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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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?
Sir I am adpkd stage 1 ,air please give me best medicine and nonveg diet plan
I have PKD and my kidneys are moderatley impaired. Any advice?
I am diagnosed with polycistic kidney disease.
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.
Greg I was told that I can’t take Juinarv as I am on beginning stage 4. Please let me know. Thanks.
Hi Greg, it was a long time since your post so I don’t know if you’ve already found an answer to your question. I’m currently on jinarc but may be stopping this week depending on my bloodwork. I believe that once we get to stage 4, the jinarc won’t do much to help. I had been fine until 1 year ago. My egfr is at 25 now and seems to be dropping 10% per month. If this continues, I expect to be at egfr 15 this week. I’m having questions about cognitive function. I’m 52 and female with no family with pkd. I started this myself. Do/did you notice a fuzzy brain and if you did, at what level of egfr? I do hope you’re doing well.
Hi my GFR IS AT 8, I DO A VEGAN DIET, AND TAKE A BLOOD PURIFIER
JAZZYROS
IM AT 17 eGfR and i thought that 15 was dialysis! So you’re at 8 and not on dialysis yet?
You’re at 8 and not on dialysis? I was told that 15 is dialysis!
Just saw this. On JYNARQUE 45/30. I have been a constant 25 eGFR for about 2 years. No fuzzy brain. Work full time in Risk Management.
Im pkd with moderate changes and high creatinine and urea.what i should do next
Limit your salt consumption.
Drink a lot of water.
Maintain good blood pressure.
Avoid processed foods as much as possible.
See a nephrologist to help guide you through the changes.
Insurance won’t pay for it and I don’t have $500.00 per day (@250 per pill)
I’m at Stage 5, ESRD not on dialysis, yet. I have one (1) long functioning kidney working at 13%. My ADPKD was discovered by accident in 197, but not diagnosed until 2003. None of my Nephrologists, not then and not now have made any food or liquid recommendations except for, “Drink plenty of water. Limit your salt. We’ll see you when you need dialysis or transplant. I’m currently being pushed toward both, but don’t want it, yet as I don’t need it yet and neither “treatment” is a cure or a good thing. I’ve decided to eat plant-based and go from there. Fact is, Americans eat way too much meat. With PKD our kidneys can’t process too much protein, especially animal protein. Same reason for limiting your phosphorus, potassium and salt. Physicians, even Nephrologists don’t know everything. They get very little education about diet in Med school and are stuck in the 1950’s regarding diet, which is not a good thing for us. I’m not a physician, but I have a lot of experience with the medical profession and am my and my family’s advocate. I am also an academic. Don’t be afraid to ask questions. You know your body better than anyone. Don’t let anyone push you into something you don’t understand or are not ready for.
Hello, I am right behind you with my declining function. I expect to be below 20egfr currently and have been on Jinarc but my nephrologist may stop that this week. Have you been feeling ok when delaying dialysis? Are you able to work? I’m noticing problems with my thinking. I feel like my brain gets stuck and I forget many things. This is new for me but I’m not sure pkd may be connected. Have you had this happen in your experiences?
Thank you for your comment – am at about the same stage and I still feel good and I am currently working diet modifications. Just knowing someone has the same attitude as me makes me feel better. I am just not quite sure yet on what particular veggies to keep in my diet – any suggestions would be appreciated.
Great information here, by the way but very limited.
If you are not taking your life into your own hand you will sit there and die. do your research try things out? Take supplements, heal your body.
Is it possible to heal pkd?
I’m looking for diet plan for my children as they are diagnosed with PKD. Any ideas please
Try to get them used to low salt. I’m 52 and it’s difficult. Everything tastes terrible to me.
Encourage water rather than sodas or caffeine. Help them to have good habit so that when their time comes, it won’t be a large adjustment for them. Hopefully, starting these things early may help delay their function.
I am 70 have had PKD for 11 yrs. My mom died of renal failure last year at 90. We both drink/drank tons of water and tried to cut out salt. I started taking Jynarque 6 months ago. So far my Gfr is up. Other than water and salt awareness PKD really hasn’t affected my life too much.
Are there any registered PKD dietitians in Morrisville/Cary/Raleigh NC ?
I started taking jynarque 3 weeks ago and I hate it, I have high blood pressure and i already was going to the bathroom a lot especially during the night and now that I’m on this medicine it’s crazy the times I go. I definite don’t want to take this for the rest of my life because your life is consumed with drinking a lot of water and going to the bathroom. I recently took a trip that supposed to have been a 7hr trip and it turned into an 10hr trip because I had to stop so much to use the bathroom. I hardly ever use to use a public bathroom, now any bathroom is good because I have to go soooo bad all the time and I use to be able to hold it but now it’s not an option.
Do any of you just feel tired and have kidney pain?