Download Diabetes and Chronic Kidney Disease Stages 1-4

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Diabetes and Chronic Kidney Disease Stages 1-4: Nutrition Guidelines
 Chronic kidney disease (CKD) causes damage to the health of your kidneys, usually over time.
When your kidneys are not in good health, it is time to change what you eat and drink so your
body will work well and you will feel better.
 How much you need to change what you eat and drink will depend on what stage of kidney
disease you have (stages 1-4), and if you have high blood pressure along with your diabetes.
What you eat and drink may also need to change over time if your kidney disease becomes
worse.
 This meal plan was designed to help slow down the rate of damage to your kidneys, lower your
blood pressure, and improve your diabetes. It will also help control the levels of protein, sodium,
potassium, and phosphorus in your body.
Changes to Your Diet with CKD
There are five stages of CKD. This diet plan addresses stages 1 through 4.
Depending on your stage of CKD, you may or may not need to incorporate the following
nutrition recommendations.
Please talk with your registered dietitian to find out what dietary changes would be most
appropriate for you at this time.
Protein Foods
 For all stages of CKD, limit portion sizes of all protein foods, such as meat, poultry, fish,
eggs, dairy, and legumes, to reduce how hard your kidneys have to work.
 Replacing some animal proteins (meat, fish, poultry, dairy) with proteins from plant
sources, such as beans, nuts, nut butters, and soy products may further reduce how hard
your kidneys have to work. Plant proteins help lower the levels of unhealthy fats in your
blood and improve blood glucose control.
 Plant proteins may have higher levels of potassium and phosphorus. They may need to
be limited in stage 3 and/or 4, only if your blood potassium or phosphorus levels are
elevated.
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 1
Controlling Your Blood Pressure
 In CKD stages 1 through 4, controlling your blood pressure is very important.
o Too much sodium (salt) in your diet may make it harder to control blood pressure.
o In stages 3 and/or 4 of CKD, too much sodium may increase your thirst and make
your body retain too much fluid. If your body retains fluids, your ankles and feet
may swell, and your heart may be damaged. Fluid may also build up in your lungs
and cause shortness of breath and other more serious problems.
 Restricting your daily sodium intake may be necessary to control issues caused by high
blood pressure. The amount of sodium recommended will vary from 1 to 3 grams a day,
depending on your stage of CKD and the severity of your symptoms. The usual
recommendation is less than 2.4 grams a day. Your registered dietitian (RD) will help
guide you on what is best for you.
Fluids
The kidneys normally remove extra fluid from the body.
In the earlier stages of CKD, stages 2 and 3, and often stage 4, your doctor may prescribe
medications to help your kidneys work more efficiently, so fluids are rarely restricted.
In the latest stage of kidney disease (late stage 4 to stage 5), your kidneys may not make as
much urine as usual and medications that help remove fluid may be less effective. When this
happens, you may be told to drink less fluid.
Phosphorus
High blood levels of phosphorus may be an early sign that your kidney failure is affecting your
bones. You may need to eat fewer high-phosphorus foods. If blood phosphorus levels remain
high after you change your diet, your doctor may prescribe a medication for you to take with
food to bind up extra phosphorus, called a phosphate binder.
Foods with Potassium
Potassium is a mineral found in most of the foods you eat. In CKD stages 1 through 4, there is
usually no restriction in potassium. But, if blood levels of potassium become too high, you will
need to eat fewer high-potassium fruits, vegetables, and dairy products. This helps protect your
heart.
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 2
Controlling Your Blood Glucose
Controlling your blood glucose (sugar) is important.
 Poor blood glucose control can damage your kidneys and other parts of your body.
 High levels of blood glucose may increase your thirst, making it difficult to limit fluid
intake.
Meal Planning Tips
General
 If your health plan offers classes about nutrition and kidney disease, be sure to take
advantage of them. If classes are not available, ask for an appointment with an RD to
prepare a personalized meal plan.
 Stick to the foods and portions shown on your meal plan.
 Plan menus based on what you usually eat. Slowly add new recipes as you become more
comfortable with your new diet recommendations.
 Develop simple, quick menus for days that you can’t cook.
 Plan ahead for special occasion meals and for when you eat at restaurants to stay within
the guidelines for sodium, potassium, phosphorus, and carbohydrates recommended for
you.
Carbohydrate Control
 Plan meals and snacks at similar times each day.
 Try to eat the same amount (servings or grams) of carbohydrate for each meal and for
snacks.
 Adding snacks to your meal plan can help you manage your blood glucose levels better.
When used correctly, snacks help manage your hunger and prevent you from overeating
at meal times.
Fluids
If you have been advised to cut back on fluid intake, carefully plan the fluids that you eat and
drink to avoid having too much. When measuring fluids, include all liquids (water and anything
that melts into a liquid at room temperature).
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 3
Sodium (Salt)
 Don’t add salt to your food in cooking or at the table.
 Read labels and choose foods with 300 milligrams of sodium per serving or less.
 Use food labels to help you plan for a total of 400 milligrams sodium (or less) for
breakfast, 600 milligrams (or less) for lunch and dinner, and 150 milligrams (or less) for
snacks.
 The following are very high in sodium and should be limited or avoided completely,
depending on your blood pressure:
o Table salt, salt blends, or salt substitutes
o Soy sauce or other Asian sauces
o Convenience foods (such as higher-sodium frozen dinners, canned or dried soups,
stews, casseroles, and deli meals)
o Fast foods (ask your registered dietitian which choices are best for you)
o Cured or processed meats and cheeses
o Salted snack foods
o Vegetables that are canned or processed with salt (rinsing these items prior to use
will reduce the amount of sodium)
Phosphorus and Potassium
 If you have been asked to eat less phosphorus and/or potassium, save up your allowed
higher potassium and phosphorus foods for the day to have when you eat out.
 If you have an elevated phosphorus level and are prescribed a phosphorus binder, take as
directed, usually with every meal and snack.
 Avoid eating too many of these foods:
o High potassium fruits and vegetables if your blood potassium is too high.
o Frozen, convenience, prepackaged foods, snacks, and many bottled beverages that
have phosphorus- and/or potassium-based additives or preservatives. You can
learn more about phosphorus and/or potassium additives in food and beverages by
looking at the ingredient list on the label or by meeting with an RD.
o If your blood phosphorus is high, you may be asked to limit foods such as dairy
products, nuts, legumes, and whole grains. Check with your RD to learn how to
cut back on high phosphorus foods.
o Foods enriched with extra vitamins and minerals (calcium, potassium, and vitamin
C, D or E), especially some dry cereals and beverages.
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 4
Food Lists
The following food lists will help you plan your kidney diet. Foods are grouped together by
similar nutrition content and serving size to help you know how to plan your meals and snacks
to provide enough calories, protein, carbohydrate, fat, sodium, potassium, and phosphorus.
As you can see in the Bread, Cereal, and Grain Choices, all foods in that group have about 80
calories and 15 grams of carbohydrate, as well as 2 grams of protein, about 4 grams of fat, 150
milligrams of sodium, 50 milligrams of potassium, and 30 milligrams of phosphorus. As a
person with diabetes, every serving of bread and grains you eat is equal to 15 grams of
carbohydrate. If you eat 8 servings of breads and grains a day, that is equal to 120 grams of
carbohydrate from this group.
The amount of carbohydrates per serving, in each group, counts toward your daily total. Your
registered dietitian will help you select the number of servings and grams of carbohydrate from
each group to include in your diet each day. For optimal blood glucose control, carbohydrate
servings should be spread evenly throughout the day.
Protein Choices
Choose fresh, lean, minimally processed meat, poultry, fish, and other protein foods as much as
possible.
Meat, Poultry, and Fish
One (1) serving has about 75 calories, 7 grams (g) protein, 0 g carbohydrate, 5 g fat. Each
serving averages 65 (25 to 100) milligrams (mg) sodium, 115 mg potassium, and 70 mg
phosphorus.
You may have
servings each day of these foods. One serving is:
Meat, Poultry, and Fish
Serving Size
Beef
1 ounce
Fish
1 ounce
Lamb
1 ounce
Pork
1 ounce
Poultry
1 ounce
Shellfish*
1 ounce
Veal
1 ounce
Wild game
1 ounce
*These foods may be higher in sodium than indicated above.
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 5
Meat Alternatives
One (1) serving has about 90 calories, 7 grams (g) protein, 5 g carbohydrate, 5 to 10 g fat, an
average of 100 (25 to 100) milligrams (mg) sodium, 100 mg potassium, and 120 mg
phosphorus.
You may have
servings each day of these foods. One serving is:
Meat Alternatives
Serving Size
Cheese, hard/unprocessed*
1 ounce
Cottage cheese*
¼ cup
Egg
1 large
Egg substitute
¼ cup
Nuts/peanuts, unsalted**
1 ounce
Peanut butter, unsalted**
2 tablespoons
Tempeh**
¼ cup
Tofu, firm
¼ cup
*These foods may be higher in sodium than indicated above.
**These foods may be higher in potassium than indicated above.
Legumes (Beans, Peas, and Lentils)
One (1) serving has about 90 calories, 6 g protein, 15 g carbohydrate, 1 g fat or less. Each
serving averages less than 10 mg sodium, 250 mg potassium, and 100 (70 to 125) mg
phosphorus.
You may have
servings each day of these foods. One serving is:
Boiled Dried Beans, Peas, and Lentils
Serving Size
Black beans
⅓ cup
Black-eyed peas
⅓ cup
Broad beans
⅓ cup
Cannellini beans
⅓ cup
Chickpeas (garbanzos)
⅓ cup
Hummus, plain,*
⅓ cup
Lentils
⅓ cup
Lupin beans
⅓ cup
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 6
Mung beans
⅓ cup
Red kidney beans
⅓ cup
Soybeans, green**
¼ cup
Soybeans, mature**
¼ cup
Winged beans
⅓ cup
Yellow beans
⅓ cup
*These foods may be higher in sodium and fat than indicated above. One (1) serving of canned
beans, peas, and lentils has about 350 mg of sodium or more. Check labels.
**These foods may be higher in potassium than indicated above.
Protein Foods with Higher Amounts of Sodium and Phosphorus
The protein foods in the chart below are higher in calories, sodium, potassium, and/or
phosphorus. Choose these foods less often.
One (1) serving has from 75 to 250 calories, about 7 g protein, 0 to 5 g carbohydrate, an
average of 10 (0 to 15) g fat. Each serving averages 200 mg sodium or more, 50 to 150 mg
potassium, and 100 to 300 mg phosphorus.
You may have
servings each ___ week /___ month of these foods. One serving is:
Protein Foods With Higher Sodium and Phosphorus
Serving Size
Bacon
4 slices
Breakfast sausage
1½ patties or 3 links
Canned, salted tuna, salmon, or sardines
¼ cup
Cheese, American/processed, all kinds
1 ounce
Canned, salted cooked beans and legumes
⅓ cup
Deli-style meats, such as roast beef, ham, pastrami, salami, or
turkey
1 ounce
Frankfurters, bratwurst, or Polish sausage
2 ounces
Ham
1 ounce
Organ meats
1 ounce
Vegetarian meat alternatives, such as vegetable/soy burgers, soy
cheeses, soy sausage links and patties, soy meat crumbles, and
soy/vegetable links
1-2 ounces
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 7
Dairy Choices
Dairy foods are higher in potassium, phosphorus, and sodium than most protein choices and
other foods.
You may be asked to limit these foods if your blood potassium or phosphorus levels are high.
You may also be asked to include low-fat servings of these foods in your diet to help control
your blood cholesterol.
Dairy Foods
One (1) serving has an average of 150 (80-200) calories, 8 g protein, 12 g carbohydrate, 5 g fat.
Each serving averages 120 mg sodium or more, 350 mg potassium or more, and 220 mg
phosphorus or more.
You may have
servings each day of these foods. One serving is:
Dairy Foods
Serving Size
Custard, baked, homemade with reduced fat
milk
½ cup
Instant cocoa, sugar free, made with water
1-ounce packet mixed with 8 ounces of water
Milk, evaporated
½ cup
Milk, reduced fat (2%), low fat (1%), or fat
free (skim, 0%)
1 cup
Pudding, low fat, sugar free
½ cup
Yogurt, low-fat plain or sugar free
1 cup
Dairy Foods with Higher Amounts of Calories, Carbohydrates, and Fat
The dairy foods given in the chart below have higher amounts of calories, carbohydrate, and fat,
with 15 g carbohydrate or more and/or 10 g fat or more per serving. These foods are also higher
in sodium, potassium, and phosphorus. Choose these foods less often.
You may have
servings a ____week / ____ month of these foods. One serving is:
Dairy Foods
Serving Size
Custard, from mix, prepared with whole
(3.25%) milk
½ cup
Eggnog
1 cup
Ice cream
1 cup
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 8
Ice milk
1½ cups
Instant cocoa, regular, made with reducedfat (2%) milk
1-ounce packet mixed with 8 ounces of reducedfat milk
Milk, whole (3.25%)
1 cup
Milk, flavored (chocolate/strawberry)
1 cup
Pudding, sweetened
½ cup
Yogurt, regular sweetened and/or frozen
1 cup
Dairy Alternatives
Protein, carbohydrate, fat, potassium, and phosphorus content of dairy alternatives vary. Check
individual product labels carefully.
One (1) serving has an average of 75 calories, 1g protein, 6 (2 to 12) g carbohydrate, 7 (1.5 to
12) g fat. Each serving averages 40 (10 to 70) mg sodium, 60 (0 to 125) mg potassium, and 60
(0 to 120) mg phosphorus.
You may have
servings each day of these foods. One serving is:
Dairy Alternative
Serving Size
Amount of Carbohydrate per
Serving
Almond milk, unenriched,
unsweetened
½ cup
1g
Nondairy creamer/milk
substitute, unflavored
½ cup
8g
Nondairy creamer, flavored
2 tablespoons
12 g
Rice milk, unenriched,
sweetened
½ cup
12 g
Soy milk, unenriched,
sweetened
½ cup
4g
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 9
Bread, Cereal, and Grain Choices
One (1) serving has about 80 calories, 2 g protein, 15 g carbohydrate, 4 (0 to 8) g fat. Each
serving averages 150 mg sodium, 50 mg potassium, and 30 mg phosphorus.
You may have
servings each day of these foods. One serving is:
Bread, Cereal, or Grain Food
Serving Size
Bagel
¼ bagel (1 oz)
Bread, all kinds
1 slice or 1 ounce
Bun, hamburger or hot dog
½ a bun
Cold unsweetened cereals, such as corn
pops, puffed wheat, or puffed rice
1 cup
Cooked cereals such as cream of rice, cream ½ cup
of wheat, farina, grits, or Malt-o-Meal
Cornbread, homemade
1 ounce
Crackers, unsalted
4 crackers (2-inch size)
Danish pastry or sweet roll
1 small (3-inch diameter)
Dinner roll or hard roll
1 small
Doughnut
1 plain, small (3-inch diameter)
English muffin
½ English muffin
Graham crackers
3 squares
Melba toast
6 rounds
Pasta, such as noodles, macaroni, spaghetti
⅓ cup cooked
Pita or pocket bread
½ a 6-inch pita
Popcorn, air-popped, unsalted
3 cups popped
Pretzels, unsalted sticks or rings
¾ ounce
Rice
⅓ cup cooked
Tortilla chips, unsalted
¾ ounce or 9 chips
Tortilla, flour
1 tortilla (6-inch diameter)
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 10
Additional Grain Choices
The grain foods in the chart below are higher in calories, sodium, potassium, and/or phosphorus.
Choose these foods less often.
One (1) serving has about 2 g protein, 15 to 35 g carbohydrate, and up to 10 g fat.
Limit the following grain foods to
serving is:
servings each ____ day____week ____/month. One
Grain Food
Serving Size
Biscuit, muffin
1 small
Cake from boxed cake mix
1/20th of a round cake, or 2-x-2-inch square
Cornbread from boxed mix
1 piece or 1 ounce
Dry cereal, most brands
¾ cup
Fruit pie
1/8th of a 9-inch pie
Oatmeal
½ cup, cooked
Pancake, waffle
1 waffle or pancake (4-inch diameter)
Pretzels, salted sticks or rings
¾ ounce
RyKrisp
3 crackers
Sandwich cookie
4
Whole-wheat cereal, bran cereal
½ cup
Desserts/Sweets
The foods in the chart below are higher in sugar and calories but have less phosphorus and
potassium than other desserts and candies. These may be a better choice for the occasional treat.
Follow serving sizes carefully.
One (1) serving has an average of 100 calories, about 2 g protein, 25 g carbohydrate, 5 (0 to10)
g fat. Each serving also averages 200 mg sodium, 50 mg potassium, and 50 mg phosphorus.
You may have
servings each _____ day_____week of these foods. One serving is:
Dessert/Sweet
Serving Size
Hard candies
4 regular
Jellybeans
10 large
Shortbread cookies
5 plain
Sugar cookies
3 (2-inch diameter)
Vanilla wafers (low fat)
10 small
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 11
Fruit Choices
Balance the foods you eat from all three lists if you have been advised to limit your potassium.
All servings are for ½ cup fruit unless noted and have about 60 calories, 0 g protein, 0 g fat, 15
g carbohydrate. Each serving also averages 0 mg sodium, 150 mg phosphorus, and potassium
content as noted.
Low Potassium (less than 150 mg)
You may have
servings each day of these foods.
Fruit or Fruit Juice
Serving Size
Apple
1 (small or 4oz)
Apple juice
½ cup
Applesauce
½ cup
Apricot nectar
½ cup
Blackberries*
½ cup
Blueberries*
½ cup
Cranberries (fresh)*
½ cup
Cranberry juice/cranberry juice cocktail
½ cup
Fruit cocktail (canned, light syrup)
½ cup
Gooseberries*
½ cup
Grape juice
½ cup
Grapes*
½ cup
Lemon*
½ cup
Lemon juice*
½ cup
Lime*
½ cup
Lime juice*
½ cup
Papaya nectar
½ cup
Peach (canned, light syrup or packed in
water) and peach nectar
½ cup
Pear (canned, light syrup or packed in
water), pear (fresh), and pear nectar
½ cup
Pineapple (fresh)*
½ cup
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 12
Plum* (1)
1
Raspberries*
½ cup
Strawberries*
½ cup
Tangerine
1
Watermelon*
½ cup
*These items have 5 to 10 g carbohydrate per ½-cup serving.
Medium Potassium (150-250 mg) Fruit and Fruit Juices
You may have
servings each day of these foods.
Fruit or Fruit Juice
Serving Size
Cantaloupe*
½ cup
Cherries
½ cup
Fig*
2 medium whole
Grapefruit
½ grapefruit
Grapefruit juice
½ cup
Mango
½ cup
Papaya (fresh)
½ cup
Peach* (fresh)
½ cup
* These items have 5 to 10 g carbohydrate per ½-cup serving.
High Potassium (more than 250 mg) Fruits and Fruit Juices
You may have
servings each day of these foods.
Fruit or Fruit Juice
Serving Size
Apricot
3 fresh apricots
Bananas
1 6-inch banana
Dates*
¼ cup
Honeydew melon
Wedge of 1/8th of 5¼-inch diameter melon
Kiwifruit
½ cup
Nectarine
1 small nectarine
Orange
1 large orange
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 13
Orange juice
½ cup
Prune juice
½ cup
Prune*
½ cup
Raisins*
¼ cup
*These items have 25 to 30 g carbohydrate per serving.
Note: Avoid Starfruit (carambola).
Vegetable Choices
Balance the foods you eat from all three lists if you have been asked to limit your potassium.
One (1) serving size has about 30 calories, 2 g protein, 5 g carbohydrate (unless noted). Each
serving also averages 50 mg sodium, 50 mg phosphorus, and potassium content as noted.
Canned vegetables are excluded unless stated otherwise.
Low-Potassium (less than 150 mg) Vegetables
You may have
servings each day of these foods
Vegetable
Serving Size
Alfalfa sprouts
1 cup raw
Bamboo shoots
1 cup canned
Bean sprouts
1 cup cooked
Beets
½ cup canned
Cabbage
½ cup cooked, 1 cup raw
Cauliflower
½ cup cooked, 1 cup raw
Corn*
½ cup cooked
Cucumber
1 cup raw
Endive
1 cup raw
Eggplant
1 cup cooked
Green beans
½ cup cooked
Lettuce, all types
1 cup
Mushrooms
¼ cup cooked, ½ cup raw
Onions
¼ cup cooked, ½ cup raw
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 14
Radishes
½ cup raw
Water chestnuts
½ cup canned
Watercress
1 cup raw
*These food items have approximately 10 to 15 g carbohydrate for a ½ cup cooked serving.
Medium-Potassium (150-250 mg) Vegetables
You may have
servings each day
Vegetable
Serving Size
Asparagus
½ cup cooked
Broccoli
½ cup cooked, 1 cup raw
Celery
½ cup cooked, 1 cup raw
Kale
1 cup cooked
Mixed vegetables, frozen*
½ cup cooked
Peas, green*
½ cup cooked
Peppers
½ cup cooked or raw
Rutabagas
½ cup cooked
Summer squash
½ cup cooked
Turnips
1 cup cooked
Zucchini
½ cup cooked, 1 cup raw
*These food items have approximately 10 to 15 g carbohydrate for a ½ cup cooked serving.
High-Potassium (more than 250 mg) Vegetables
You may have
Vegetable
servings each day.
Serving Size
Artichokes
Avocado**
¼ of 1 medium
Bamboo shoots
½ cup raw
Beets
½ cup raw
Brussels sprouts
½ cup cooked
Chard
½ cup cooked
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 15
Greens, beets, collard or mustard
½ cup cooked
Kohlrabi
½ cup cooked
Okra
3/4 cup cooked
Parsnips*
½ cup cooked
Potatoes*
½ cup boiled, no skin
Pumpkins
½ cup cooked
Spinach
½ cup cooked, 1½ cups raw
Sweet potatoes*
½ cup cooked, no skin
Tomatoes
1 cup raw
Tomato sauce or puree, low sodium
½ cup
Tomato juice or V-8 juice, low sodium
1 cup
Wax beans
½ cup cooked
Winter squash*
½ cup cooked
Yams*
½ cup cooked
*These food items have approximately 10 to 15 g carbohydrate for a ½ cup cooked serving.
**This food is higher in calories and fat than indicated
Fat Choices
Healthy fats play an important role in your diet. They help your body absorb nutrients.
Fats are high in calories. You may need to limit fats, depending on the other health issues you
have and whether you need to gain or lose weight.
High blood glucose can increase the levels of unhealthy fats in the blood, causing more damage
to the kidneys.
One (1) serving has averges 100 calories, and about 0 g protein, 4 (0 to 10) g carbohydrate, 5 g
fat. Each serving also averages 55 mg sodium or more, 10 (0 to 50) mg potassium, and 5 (0 to
20) mg phosphorus.
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 16
You may have
servings each day of these foods. One serving is:
Healthier, Unsaturated Fats
Food
Serving Size
Margarine, trans fat free
1 teaspoon
Margarine spreads, trans fat free
1 tablespoon
Mayonnaise
1 teaspoon
Miracle whip
1 teaspoon
Mayonnaise, low fat or nonfat
1 tablespoon
Oils, such as canola, corn, olive, peanut,
safflower, soybean, and sunflower
1 teaspoon
Salad dressing, made with the above oils*
1 tablespoon
Salad dressing, low fat or nonfat*
2 tablespoons
Salad dressing, with added sugars*
2 tablespoons
Tartar sauce*
2 tablespoons
Saturated Fats (Limit Use)
Food
Serving Size
Bacon fat
1 teaspoon
Butter
1 teaspoon
Cream, half-and-half
2 tablespoons
Cream, light
2 tablespoons
Cream cheese
1 tablespoon
Cream cheese, low fat or nonfat
2 tablespoons
Cream, powdered substitute
2 tablespoons
Cream or milk based salad dressing*
1 tablespoon
Cream, whipped
1 tablespoon
Lard
1 teaspoon
Sour cream, regular
1 tablespoon
Sour cream, low fat or nonfat*
2 tablespoons
*These foods may be higher in sodium, potassium, and/or phosphorus than indicated.
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 17
Fluid Choices
Fluids may or may not be limited depending on your stage of CKD. Note: Fluids are any drink
or food that is liquid at room temperature. The sodium, potassium, and/or phosphorus content of
beverages can vary greatly. Read labels carefully. Please allow 40 mg of potassium for every 8ounce serving of (brewed) tea and 150 mg of potassium for every 8-ounce serving of (brewed)
coffee.
You may have
cups of fluid each day.
Coffee
Ice cream, frozen yogurt,
sherbet
Soup/broth
Fruit drinks
Milk, nondairy creamers
Tea
Fruit or vegetable juice
Sugar-free popsicles, juice
bars
Water
Fruit smoothies with added
ice or liquids
Diet soft drink
Sugar-free gelatin snack
Notes:
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Diabetes and Chronic Kidney Disease Stages 1-4—Page 18
Diabetes and CKD Sample 1-Day Menu
Meal
Menu
Breakfast
½ cup cranberry juice cocktail
½ cup low-fat, sugar free yogurt
2 slices white bread toast with 2 teaspoons margarine and 2 teaspoons
low-sugar jelly
1 cup coffee, black
or
1 cup Rice Krispies
½ cup low-fat milk or 1 cup rice milk
1 small banana
Sugar substitute
1 cup coffee with nondairy creamer
Turkey sandwich: 2 slices white bread, 1 ounce sliced turkey, lettuce
leaf, thin-slice tomato, 1 tablespoon light mayonnaise, and/or 1
teaspoon mustard
Lunch
½ cup cucumber salad with 1 tablespoon oil and vinegar dressing
1 medium peach or ½ cup cantaloupe
10 small vanilla wafers
1 cup sugar-free lemonade
Evening Meal
2-3 ounces broiled fish or baked chicken, skin removed
1 cup rice or herb noodles
½ cup green beans or carrots
⅓ cup low-sugar baked beans
1 cup spinach salad with 1 tablespoon oil and vinegar dressing
1 dinner roll with 1 teaspoon margarine
½ cup sugar-free orange gelatin
1 cup unsweetened iced tea
Snack
1 slice (1/10th) pound cake
½ cup sliced strawberries
Copyright© Academy of Nutrition and Dietetics. This handout may be duplicated for client education.
Diabetes and Chronic Kidney Disease Stages 1-4—Page 19
Sample Meal Plan
Use this form to develop an individualized meal plan.
Meal
Menu
Breakfast
Lunch
Dinner
Snack
Notes:
Copyright Academy of Nutrition and Dietetics. This handout may be duplicated for client education.
Diabetes – Chronic Kidney Disease Stages 1-4 Page 20