When you are on dialysis, your diet is an important part of your overall treatment plan. Following a healthy meal plan that is high in protein and low in sodium and phosphorus can prevent many health problems such as heart disease, bone disease, and infections. This will help you feel better and live longer. For most of us, a good day starts with a good breakfast - something to both sustain and satisfy. Managing chronic kidney disease (CKD) requires a well-balanced diet that supports kidney function while keeping sodium, phosphorus, and potassium in check. Eating well with kidney disease doesn’t mean sacrificing flavor or variety.
The Importance of Breakfast in a Renal Diet
Breakfast has long been praised as the most important meal of the day, and while that isn’t necessarily true for everyone, starting your day off with a healthy meal can benefit your kidney-friendly diet. If you have other conditions like diabetes or high blood pressure, a healthy breakfast helps control your blood sugar and keep your blood pressure in check. Enjoying a kidney-friendly breakfast can set the stage for your healthy day and give you a leg up for successfully meeting your nutritional goals. Thankfully, many of the breakfast favorites like fruits, whole grain cereals (without added sugars), and oatmeal tend to be higher in fiber and other nutrients, so people who eat these types of food for breakfast are in a good spot to meet their daily nutritional goals. Your dietitian can help you determine what nutrients you’ll need daily.
Key Considerations for a Kidney-Friendly Breakfast
Limiting Potassium and Phosphate
“There are a few things to bear in mind when it comes to breakfast choices for people living with chronic kidney disease (CKD),” says kidney dietitian Laura Kyte. “Depending on the stage of your CKD, you may have been advised to limit foods rich in potassium and / or phosphate. When it comes to dairy products, Laura notes how they tend to be high in both potassium and phosphate. “Most CKD patients will be limited to around half a pint (285ml) of milk a day - and this includes yoghurt too.” This can impact breakfast choices as you may not want to use your allowance all in one go in the morning.
Choosing the Right Foods
When planning breakfast, keep your specific diagnosis and treatment type in mind. While many foods fit easily in a kidney-friendly breakfast, not all will. In general, foods that are low in sodium, potassium, and phosphorus are good for people with CKD, but be sure to check with your doctor and dietitian for specific suggestions.
Prioritizing Whole Foods
Whole foods that aren’t overly processed are generally a good idea for your kidney-friendly breakfast. Foods to skip or moderate: Watch out for foods that can be high in sodium or overly processed.
Read also: Delicious Breakfast for Kidney Health
The Role of Protein
Protein, especially from eggs, is essential at breakfast for people on dialysis. The dialysis process is a stressor on the body and also tends to remove protein from the blood. Protein is needed to prevent and fight infections.
Fruits and Vegetables
Fruits and vegetables are recommended at each meal to increase fiber and other micronutrients needed for health. Fiber keeps bowels regular, which improves the dialysis experience. Other nutrients in plant foods provide anti-inflammatory effects. Throughout the day, choose fresh foods rather than packaged or processed foods whenever possible. Fresh foods usually mean high quality protein and less phosphorus and sodium. Starting your day with a portion of fruit is still important though, with Laura recommending low-potassium options such as apples, pears, blueberries, watermelon or clementine.
Bread Choices
Contrary to much advice online, Laura would always recommend brown bread over white. “Wholegrain breads are often demonised within the CKD community due to their higher mineral content, but in reality, the higher fibre means much of the potassium and phosphates aren’t readily absorbed into the body.”
Variety is Key
Finally, Laura believes one of the best ways to sustain a kidney-healthy breakfast habit is to ensure variety across the week. “In my experience people with later stage CKD often find they wake up feeling nauseous, with eating being the last thing they want to do” says Laura.
Kidney-Friendly Breakfast Ideas
Spiced Porridge with Quick-Stewed Apples
A cosy treat for colder mornings, porridge is a well-established breakfast favourite for a reason - and it’s no different for those with CKD. Hearty and healthy, oats are rich in fibre and a great option. Depending on the time of year and availability, you can swap the apple for other seasonal, low-potassium fruits such as pears, clementine, blueberries or even canned peaches in juice (drained).
Read also: Delicious Plant Paradox Breakfasts
To make your oat porridge, add around 40g of oats (per person) into a pan with 200ml of a dairy milk-alternative, plus a pinch of cinnamon and all spice. Meanwhile, core and slice an apple and add to a small pan with two teaspoons of water. Add a pinch of cinnamon, cover and cook on medium heat for around 10 minutes (or until the apple is tender). Serve your porridge with an extra splash of milk if needed.
If you fancy something a bit different, why not try bulgur wheat porridge? Lower in potassium than other whole grains, it’s also a good source of B vitamins, magnesium, iron, and manganese.
Creamy Garlic Beans on Toast
Tinned beans are a great source of fibre, protein and iron, and since they’re plant-based, the phosphorus and potassium is not absorbed as well as from animal sources.
Cannellini beans work well here, but you can also use mixed beans or even kidney beans. Choose no-salt-added varieties if possible, and make sure to drain and rinse in water.
Add a healthy glut of olive oil to a pan with two crushed and finely chopped garlic cloves. Sauté over a medium-low heat for a few minutes until the garlic is starting to soften and turn golden (but not burn!), before adding in your beans. Simmer for around 10 minutes, adding a splash of water if needed, until the beans are softened but still retain their shape. Take off the heat and stir in a dollop of crème fraîche. Pile on top of toasted brown or wholegrain bread.
Read also: Foods for a Healthy Pregnancy Breakfast
Blueberry Wholegrain Muffins
If you’re wanting a ‘grab-n-go’ breakfast option, these muffins are a brilliant choice. You can bake them up over the weekend ready for the week ahead, and then freeze and take one out the night before, as and when you fancy.
Blueberries are a great low-potassium fruit option, but you could also swap in shredded apple and carrot for a more autumnal option, or dried cranberries and a little orange zest for a more festive flavour.
To make, simply add 200g wholewheat flour to a mixing bowl with 50g rolled oats, 3-4 teaspoons brown sugar, 1 teaspoon baking soda and 1 teaspoon baking powder, a pinch of ground cinnamon, 2 eggs, 4 tablespoons vegetable / rapeseed / light olive oil and 150ml of Greek or plain yoghurt. Mix together well and add in a big handful of blueberries. Sprinkle a few oats on top if you’d like. Dollop into a greased muffin tray or 10 silicone muffin cups, and bake in a pre-heated oven at 180°C/350°F/Gas Mark 4 for around 25 minutes, or until golden.
Omelette with Spring Onions and Goat's Cheese
Omelettes are a speedy and satisfying option for when time is short, but hunger levels are high. The goat's cheese adds delicious creamy tang, but can just as easily be left out, or enjoyed as a weekly treat, for those limiting cheese. You can keep it simple with chopped spring onions, or play around and add in other chopped vegetables such as red peppers and onions - all low-potassium options.
To make an omelette for one, whisk two eggs with a fork and add in a little black pepper. Heat up a drizzle of olive oil in a small frying pan and pour in the eggs. Sprinkle finely sliced spring onions on top and add a few small dollops of soft goat's cheese around the omelette surface.
Haddock and Kale Kedgeree
Rice, be it white, wild or brown, is a great, kidney-friendly choice - low in potassium and phosphorus, it’s also filling and provides energy for the day ahead. Haddock is a brilliant source of protein, but oily fish like salmon - as part of your two portions a week - would also work well.
To make your quick morning kedgeree for two people (with leftovers), sauté an onion in olive oil until soft and golden, adding in one teaspoon of turmeric and half a teaspoon of curry powder. Stir in two garlic cloves (crushed and chopped) and two bags of ready-cooked rice (500g total - opt for a pouch with no added salt). Pour in a large ladleful of low-salt vegetable stock, and nestle in two fillets of haddock, cut into pieces, and a large handful of green kale, blanched and torn into pieces. Cover and simmer for 10-15 minutes until the fish is opaque and cooked through. Finish with fresh parsley.
Buckwheat Granola with Macadamia Nuts and Cranberries
Nutty, crunchy and incredibly moreish, buckwheat granola is a wholesome way to start your day. Buckwheat is not only high in fibre, magnesium, and iron, but, crucially for kidney health, it’s low in phosphorus. Cranberries are lower in potassium than other dried fruits and are a wonderful addition.
To make the granola, add approx. 150g of roasted buckwheat (kasha) into a bowl with 50g chopped macadamia nuts and a generous handful of dried cranberries. Spread the mixture across a large roasting tray. Pour over a few generous glugs of olive oil and a drizzle of honey and a sprinkle of spice (nutmeg, ginger and cinnamon work well, as do fennel seeds).
High Protein Scramble
This yummy high protein scramble has lots of flavor but is low in potassium. Avocado oil has a high smoke point so it is good for sautéing. Salt-free seasoning such as Mrs. Dash can be used.
Protein Powder Recipes
This recipe uses protein powder, which is great to add to other things too. Add it to oatmeal, for instance. Another tip, keep a bunch of grapes in your freezer at all times.
Beverages of Choice
For some, breakfast is synonymous with a hot cup of coffee or tea. Others prefer to start the day with a glass of orange juice or water. While you often can drink coffee, preferably served black, and other caffeinated beverages when living with kidney disease, it’s always best to consult your dietitian first. You will likely need to moderate how much fluid you can drink. And when it comes to juice, stick to 100 percent fruit juices and consult nutrition labels to check for added sugars. Following a kidney-friendly diet will also mean staying away from cereals that feature chocolate, nuts or dried fruits, as well as fruit juices, including orange juice - all of which are high in potassium. Coffee may be limited to around one cup a day (including decaf), with a good quality filter coffee slightly better than instant.
Foods to Avoid
Avoid salty processed meats, especially bacon and sausage. These processed meats are full of sodium and phosphorus. Following a kidney-friendly diet will also mean staying away from cereals that feature chocolate, nuts or dried fruits, as well as fruit juices, including orange juice - all of which are high in potassium.
Additional Resources
Your dietitian is available to guide you as the dialysis diet can be confusing at first.