Diet and PKD: What You Should Eat for Your Stage

Kidneys are instrumental in maintaining the proper balance of nutrients in your body. They filter waste products and extra water from the blood, and they balance salts and minerals such as calcium, phosphorus, sodium, and potassium circulating in the blood. Every person with PKD has different dietary needs based on body weight, lifestyle habits, and other possible health conditions, like hypertension or diabetes. So when it comes to diet and PKD, should you plan your diet based on your stage?

Here’s a general guide to essential nutritional considerations and recommendations according to your stage of PKD.

Diet for Early Stages (1-3) of PKD

In setting a diet for the early stages of PKD, what should you look at first? The most important thing is to eat a varied, well-balanced, and healthy diet, according to Rachael Majorowicz, R.D.N., and Rebecca Schaffer, M.S., R.D.N., registered dietitians at the Mayo Clinic. They recommend that patients follow the principles laid out in the DASH (Dietary Approaches to Stop Hypertension) diet or the Mediterranean diet.

The DASH diet focuses on low-fat foods, lean sources of protein (such as fish, poultry, and nuts), whole grains, and fruits and vegetables. Fruits, vegetables, nuts, whole grains, and vegetable oils are the basis of the Mediterranean diet. However, fish is the main source of protein, while poultry and dairy products are advised in moderation.

It’s recommended you:

  • Drink a lot of water. People with PKD should drink a minimum of 3 liters of water per day to reduce the risk of kidney stones. In addition, drinking a large amount of water may also inhibit cyst growth.
  • Restrict sodium. Too much salt is associated with high blood pressure and a decline in glomerular filtration rate (GFR), so people with PKD need to restrict daily consumption of sodium to 1,500 to 2,300 milligrams. (By comparison, most Americans eat more than 3,500 milligrams each day.)
  • Eat modest amounts of protein. The amount of protein a person with PKD needs varies and is based on body weight. In the general population, 0.8 grams of protein per kilogram of body weight is recommended. For people in the early stages of kidney disease, the recommendation may be closer to 0.6 grams per kilogram.

Diet for Late Stages (4-5) of PKD

As kidney function declines, nutritional needs change, often significantly. You may need to:

  • Limit phosphorus. An imbalance in phosphorus becomes more likely as kidney function declines. Too much phosphorus can increase the risk of heart and bone disease. A high phosphorus level in the blood is a big risk factor for cardiovascular disease in people with advanced chronic kidney disease.
  • Limit potassium. If too much potassium builds up in the blood, it can prevent the heart from working properly. Eating excessive amounts of foods that are particularly high in potassium (such as melons, vegetable juice, and low-sodium foods with potassium chloride in the ingredients) may lead to fatal complications.
  • Reduce fluid intake. Fluid recommendations vary depending on each person’s urine output and any edema. For someone who’s still making some urine every day, no more than about 6 cups of fluid are typically recommended. For people who make no urine, that amount decreases to no more than 4 cups. The risk of having fluid buildup in the blood is that it can cause heart failure.
  • Eat more protein. However, it’s important to note that protein needs do not increase until a person requires dialysis. This is because of increased nutrition needs and loss of protein through the dialysis process.

Consult an R.D.N.

If you have questions regarding your speci­fic nutrition needs, contact a registered dietitian nutritionist (RDN) specializing in managing kidney disease.  


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  1. John Laferty

    I’m stage 4b. Urine flow is heavy. Only one large kidney remaining. I’m told by my Nephrologist that 3 to 4 liters a day is the recommended. This I find painful and results in many trips to the toilet. Way is your recommendation so much lower at just a few cups?

  2. Harihar bal

    Sir I am adpkd stage 1 ,air please give me best medicine and nonveg diet plan

  3. Albert Manje Molapisi

    I am diagnosed with polycistic kidney disease.

  4. Greg

    I’m stage 4.eGFR24. my nephrologist says drink plenty of water. I’m also on Jynarque, you need to drink a lot when taking it.

    • Nas

      Greg I was told that I can’t take Juinarv as I am on beginning stage 4. Please let me know. Thanks.

  5. Katherine Anderson

    Insurance won’t pay for it and I don’t have $500.00 per day (@250 per pill)


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