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Canadian Med Center

Lifestyle Changes to Manage Chronic Kidney Disease

Wednesday 13 March 2024
Chronic Kidney Disease
8 minute(s) read

Table of Contents

I. Dietary Changes for CKD

II. Exercise and CKD

III. Fluid Intake Guidelines for Dialysis

IV. Conclusion

Chronic Kidney Disease (CKD) is a progressive condition that can lead to a gradual loss of kidney function over time. While medications and medical care are critical to treatment, making specific lifestyle changes can also help support kidney health and overall well-being.

This article will explore key lifestyle adjustments, focusing on dietary modifications, exercise, and fluid intake guidelines for individuals living with CKD.

Dietary Changes for CKD

A woman holding a picture of kidneys and sitting in front of a table with fruits and vegetables

Taking care of your diet is important in managing chronic kidney disease (CKD). The right foods can:

  • Provide energy
  • Help maintain muscle mass
  • Slow the progression of CKD
  • Prevent infections [1]

While no single diet suits everyone, people with CKD must pay special attention to certain nutrients. With CKD, your kidneys have a harder time removing waste and fluid from your blood. Eating the proper amounts of protein, sodium, potassium, phosphorus, and calcium can help reduce buildup. This prevents too much strain on your kidneys. [1]

Your doctor and dietitian will guide you on how much of these nutrients you need each day. This is based on the results of your blood tests and your current kidney function. As your CKD progresses, you may need to restrict more nutrients. Your healthcare team will adjust your diet plan accordingly. [1]

Limit Protein

Limiting protein intake is important for managing chronic kidney disease. With impaired kidney function, consuming too much protein can overload your kidneys and prevent them from filtering waste properly. However, getting too little protein is also problematic and can cause malnutrition. Your doctor or dietitian will determine the right amount of protein for you based on factors like: [1]

  • Your body size
  • Severity of kidney damage
  • Protein levels in your urine. [1]

Both plant and animal sources provide protein, so talk to your doctor about the right combination for your condition. Some options include:

  • Animal proteins: Chicken, fish, meat, eggs, and dairy are good options, but watch your portion sizes. Aim for 2 to 3 ounces of cooked chicken, fish, or meat (about the size of a deck of cards), 1/2 cup of yogurt or milk, or one egg.
  • Plant proteins: Beans, nuts, and grains are excellent plant-based protein sources. A good portion is 1/2 cup of cooked beans, 1/4 cup of nuts, one slice of bread, or 1/2 cup of cooked pasta or rice. [2]

Limit Sodium

Your kidneys play an important role in regulating sodium levels in your body. When your kidneys are not functioning properly, consuming too much sodium can lead to:

  • Fluid retention
  • High blood pressure
  • Extra strain on your heart [1]

Aim for less than 2,300 milligrams of sodium per day to support your kidney health. You can work towards this goal by making simple swaps and reading labels. [2]

  • Eat fresh food: Many prepared or packaged foods contain high sodium levels due to added preservatives. By choosing fresh ingredients, you have better control over the amount of sodium you consume.
  • Cook from scratch: Instead of relying on prepared foods, consider cooking your meals from scratch. Fast food, frozen dinners, and canned goods have higher sodium content. By preparing your food, you have greater control over your ingredients.
  • Use sodium-free seasonings: There are numerous healthier alternatives that can add flavor to your dishes without excessive sodium. Try flavoring your food with herbs and spices instead of adding extra salt.
  • Read the nutrition facts label: Pay attention to the percentage of “Daily Value” for sodium. A value of 20% or more indicates that the food is high in sodium. 
  • Read food labels: Keep an eye out for labels that indicate lower sodium levels, such as "sodium-free," "salt-free," "low or reduced sodium," and "unsalted or lightly salted." [2]

Limit Potassium

Potassium is essential for your body, helping your muscles and nerves function properly. However, too much or too little potassium in your bloodstream can be dangerous, especially for those with kidney damage. Damaged kidneys have difficulty removing excess potassium from the blood, which could lead to heart problems. [1]

The good news is that you can help control your potassium level through the foods you eat.

  • Foods high in potassium: oranges, bananas, potatoes, tomatoes, brown and wild rice, bran cereals, dairy foods, whole-wheat bread and pasta, nuts, and beans.
  • Foods low in potassium: apples, peaches, carrots, green beans, white bread and pasta, white rice, rice milk, and cooked rice. [2]

Work closely with your healthcare provider to determine your daily potassium needs and limits. They will factor in your current kidney function and medications. [2]

Limit Phosphorus

As your kidneys work less effectively, phosphorus levels can start to rise in your blood. Having too much phosphorus circulating in your system can lead to some unpleasant effects: [2]

  • It takes away calcium from your bones, leaving them fragile and prone to breaking
  • It can make your skin itch
  • It may cause bone and joint pain [2]

Fortunately, you can manage your phosphorus levels through your diet. By understanding which foods are high or low in phosphorus, you can take control of your kidney health. Here are some guidelines to follow:

  • Foods high in phosphorus: Meat, poultry, fish, bran cereals, oatmeal, dairy foods, beans, lentils, nuts, and dark-colored sodas.
  • Foods low in phosphorus: Fresh fruits and vegetables, breads, pasta, rice, rice milk, corn and rice cereals, and light-colored sodas. [2]

Your doctor may also prescribe phosphate binders to take with meals. These binders help soak up phosphorus in the stomach so less gets into your blood. The phosphorus then leaves your body through stool instead. [2]

Exercise and CKD

Two women lifting weights at the gym

Staying physically active is important for anyone with chronic kidney disease (CKD). Exercise provides many benefits that can help you feel better and manage your condition. Whether you have mild, moderate, or severe CKD, being active can help: [3]

  • Control blood pressure
  • Improve sleep
  • Lower cholesterol
  • Build muscle tone
  • Maintain a healthy weight
  • Strengthen bones
  • Boost mood
  • Reduce the risk of heart disease [4]

When starting an exercise program with CKD, there are four key factors to consider:

  • Type of Exercise: Focus on low-impact strength training using light weights and high repetitions. This will strengthen muscles without putting too much strain on joints. Also, choose aerobic activities that use large muscle groups, like walking, swimming, cycling, or cross-country skiing.
  • Duration: Aim for exercise sessions lasting at least 30 minutes. Build up to this gradually if you're new to exercise.
  • Frequency: Exercise at least three days per week, with a day of rest between sessions. For example, you could exercise on Mondays, Wednesdays, and Fridays. Exercising three days a week is the minimum needed to get the benefits.
  • Intensity: Exercise at an intensity where you can maintain a conversation during the activity. The exertion level should feel moderately challenging but not extremely tiring. You shouldn't feel so sore after a workout that it prevents you from exercising the next time. [5]

Individuals with mild to moderate CKD can engage in physical activity as often as someone without kidney issues. However, those with later-stage CKD may become tired more quickly. In any case, it is crucial to consult with your doctor before starting a new exercise routine. [3]

While exercise is highly beneficial, there are certain situations when you should refrain from physical activity. These include:

  • After a large meal (wait one hour)
  • During a fever
  • When your dialysis or medication schedule has changed
  • If the weather is very hot or humid
  • If you have joint or bone problems that worsen with exercise [5]

Fluid Intake Guidelines for Dialysis

Maintaining proper fluid balance is essential for those with chronic kidney disease. As kidneys fail, they lose the ability to filter waste and excess fluid from the blood. This can lead to symptoms like: [6]

  • Swelling in the feet, ankles, wrist, and face
  • Shortness of breath
  • Cramping
  • Headaches
  • High blood pressure [6]

Following your doctor's fluid intake recommendations is critical to managing symptoms and supporting your treatment plan. Fluid retention can affect other organs and even lead to heart failure. [6]

The right fluid prescription depends on your kidney function and treatment. Your doctor will evaluate your symptoms and kidney status to determine how much fluid you can have.

  • Kidney function: While not everyone with CKD needs to restrict their fluid intake until they reach stage 4 or 5, the progression of CKD and its treatment can vary from person to person. Your doctor will evaluate your symptoms and kidney function to provide appropriate guidance.
  • Hemodialysis: If you're on hemodialysis, you'll need to limit fluids. This lowers risks during dialysis sessions, such as high blood pressure, cramping, and heart strain. 
  • Peritoneal dialysis: With peritoneal dialysis, you may be able to drink water normally. But you still need to watch sodium and sugar intake to control thirst and weight gain. 
  • Kidney transplant: Those who have received a kidney transplant generally need to increase their fluid intake, especially if transitioning from a fluid-restricted diet. [6]

Your doctor will determine the specific fluid restriction amount based on your needs. It is crucial to follow your doctor's instructions diligently to avoid fluid overload worsening your CKD. Some tips to help manage your fluid levels include: [6]

  • Know your dry weight, which is your weight without extra fluid. For hemodialysis patients, aim for a weight gain of no more than 2.2 pounds between treatments.
  • Reduce sodium intake. Too much salt increases thirst and fluid retention.
  • Take all medications as prescribed, including diuretics, to maintain fluid balance.
  • Don’t skip dialysis treatments. Missing treatments allow waste and excess fluid to build up, causing you to feel unwell.
  • Develop new water habits. Instead of drinking large amounts at once, have smaller glasses of water throughout the day. [6]


Managing chronic kidney disease requires a comprehensive approach that goes beyond medical treatment. While working closely with your healthcare provider to manage medications and treatment plans is crucial, making thoughtful lifestyle choices can also significantly impact your health and quality of life.

For more information, visit our chronic kidney disease blog.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.