Andy Montoya
Cheese is often restricted on the renal diet due to its high phosphorus, potassium, and sodium content. However, cheese is also a good source of calcium and protein, and it can be challenging for dialysis patients to meet their protein requirements without it. While some cheeses are unsuitable for kidney disease patients, others are more kidney-friendly and can be incorporated into the diet in moderation.
| Characteristics | Values |
|---|---|
| Cheese consumption for dialysis patients | Depends on the stage of kidney disease and the type of dialysis |
| Phosphorus content | High in many cheeses, but some have lower levels, e.g., goat cheese, grated parmesan, mozzarella, Monterey Jack, Swiss cheese, and Brie |
| Sodium content | Generally high, but some cheeses have lower sodium, e.g., Swiss cheese, ricotta, and cottage cheese |
| Potassium content | Varies, with feta and goat cheese being the lowest in potassium |
| Protein content | High, but not a concern for dialysis patients with higher protein requirements |
| Recommended portion size | 30 grams or 1 ounce |
| Recommended frequency | Can be incorporated into the diet in moderation |
| Alternatives | Plant-based cheeses, although these may have comparable saturated fat and less protein and calcium |
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What You'll Learn
Phosphorus and sodium content in cheese
Processed cheeses like nacho or American cheese tend to have phosphorus additives and are higher in sodium. Cheese can be very high in sodium, and it is important to account for this in your daily total. A low phosphorus cheese is not necessarily healthy for a renal diet, as it may still be high in sodium. People with kidney disease should limit sodium to 2,300 mg per day. Staying below this limit may be difficult if you eat large amounts of very salty cheeses like feta, Asiago, or Parmesan.
The phosphorus content of cheese ranges from 15 mg to 160 mg per standard portion size. Cream cheese, brie, parmesan, and goat cheese are the lowest in phosphorus. Ricotta, cottage cheese with no salt added, and Swiss cheese are the lowest sodium options. Overall CKD-friendly cheeses include cream cheese, goat cheese, ricotta, and parmesan.
It is important to read the label when choosing cheese, as some cheeses have phosphorus additives. Look for ingredients on the label that contain "phos", which indicates additional phosphorus has been added. However, even if a cheese does not have phosphorus additives, it may still list the phosphorus content, which is mostly organic phosphorus that is only 80% absorbed by the body.
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Dialysis type and dietary restrictions
For patients with kidney disease, dietary restrictions are an important part of their treatment plan. These restrictions can vary depending on the type of dialysis and the stage of kidney disease. Here are some key considerations for dialysis types and their associated dietary restrictions:
Hemodialysis
Hemodialysis is the most common type of dialysis, and it involves filtering the blood to remove excess fluid and waste products. Patients on hemodialysis typically need to restrict their fluid intake, and this restriction can range from one to two litres or more per day, depending on their urine output. It is important for patients to monitor their weight and watch for swelling, as sudden weight gain can indicate excess fluid consumption. Additionally, a well-balanced diet with limited sodium, potassium, and phosphorus is recommended.
Peritoneal Dialysis
Peritoneal dialysis is another effective option for patients. While it does not require the same level of fluid restriction as hemodialysis, those undergoing peritoneal dialysis still need to limit their phosphorus intake. Patients on this type of dialysis should also be mindful of their protein intake, as it can impact their phosphorus levels.
CKD Diet
For patients with chronic kidney disease (CKD), a renal or kidney-friendly diet is often recommended. This typically involves limiting sodium intake to under 2,300 milligrams per day and reducing potassium and phosphorus intake. Cheese, for example, is often restricted or limited due to its high phosphorus, potassium, and sodium content. However, some cheeses are more kidney-friendly, such as goat cheese, ricotta, and Swiss cheese.
Late-Stage CKD
In the later stages of CKD, dietary needs may change. Patients on dialysis may need to eat more, especially protein-rich foods. It is important to monitor blood sugar levels, as the fluid used in dialysis contains glucose, which can affect these levels. Fluid buildup is also a concern, so limiting fluid intake between treatments is crucial.
It is important to note that individual needs may vary, and patients should consult with their healthcare team and dietitians to determine the most suitable diet for their specific condition and treatment plan.
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Recommended daily intake of sodium
For dialysis patients, it is important to limit the intake of sodium, potassium, and phosphorus. This is because the kidneys cannot adequately remove these minerals, leading to a risk of elevated blood levels. A renal or kidney-friendly diet usually limits sodium to under 2300 milligrams (mg) per day. However, some sources suggest that for individuals with kidney disease, a lower limit of 1500 mg may be more appropriate to maintain healthy blood pressure.
According to the National Kidney Foundation, the recommended sodium intake for CKD is 2300 mg per day. However, it is important to note that this may vary depending on the individual and their specific health needs. It is always best to consult with a healthcare professional or dietitian to determine the appropriate intake for your particular situation.
Dialysis patients should be cautious when consuming cheese, as many varieties are high in sodium, phosphorus, and potassium. However, some cheeses are more kidney-friendly and can be incorporated into the diet in moderation. These include low-sodium options such as ricotta, cottage cheese without added salt, and Swiss cheese. Goat cheese, grated parmesan, mozzarella, Monterey Jack, and Brie are also good options as they are low in phosphorus.
When following a kidney-friendly diet, it is important to read labels and look for ingredients containing "phos," which indicates added phosphorus. It is also recommended to choose low-sodium cheese options and consider the protein content, especially if protein intake needs to be limited. In addition to cheese, there are other sources of hidden sodium that patients should be aware of. For example, poultry products are often soaked in a saltwater solution, resulting in higher sodium content.
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Kidney-friendly superfoods
While cheese is generally a good source of calcium, protein, vitamin B12, and vitamin A, many varieties are high in phosphorus, sodium, and potassium. This means that people with kidney disease should be mindful of their cheese intake, as the kidneys may struggle to process these nutrients, leading to a buildup of chemicals in the blood. However, some cheeses are more kidney-friendly than others, and those with kidney disease can still enjoy cheese in moderation.
Low-Phosphorus Cheeses
Goat cheese, grated parmesan, mozzarella, Monterey Jack, Swiss cheese, and Brie are all lower in phosphorus. Cream cheese, ricotta, and cottage cheese are also good options, as they are lower in sodium.
Egg Whites
Egg whites are a kidney-friendly source of protein that is low in phosphorus. They may be a preferable option for those on a renal diet compared to whole eggs.
Garlic
Garlic is a tasty, nutritious alternative to salt, adding flavor to dishes while providing manganese and vitamin B6. It also contains sulfur compounds with anti-inflammatory properties.
Buckwheat
Buckwheat is a whole grain that is low in potassium and gluten-free. It provides B vitamins, magnesium, iron, and fiber.
Olive Oil
Olive oil is a healthy source of vitamin E and unsaturated fat. It is phosphorus-free, making it suitable for those with kidney disease.
Arugula
Arugula is a flavorful green vegetable that is low in potassium. It provides vitamin K, manganese, and calcium, all essential for bone health.
Red Bell Peppers
Red bell peppers are another tasty, low-potassium vegetable option. They are rich in vitamins C, A, and B6, as well as folic acid and fiber. They also contain lycopene, an antioxidant that helps protect against certain cancers.
Cabbage
Cabbage is an affordable addition to the kidney diet, as it is low in potassium and high in vitamin K, vitamin C, fiber, vitamin B6, and folic acid. It can be prepared in a variety of ways, such as raw in coleslaw or steamed, microwaved, or boiled as a side dish.
Blueberries
Blueberries are full of phytonutrients and are less acidic than other citrus fruits. They can help with age-related conditions like dementia and Alzheimer's. In general, berries are high in antioxidants, which play a role in preventing the development of cancerous cells.
It is important to remember that dietary needs may vary depending on the stage of kidney disease and the type of dialysis. Always consult with a healthcare professional or a kidney dietitian for personalized advice and to ensure that any dietary changes are safe and appropriate for your specific needs.
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Natural vs processed cheese
For dialysis patients, the amount and type of cheese that can be consumed depend on the stage of kidney disease and the type of dialysis. It is important to monitor the intake of sodium, potassium, and phosphorus. Phosphorus additives are usually found in processed cheese sauce, canned spray cheese, pasteurized cheese products, and processed American cheese. Therefore, processed cheese often contains higher levels of phosphorus.
Natural cheese, on the other hand, does not typically contain added phosphorus. However, it is still important to monitor the phosphorus content in natural cheese, as dairy products tend to be high in phosphorus. Some natural cheeses that are lower in phosphorus include goat cheese, grated parmesan, mozzarella, Monterey Jack, Swiss cheese, and Brie. These natural cheeses can be safely incorporated into the diet of dialysis patients who need to monitor their phosphorus intake.
In addition to phosphorus content, it is also important for dialysis patients to consider the sodium and protein content of cheese. Processed cheese often contains higher levels of sodium and added ingredients that may increase the overall sodium content. Natural cheese may offer lower sodium options, such as ricotta and cottage cheese without added salt.
Regarding protein, both natural and processed cheese can be high in protein. However, natural cheese may offer a wider range of options in terms of fat content, allowing dialysis patients to choose lower-fat versions if needed.
In summary, for dialysis patients who need to monitor their phosphorus, sodium, and protein intake, natural cheese may be a better option than processed cheese. Natural cheese tends to have lower phosphorus and sodium levels and offers more flexibility in terms of fat and protein content. However, it is important to note that individual needs may vary, and it is always recommended to consult with a healthcare professional or a kidney dietitian for personalized advice.
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Frequently asked questions
Cheese is often limited in the renal diet due to its high phosphorus and sodium content. However, it can be incorporated into the diet in moderation, especially with the help of a dietitian.
Natural cheeses like mozzarella, cheddar, and Swiss are better options than processed cheeses like American cheese or cheez-whiz. Cream cheese, goat cheese, ricotta, and parmesan are also good options as they are lower in phosphorus, sodium, and/or potassium.
Yes, blue cheese and Brie are high in sodium and phosphorus, respectively, and should be avoided or limited. Processed cheese sauces, canned spray cheese, pasteurized cheese products, and processed American cheese often contain added phosphorus.
The amount of cheese allowed depends on the individual's specific needs and the type of dialysis they are receiving. A general guideline for cheese serving size is one ounce.
Plant-based proteins like nuts and beans are recommended over animal-based proteins for kidney patients. Peanut butter is also a good source of plant-based protein and is low in carbohydrates, but it should be consumed in moderation due to its oxalate content.
