LIVER & KIDNEY are the body’s Filtration System

Body Cleansing & Detox

for WHOLE BODY

NO YES NOTES
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CLEANSING
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DETOX
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for LIVER
NO YES NOTES
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CLEANSING
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DETOX
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 for KIDNEY
Follow a “Renal Diet”. The high-sodium, high-potassium and high-phosphorus foods listed below are likely best limited or avoided.
NO YES
MINIMIZE
Fruits Vegies OTH Fruits Vegies OTH
Avocado Spinach Dairy (incl. chocolate) Berries Cauliflower Salmon Fish High-Protein Foods
Banana Beet Greens Processed Meats Cherries Cabbage (be careful it has too Beef
Orange Swiss Chard Canned Foods Red Grapes Turnips much phosphorus) Chicken Broth
Melons Pickles Whole Grains, Seeds, Bran Apple Celery Egg Whites
Apricot Olive (incl brown rice) Pineapple Bell Peppers Chicken (skinless)
Dates Tomatoes Pickled/Fermented Foods Grapefruit Onions Shiitake Mushrooms
Prunes Lentils (incl. Olives, Tofu, Relish) Arugula Omega-3 Seeds
GENERAL

Raisins Beans Pretzels Radish Bulgur

Squash Chips Macadamia Nuts
Instant Coffee Crackers Buckwheat
Packaged Meals (incl. Olive Oil
Frozen Meals) Garlic
Instant Meals
Pre-Made Meals
Nuts (Almond, Peanuts, etc)
Organ meats like liver
CLEANSING
DETOX

Sodium: Damaged kidneys can’t filter out excess sodium. It’s often recommended to limit sodium to less than 2,000 mg per day.
Potassium: High levels can cause problems. . It’s usually recommended to limit potassium to less than 2,000 mg per day.
Phosphorus: Dietary phosphorus is restricted to less than 800–1,000 mg per day.
Protein Waste products from protein metabolism can’t be cleared out by damaged kidneys.
Make sure you get enough: •Calcium, vitamin D, iron, and folate •Protein •Total calories

The Renal Diet: Foods to Eat & Avoid in CKD (Chronic kidney disease)
What is the Renal Diet?
Designed to avoid stress to the kidney.
The kidneys are, along with the liver, the body’s filtration system. They sift through the blood and remove salt, minerals, fluid, and waste products like urea. That
waste is transported to the bladder and leaves the body as urine [1].
Certain foods give the kidneys more work to do than others. After all, the more salts and waste they have to filter out, the harder they work. Plus, salt and other
electrolytes raise blood pressure, which also stresses the kidneys [1, 2, 3].
Healthy kidneys don’t generally have a problem working a bit harder, but certain factors – genetics, underlying health conditions, or eating a bad diet over a long
period of time – can stress the kidneys until they begin to fail [1, 2, 3].
A renal diet prevents stress to the kidneys and slows the progression of CKD. It avoids foods that are high in salt, certain minerals, and proteins [ 4].
Glomerular Filtration Rate (GFR)
Each kidney is made up of many small structures called nephrons. Each nephron contains a glomerulus: a tiny filter where salts, fluid, and waste leave the blood
and head to the urine. The efficiency of the glomeruli is measured as the glomerular filtration rate, or GFR [5, 6].
The kidneys need to be strong – with a high, efficient GFR – to be able to process salty, high-protein foods efficiently [3].
Low GFR is often the first sign of chronic kidney disease (CKD). As GFR falls, kidney disease is considered more and more serious. CKD progresses through stages
numbered 1 through 5, where stage 5 is considered kidney failure [7, 8].
Who Needs the Renal Diet?
Generally speaking, only people with chronic kidney disease need to eat a renal diet. However, people who are at risk of developing CKD should consider avoiding
some of the worst kidney stressors. People who eat healthy, varied diets – the Mediterranean or MIND diet, for example – develop CKD at a much lower rate than
average [3].
Diabetes and Chronic Kidney Disease
Up to 40% of people with diabetes develop chronic kidney disease or CKD. High blood sugar causes high blood pressure and stresses the kidneys in much the
same way as sodium and waste [9, 10, 11].
Therefore, people with diabetes must carefully control their blood sugar to avoid stress and damage to the kidneys. If a diabetic person develops CKD, they must
follow a modified version of the renal diet that also excludes foods that raise blood sugar [11].
Genetics of Kidney Disease
Some genetic variants can make people much more likely to develop CKD than others. One of the most studied genes in this category is APOL1, which produces part of the protein that makes HDL (good) cholesterol [12].
In the APOL1 gene, the highest risk of kidney disease seems to be associated with [13, 14]:
The minor G allele at rs73885319
The minor G allele at rs60910145
Another well-studied gene is UMOD, which produces uromodulin, a protein made in the kidneys and excreted in the urine. More than 40 mutations in UMOD can increase the risk of kidney disease [15].
At rs4293393, the T allele is associated with increased risk of kidney disease and the C allele is protective against kidney disease [16, 17].
At rs13333226, the G allele is slightly protective against kidney disease [18].
Mutations in the MYH9 and SHROOM3 genes are also associated with increased risk of kidney disease.
MYH9 produces a protein involved in cell movement. The A allele at rs11912763 and the G allele at rs5750250 are associated with increased risk of kidney disease [19, 14].
SHROOM3 produces a protein that regulates cell shape in some tissues. The A allele at rs17319721 is associated with increased risk of kidney disease [20, 21].
If you are genetically at a higher risk of kidney disease, choosing kidney-friendly foods may help you stay healthy for longer.
 Renal Diet Foods
Guidelines Snapshot
Foods to avoid:
Salty, processed, fermented, or pickled foods
Whole grains, chocolate, beans, nuts, and lentils
Oranges, bananas, melons, and tomatoes
Cheese
Foods to increase:
Lots of fruit and vegetables that aren’t very high in potassium
Fish as a source of protein and omega-3 fats
Other sources of omega-3 fats
Make sure you get enough:
Calcium, vitamin D, iron, and folate
Protein
Total calories
To Avoid
In early stages of CKD, avoid salt, potassium, and phosphorus. As CKD progresses, that might also include avoiding protein and even fluids.
Some of the foods that produce the most stress on the kidneys include [4, 22]:
Salt
Highly processed foods (lunch meat, canned soups, bottled sauces, fast food)
Pickled foods (including tofu, olives, and relish)
Salted or cured meats
Beans, nuts, and lentils
Whole grains
Chocolate
Oranges, bananas, melons, tomatoes
Potatoes and sweet potatoes
Avocado
Milk
More than 8 ounces of protein per day
1) Foods High in Sodium
Sodium is one half of table salt or sodium chloride. Processed foods and meat are highest in sodium, while fruits and vegetables are the lowest. It is important to
minimize salt because, without proper filtration in the kidneys, sodium can raise blood pressure to dangerous levels [4, 22].
Depending on GFR and stage of disease, each person’s recommended sodium intake may be different. The American Heart Association recommends less than
2400 mg of sodium a day for everyone; those on a renal diet will need to have less than that. The goal is to keep blood pressure below 140/90, which may require
some fine-tuning of sodium intake [22].
Besides table salt and salted snacks, some of the foods that are highest in sodium include:
Beef and chicken broth [23, 24]
Prepared soup mixes [25]
Prepared gravies and sauces [26, 27, 28]
Prepared desserts like pudding [29]
Fermented or pickled foods like tofu, capers, and olives [30, 31, 32]
Cured meats like bacon or salt pork [33, 34]
Cured sausages like salami [35]
Some cheeses like Roquefort and parmesan [36, 37]
In short, to keep your sodium intake low, avoid salted, pickled, or highly processed foods.
2) Foods High in Potassium
Potassium is an essential nutrient. Our bodies need it to keep all of its cells functioning normally. However, those with chronic kidney disease need to keep a close
eye on their potassium intake because both low (< 3.5 mmol/L) and high (> 5.5 mmol/L) levels of potassium can increase the risk of mortality in renal disease [ 38,
39, 40].
For most people, the daily recommended intake of potassium is 2.6 – 3.4 g without a set upper limit. People on a renal diet should stay below 3 – 4 g per day [ 38,
22].
Some of the foods that are highest in potassium include [38]:
Apricots, raisins, and prunes
Bananas
Lentils
Squash
Potatoes
Beans
Instant coffee [41]
Many vegetables contain relatively high amounts of potassium. People on a renal diet can eat potatoes, squash, and other vegetables safely by taking a few extra
steps to prepare them. Peel and slice the vegetables and soak them in warm water for about two hours. Then drain them and boil them in fresh water [ 22].
Each person is different. Talk to your doctor to make sure that this preparation method will reduce potassium enough for your kidneys to safely handle these
vegetables.
3) Foods High in Phosphorus
Phosphorus is important for the growth and maintenance of tissues, especially bones and teeth. Healthy adults need about 580 mg per day to prevent deficiency,
and people on a renal diet should stay below 1 g per day [42, 22].
Some foods that are high in phosphorus include:
Whole grains, seeds, and bran [43, 44, 45]
Cheese [46]
Smoked salmon [47]
Meat, especially bacon and organ meats [48, 49]
Nuts and nut butter [50, 51]
People on a renal diet also often take phosphate binders. These medications attach themselves to phosphorus in the digestive system and prevent it from being
absorbed into the bloodstream [22, 52].
4) High-protein Foods
Protein may or may not be limited in a renal diet depending on the person and the stage of chronic kidney disease [22].
Too much protein can result in large amounts of urea building up in the kidneys. This condition is called uremia; its symptoms include fatigue, nausea, and lack of
appetite. On the other hand, some protein is absolutely required to build and maintain tissues. This balancing act is very important to get right [ 22, 53].
If your doctor advised a renal diet, ask about the ideal protein intake for you. For dialysis patients, recommended intakes range from 0.6–1.3 g per kg of body
weight per day. For a 150 lb person, that would be between 40.8 and 88.4 g (1.4 and 3.1 oz) per day [22].
5) Excessive Fluids
People don’t usually need to limit their water intake on a renal diet. The exception is for stage 5 chronic kidney disease (CKD), or renal failure. People who reach
this stage of CKD have very low kidney function and produce very small quantities of urine. They are usually restricted to 600-1000 mL of fluids per day [ 22].
To Eat
Looking at a long list of foods you can’t eat can be daunting, so let’s talk about the foods that you can – and should! – put in your grocery cart.
Grocery List
Some of the best foods for people on a renal diet include [4, 22]:
Apples, berries, cherries, grapefruit, pineapples
Leafy greens, sprouts, leeks, endives, parsley, chives
Beets, carrots, onions, radishes, turnips, jicama
Garlic and ginger
Sweet and hot peppers
Mushrooms
Cauliflower
Spaghetti squash, summer squash, zucchini
Bread (not whole grain, which is high in phosphorus)
Low-salt dry and cooked cereals (not whole grain)
Popcorn, rice cakes, tortillas
Non-dairy creamers, rice milk
Vegetable oils (olive and canola)
Most spices (in moderation)
Jam and jelly
If you have mild, early-stage CKD, your diet will not be limited to only these foods. Talk to your doctor about your allowances for sodium, phosphorus, and
potassium to make sure you’re eating the ideal diet for you.
Healthy Fats
People eating a renal diet should add polyunsaturated fatty acids (PUFAs), especially omega-3 fatty acids, to their diet. Omega-3 fats may prevent uremic pruritus,
a terrible itchy feeling on the back, abdomen, head, and arms that develops in the later stages of chronic kidney disease (CKD). Omega-3 fats may also decrease
the risk of cardiovascular disease in people with CKD [54, 55].
To increase your omega-3 intake, try getting some of your protein from oily fish like salmon, herring, and mackerel. Be careful with salmon, however, as it can
contain as much as 371 mg of phosphorus in a 100 g serving, where the other fish have much less. By contrast, beef steak contains a little over 300 mg of
phosphorus in a 100 g serving [56, 57, 58, 59].
Common Deficiencies
Because of the strict limits on potassium and phosphorus, it can be very difficult for people on a renal diet to get enough of some other vitamins and minerals.
Some of the nutrients that may need to be supplemented include [22]:
Calcium (foods high in calcium tend to also be high in phosphorus)
Vitamin D
Iron
Folate
Iron is especially tricky because phosphate binders can also decrease the absorption of iron supplements. Eat foods high in iron to prevent anemia. Some good
choices include spinach, shellfish, and beef, but be mindful of your protein limits, if any [22].
Total Calories
Because of the restriction on salt, some people find that a renal diet doesn’t taste very good and, as a result, eat less food. Getting enough calories can be difficult
for such people, but low caloric intake can lead to energy deficit and malnutrition. It is very important to meet your caloric needs, even if you don’t find that food
tastes very good [22].
The approximate caloric needs of a person with chronic kidney disease are 30 kcal per kg per day. For a 150 lb person, that’s about 2040 calories [ 22].
Medications to Avoid
Some drugs are processed in the kidneys and excreted in the urine. These drugs can stress the kidneys and should be avoided if you are eating a renal diet. They
include:
NSAIDs like ibuprofen and naproxen [60]
Some antibiotics such as vancomycin [61]
Some diuretics such as furosemide [62]
Some ACE inhibitors [63]
Make sure to follow your doctor’s recommendations to protect your kidneys.
Challenges
It can be difficult to follow a renal diet. Some of the challenges laid out for people with chronic kidney disease (CKD) include:
Guilt, anxiety, and depression: it’s hard to go out or eat in with friends and have to eat completely different foods from everyone else. Some people become
anxious and depressed, while others break their diets in social settings [22].
Health literacy and available information: much of the information presented online is either inaccurate or too difficult to understand. It’s important to find high-
quality sources or speak to your doctor directly about what’s best for you [64, 65].
Cost: the renal diet is more expensive than the average American diet. This may make it inaccessible to some people with CKD unless they receive subsidies or
stipends [66].
Protein balance: the true benefit of low-protein diets is still being debated. Finding the correct protein intake for each person can be a serious challenge,
especially since low protein can lead to wasting and other health problems [53].
New & Evolving Perspectives
The renal diet of today is not the same as the renal diet of just a few decades ago, and it is likely to continue changing in the near future. Even now, different
people may say “renal diet” and mean different things. It’s easy to get confused, and this confusion is probably part of why some people don’t follow their diets
as well as they should for optimal health [67, 64].
Alternative Diet Plans
One possible alternative to a strict renal diet is the “six-tip diet.” Adherents only need to follow six tips to keep the diet [68]:
Do not add salt during cooking or at the table
Avoid salami, sausages, cheese, dairy products, and canned food
Replace noodles and bread with special low-protein/hypoproteic food (prescribed food)
Eat meat, fish, or eggs at one meal per day (in prescribed amounts)
Eat 4-5 servings per day of fruit and vegetables
Once or twice a week, eat normal (not low-protein/hypoproteic) noodles with legumes
According to the main study that developed this diet, people with stage 3-5 CKD saw improvements to their lab tests when they were assigned to the six-tip diet.
Many people find this plan easier to follow than the conventional renal diet, and more people tend to stick to it than to a low-protein diet [ 68].
In earlier stages of chronic kidney disease (CKD) or in people at risk of CKD, the Mediterranean or DASH (Dietary Approach to Stop Hypertension) diets could be
enough to halt the progression of the disease without resorting to a strict renal diet [22].
Takeaway
The renal diet is usually recommended for people with chronic kidney disease, or CKD, as a way to reduce stress on the kidneys and slow their deterioration. You
can also use the renal diet as a guideline if you are at high risk of CKD.
People eating a renal diet should limit their intake of sodium, potassium, and phosphorus. Some doctors and researchers also recommend low protein intake;
however, very low protein causes other health problems. People with late-stage CKD may also have to limit fluids.
The biggest challenge for the renal diet is compliance. It can be difficult to follow this diet in a social setting, and there’s a lot of bad or confusing information
about the diet online. Some alternative diets have begun to emerge to potentially control CKD, including the “six tips diet,” the Mediterranean diet, and the DASH
diet.