Using the DASH Diet for Kidney Disease

Should you tweak the popular DASH diet if you have kidney disease?

Managing chronic kidney disease (CKD) usually involves both medical treatment and lifestyle changes. At home, that means watching your blood pressure and eating a kidney-friendly diet.

The Dietary Approaches to Stop Hypertension (DASH) diet has been found to lower the risk for heart disease as well as kidney disease. However, if you already have chronic kidney disease, talk with your healthcare provider before starting the diet. The DASH diet may require some changes if you have dietary restrictions.

This article discusses what the DASH diet is, when it should be modified, and how it affects chronic kidney disease.

Fresh fruit and vegetables
Sean Gallup / Getty Images

What Is the DASH Diet?

The DASH diet is a heart-healthy eating plan recommended by the National Heart, Lung, and Blood Institute (NHLBI). Studies have found that it lowers blood pressure, which helps to reduce the risk for kidney disease as well.

The DASH diet emphasizes eating fruits, vegetables, low-fat dairy, fish, poultry, beans, nuts, and vegetable oils. It limits sodium, sugar, and red meat. It is low in saturated and trans fats and high in calcium, potassium, magnesium, fiber, and protein.

DASH Diet and Chronic Kidney Disease

For those with chronic kidney disease, research shows that the DASH diet may help prevent it from getting worse.

A 2019 study found that the DASH diet reduced the risk of kidney failure for those with moderately severe chronic kidney disease. This was especially true for those who also had high blood pressure and diabetes.

However, if you have chronic kidney disease, it’s important to check with your healthcare provider before starting the DASH diet. Specifically, you may need to limit how much potassium and phosphorus is in your diet.

The DASH diet should not be used if you’re on dialysis. That’s because you’ll have specific guidelines for the type of foods to eat.

Limiting Potassium

When you have kidney disease, your healthcare provider may ask you to monitor how much potassium you eat. That’s because if your kidneys aren’t working correctly, potassium can build up in your blood. This can change how your heart beats and possibly cause a heart attack.

Potassium-rich foods include certain vegetables, fruits, milk, and meats. Ask your provider if you should limit potassium-rich foods. These may include:

  • Cantaloupe
  • Honeydew melon
  • Bananas
  • Pumpkin
  • Dried beans
  • Tomatoes
  • Oranges
  • Grapefruit juice
  • Spinach
  • Chicken breast
  • Potatoes
  • Cashews
  • Peanuts

Eating a variety of fruits and vegetables may help to ensure that you don’t get too much potassium on a daily basis.

Limiting Phosphorus

Your healthcare provider may also suggest limiting phosphorus, which can build up in your blood with kidney disease as well.

When your blood has too much phosphorus, your body pulls calcium from your bones to balance out your blood. This calcium loss can lead to bone disease and cause your bones to break more easily.

If you need to limit dietary phosphorous, you may need to work with a dietitian. In general, it’s best to limit:

  • Processed foods, including fast food, prepared convenience foods, and canned foods
  • Soft drinks
  • Red wine
  • Dairy
  • Egg yolks
  • Meat
  • Fish

Note that some medications and dietary supplements also contain phosphorous.

DASH Diet Guidelines

The DASH diet focuses on healthy foods, particularly ones that are low in sodium. The National Kidney Foundation gives the following tips for eating on the DASH diet:

  • Limit salt when cooking. Instead, try cooking with more spices and herbs.
  • Buy foods that are low in sodium (less than 140 milligrams per serving) or very low (less than 35 milligrams).
  • Eat plenty of fruits and vegetables. Check with your healthcare provider about which ones to choose if you’re limiting potassium or phosphorus.
  • Choose low-fat dairy products. These may need to be limited because of dietary restrictions.

The following table details what a DASH diet plan would look like for different calorie needs. The serving numbers may differ if you’re limiting phosphorus and potassium. Always check with your healthcare provider or dietitian about your specific dietary needs.

Summary

The DASH diet can be beneficial for your kidney health. However, if you already have chronic kidney disease, you should check with your healthcare provider before starting. You may need to limit the amount of potassium and phosphorus in the foods you eat. You should not follow the DASH diet if you are on dialysis.

A Word From Verywell

It can be tricky to know what to eat, especially when you have chronic kidney disease. The DASH diet can serve as a healthy guide, once you get the OK. With its focus on limiting salt and increasing nutrients, it may help slow kidney disease and improve your overall health.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Banerjee T, Crews DC, Tuot DS, et al. Poor accordance to a DASH dietary pattern is associated with higher risk of ESRD among adults with moderate chronic kidney disease and hypertension. Kidney Int. 2019;95(6):1433-1442. doi:10.1016/j.kint.2018.12.027

  2. National Heart, Lung, and Blood Institute. DASH eating plan.

  3. National Kidney Foundation. Tips to tackling the DASH diet.

  4. Cupisti A, Kovesdy CP, D'Alessandro C, Kalantar-Zadeh K. Dietary approach to recurrent or chronic hyperkalaemia in patients with decreased kidney function. Nutrients. 2018;10(3):261. doi:10.3390/nu10030261

  5. Rastogi A, Bhatt N, Rossetti S, Beto J. Management of hyperphosphatemia in end-stage renal disease: a new paradigm. J Ren Nutr. 2021;31(1):21-34. doi:10.1053/j.jrn.2020.02.003

  6. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease—mineral and bone disorder (CKD-MBD). Kidney Int Suppl (2011). 2017;7(1):1-59. doi:10.1016/j.kisu.2017.04.001

  7. National Heart, Lung, and Blood Institute. Following the DASH eating plan.

By Veeraish Chauhan, MD
Veeraish Chauhan, MD, FACP, FASN, is a board-certified nephrologist who treats patients with kidney diseases and related conditions.