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Nephrology Nutrition Services

Nephrology Nutrition Staff

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Chronic Kidney Disease Education 2015

Free education meetings at two locations: U of M Hospital in Ann Arbor, and Northville Health Center in Northville.

Session 1 - summary of how kidneys work, causes of kidney disease, and how to keep your kidneys as healthy as possible. Review of nutrition and adjusting to chronic illness.

Session 2 - Treatment options for kidney failure, resources, nutrition and adjusting to chronic illness.

Click here for more information.

Nephrology Nutrition Services

As kidney disease progresses, nutritional needs change. The Nephrology nutrition staff assist patients in learning about food and understanding the changes required through each stage of their disease: pre-dialysis, dialysis and transplant.

Pre-dialysis patients should ask their Nephrologist for a referral to a Nephrology dietitian as soon as possible so their regular diet can be assessed and adapted to their specific kidney function and needs.

Dialysis patients see their Nephrology dietitian regularly. Labs are reviewed and changes to diet made as needed to address any problems.

A post-transplant diet is much less restrictive, but should still be heart-healthy.

Always direct any specific diet and nutrition questions to your dietitian.

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Nephrology Nutrition Staff

Sharon Boyd

Sharon M. Boyd
Senior Dietitian
(Ann Arbor Dialysis Unit)

Amy Peregord

Amy Peregord
(Ann Arbor MDS)

Tracy Pluta

Tracy A. Pluta
Clinical Dietitian
(Livonia Dialysis Unit)

Julia Poole

Julia Poole
(Acute Hemodialysis)

Ann Twork

Ann M. Twork
Senior Dietitian
(UM Hospital)

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Nutrition Information

Fluids - Your kidneys may still be able to remove some fluid or they may not remove any fluid at all. That is why every patient has a different daily allowance for fluid. Talk with your dietitian about how much fluid you can have each day.

Any food that is liquid at room temperature also contains water, including soup, Jell-O and ice cream. Many fruits and vegetables contain lots of water, too, including melons, grapes, apples, oranges, tomatoes, lettuce and celery. All these foods add to your fluid intake.

The best way to reduce fluid intake is to reduce thirst caused by the salt you eat. Avoid salty foods like chips and pretzels. Choose low-sodium products. Drink from smaller cups or glasses. Freeze juice in an ice cube tray and eat it like a popsicle.

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Potassium - Healthy kidneys keep the right amount of potassium in the blood to keep the heart beating at a steady pace. If your potassium begins to rise, talk with your dietitian about ways to limit the amount of potassium you eat.

Potassium is a mineral found in may foods, especially milk, fruits and vegetables. To control potassium levels in your blood, avoid foods like avocados, bananas, kiwis and dried fruit, which are very high in potassium. You can remove some of the potassium from potatoes and other vegetables by peeling them, then soaking them in a large amount of water for several hours. Drain and rinse the vegetables before cooking them.

High-Potassium Foods
Lower-Potassium Alternatives
Oranges and orange juice
Sweet potatoes
Cooked spinach
Beans (baked, kidney, lima, pinto)
Apples and apple juice
Cranberry juice
Canned fruit
Strawberries, blueberries, raspberries
Mustard greens

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Phosphorus - Too much phosphorus in your blood pulls calcium from your bones making them weak and likely to break. It may also make your skin itch. Talk with your dietitian about ways to limit the amount of phosphorus you eat. You may also need to take a phosphate binder to control the phosphorus in your blood.

Phosphorus is a mineral found in foods like milk and cheese, dried beans, peas, colas, nuts and peanut butter.

High-Phosphorus Foods
Lower-Phosphorus Alternatives
Dairy foods (milk, cheese, yogurt)
Beans (baked, kidney, lima, pinto)
Nuts and peanut butter
Processed meats (hot dogs, canned meat)
Canned iced teas and lemonade
Bran cereals
Egg yolks
Liquid non-dairy creamer
Pastas, such as rice and noodles
Rice and corn cereals
Green beans
Lemon-lime soda
Root beer
Powdered iced tea and lemonade mixes

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Protein - Proteins help build and maintain muscle, bone, skin, connective tissue, internal organs, and blood. They help fight disease and heal wounds. But proteins also break down into waste products that must be cleaned from the blood by the kidneys. Eating more protein than your body needs may put an extra burden on the kidneys and cause kidney function to decline faster. Talk with your dietitian about the amount of protein and the sources of protein in your diet.

Animal sources of protein such as egg whites, cheese, chicken, fish and red meats contain more of the essential amino acids your body needs. A well-balanced vegetarian meal plan can also provide these nutrients. Eating mostly high-quality proteins is important because they produce less waste than others. High-quality proteins come from meat, fish, poultry and eggs (especially egg whites).

High-Protein Foods
Lower-Protein Alternatives
Ground beef
Chicken breast
Egg substitutes
Imitation crab meat
Chicken drumstick

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Fat - Fat provides energy, helps produce hormone-like substances that regulate blood pressure and other heart functions, and carries fat-soluble vitamins. You need fat in your diet, but some fats are healthier than others. Saturated fats and trans-fatty acids can raise your blood cholesterol levels and cause clogging of blood vessels. Talk with your dietitian about healthy and unhealthy sources of fat.

Saturated fats are found in animal products like red meat, whole milk and butter. These fats are usually solid at room temperature. Trans-fatty acids are often found in commercial baked foods like cookies and cakes, and in fried foods like doughnuts and french fries. Vegetable oils like corn or safflower oil are healthier than animal fats like butter or lard. Avoid hydrogenated vegetable oils, which are high in trans-fatty acids. Monounsaturated fats - olive, peanut and canola oils - are healthy alternatives to animal fats.

Bad Fats
Good Fats

Saturated fats

  • Red meat
  • Whole milk
  • Butter
  • Lard

Monounsaturated fats

  • Corn oil
  • Safflower oil
  • Olive oil
  • Peanut oil
  • Canola oil

Trans-fatty acids

  • Commercial baked goods
  • French fries
  • Doughnuts
Hydrogenated vegetable oils

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Sodium - Too much sodium in your diet can be harmful because it causes your blood to hold fluid. The extra fluid raises your blood pressure and puts a strain on your heart and kidneys. Talk with your dietitian about ways to reduce the amount of sodium in your diet. Look for the sodium content on the nutrition labels of the foods you buy. Choose “sodium-free” or “low-sodium” food products.

Sodium is found in ordinary table salt and many salty seasonings like soy sauce and teriyaki sauce. Canned foods, some frozen foods, and most processed meats have large amounts of table salt. Snack foods like chips and crackers are also high in salt. Try alternative seasonings like lemon juice, salt-free seasoning mixes, or hot pepper sauce. But avoid salt substitutes that use potassium.

High-Sodium Foods
Lower-Sodium Alternatives
Canned vegetables
Hot dogs
Packaged rice with sauce
Packaged noodles with sauce
Frozen vegetables with sauce
Canned soup
Tomato sauce
Snack foods
Salt-free herb seasonings
Frozen vegetables
Plain rice
Plain noodles
Unsalted pretzels
Unsalted popcorn

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Calories - Calories provide energy for your body. Talk with your dietitian to determine how many calories you need each day to maintain a healthy weight.

As chronic kidney disease (CKD) progresses, you may find that foods do not taste the same, and you may lose your appetite. Your dietitian can help you find healthy ways to add calories to your diet if you are losing too much weight.

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Vitamins and minerals - Vitamins and minerals may be missing from your diet because you have to avoid so many foods. Your Nephrologist may prescribe a vitamin and mineral supplement. Do not take vitamin supplements that you can buy off the store shelf. They may contain vitamins or minerals that are harmful to you. Talk to your dietitian if you have any questions about vitamin supplements.

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Additional Resources


Low Protein Recipes

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Other Resources



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