A Good Match: Merging the Heart and Kidney Diets

Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.

In most cases, people with chronic kidney disease (CKD) already have a diagnosis of heart disease or arteriosclerosis. Working with your care team to help you manage these conditions is very important, and part of that plan is eating a heart-healthy diet together with a kidney-friendly diet.

But how do you make a “love connection” between these two diets? Learn more about the kidney diet and the heart-healthy diet to discover how combining the two can help you develop and resume a better quality of life.

Main factors of a kidney diet

Protein: Consume the amount your body needs (some people need to limit protein while others need to increase it).
Sodium: Avoid adding salt and limit processed foods to help control blood pressure and fluid balance.
Fluid: Follow the advice of your physician and dietitian; some people with early CKD do not need to limit fluid, but in later stages, limit it only if you have problems with swelling or excess fluid weight gain.
Phosphorus: Decrease to keep bones healthy and prevent calcification of organs and tissues.
Potassium: Go by the advice of your dietitian to remain at a safe level in your blood (some people don’t need to limit potassium and some are prescribed a high-potassium diet, whereas others should reduce or avoid high-potassium foods).
Calcium: Follow the advice of your physician and dietitian to prevent high and low blood calcium levels.

Main factors of a heart-healthy diet

Cholesterol: Lower intake to reduce cholesterol levels and enhance the effect of cholesterol-lowering medications.
Trans-fats and saturated fats: Avoid hydrogenated foods such as shortening and margarine; choose lean meats, fish, poultry, and fat-free or low-fat dairy products within the guidelines of your kidney diet.
Omega-3 fatty acids: Include fish in your diet at least twice a week with albacore tuna, herring, mackerel, rainbow trout or salmon.
Fat: Moderate intake with healthy fats such as olive oil or canola oil, nuts and avocado.
Fruits and vegetables: Add more to your daily menu to increase antioxidant intake. If you are on a potassium restriction, choose low-potassium fruits and vegetables, and check with your dietitian as to how many servings you should include each day.
High-fiber foods: Choose fiber-rich foods within the guidelines of your diet.

How to build a relationship between the heart and kidney diets

As you can see, these diets have different objectives and some components conflict, so it’s essential to know which ones are better for your own situation. Also, as kidney function declines so do diet and nutrition needs. Here are some things to consider when combining your heart-healthy and kidney diet:

Protein consumption for people who are not on dialysis are usually advised to decrease their protein intake to prevent the build up of waste products in their blood. Cutting down on animal protein can also decrease saturated fat which is healthy for your heart. People on dialysis need higher amounts of protein and can choose from fish, skinless poultry and very lean cuts of meats. Talk with your dietitian about including some meatless meals with non-animal protein sources such as soy products.

Sodium reduction is good for kidney and heart health—the lower it is the better for most people. According to the Dietary Guidelines for Americans 2010, people should limit sodium to 2,300 mg daily. For people who are 51 years-old and older, African Americans (at any age), and those who have hypertension, diabetes or kidney disease, the recommendation is 1,500 mg sodium per day. To keep your sodium intake in this range, avoid processed and cured foods, fast foods and do not add salt to your food.

A low-phosphorus diet and medications that help to control phosphorus are usually required by people on dialysis. Phosphate additives in our food supply are a growing problem, and research has shown that people with high phosphorus levels have a greater risk for cardiovascular events. Avoiding phosphate additives is good for both diets. If a stricter low-phosphorus diet is required, you may need to limit some heart-healthy foods that are naturally high in phosphorus such as fat-free and low-fat dairy products, nuts, chocolate and dried beans.

Potassium is abundant in fruits, vegetables, nuts, milk and yogurt—foods that are heart-healthy. This is one area where the diets conflict. While high potassium intake is good for people with healthy kidney function, most people with kidney disease must limit the amount of potassium they eat so it will not build up to dangerous levels in their blood. Know your potassium lab results and discuss how much potassium you need to consume with your dietitian and physician. If you are on a low-potassium diet, include the recommended servings of lower potassium fruits and vegetables for the antioxidants and anti-inflammatory benefits.

Fat and sugars are limited in a heart-healthy diet, but some people with CKD have difficulty eating enough calories. A liberal diet with extra fats and sweets may be prescribed to help prevent unwanted weight loss and malnutrition.

Cholesterol control through diet is part of a heart-healthy diet, and many CKD patients are on cholesterol-lowering medications. However, avoiding saturated fats and trans-fats is more critical.

Work with your team of diet matchmakers

You have a team of healthcare experts who will help you get the most out of your kidney-friendly and heart-healthy diet. Work with them not only on your diet prescriptions, but overall lifestyle improvements including exercising more, managing stress and quitting smoking. Showing your entire body love is a great step to feeling better.