romaine, spinach, arugula, radicchio, watercress)
- Sprouts
- Squash (cushaw, summer, crookneck, spaghetti, zucchini)
- Sugar snap peas
- Swiss chard
- Tomatoes
- Turnips
Whole grains
Grains like bread can be refined or whole grains. Whole grains are rich in fiber, a nutrient that is beneficial for your blood sugar. Whole grains also have more protein and nutrients than refined grains.
Refined grains might spike your blood sugar levels more sharply, worsening blood sugar control. Blood sugar spikes aren’t good for your kidney health either since they cause further damage to the blood vessels and tubules that help filter your blood.
Examples of whole grains include:
Lower-potassium produce
If your stage of kidney requires you to limit high-potassium foods, then you can choose from some of the examples below:
- Apples
- Blackberries
- Blueberries
- Cranberries
- Fruit cocktail
- Grapes and grape juice
- Grapefruit
- Mandarin oranges
- Peaches
- Pears
- Pineapple
- Plums
- Raspberries
- Strawberries
- Tangerine
- Watermelon
- Alfalfa sprouts
- Asparagus (6 raw spears)
- Broccoli (raw or cooked from frozen – cooked broccoli is higher in potassium)
- Cabbage
- Carrots (cooked)
- Cauliflower
- Celery (1 stalk)
- Corn (half an ear if it’s on the cob)
- Cucumber
- Eggplant
- Green beans or wax beans
- Kale
- Lettuce
- White mushrooms (raw)
- Onion
- Parsley
- Peas (green)
- Peppers
- Radish
- Water chestnuts
- Watercress
Low-sodium foods
Regardless of your kidney disease stage, you should be careful about your sodium content.
Choose from lower-sodium foods below:
- Any fresh or frozen beef, lamb, pork, poultry, and fish
- Eggs and egg substitutes
- Low-sodium peanut butter
- Dry peas and beans (not canned)
- Low-sodium canned fish
- Drained water- or oil-packed canned fish, poultry
- Milk, yogurt, ice cream, and ice milk
- Low-sodium cheeses, cream cheese, ricotta cheese, and mozzarella
- Bread, bagels, and rolls without salted tops – opt for whole grains
- All rice and pasta – avoid adding salt, and try to choose whole grains
- Low-sodium corn and flour tortillas and noodles – opt for whole grains
- Low-sodium crackers and breadsticks – whole grains whenever possible
- Unsalted popcorn, chips, and pretzels
- Fresh and frozen vegetables without sauces
- Low-sodium canned vegetables, sauces, and juices
- Fresh potatoes, frozen French fries, and instant mashed potatoes
- Fresh, frozen, and canned fruit without added sugar
- Dried fruits in moderation
High-quality protein
If you have end-stage kidney disease and are on dialysis, your protein needs may be increased. If you’re not on dialysis and have kidney disease, it’s important not to overeat protein since its waste byproducts can’t be easily filtered out of your blood by your kidneys.
It’s important to not under-eat protein either since this may cause a decline in kidney function, according to studies.
Another benefit of protein is that it doesn’t raise your blood glucose levels as carbohydrates do. Including protein-rich foods with your meals and snacks might help stabilize your blood sugar levels.
Some examples of high-quality protein include:
- Chicken or turkey
- Fish
- Lean red meat like pork chops
- Eggs
- Greek yogurt (if your potassium and phosphorus levels aren’t high)
- Cottage cheese (watch the portion size since it’s high in sodium)
- Protein bars and powders
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Conclusion
Knowing which foods to eat and avoid can help you manage your diabetes and kidney disease. A diet for managing diabetes and kidney disease should be low in refined carbohydrates and added sugar, low in sodium, and potentially lower in potassium or phosphorus, depending on the stage of kidney disease. Adequate high-quality protein intake and nutrient-dense foods like non-starchy vegetables and whole grains can also be beneficial.
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