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Renal diet for vegetarians: Which protein sources are best?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/renal-diet/AN01465
- With Mayo Clinic urologist
Erik P. Castle, M.D.
read biographyclose windowBiography of
Erik P. Castle, M.D.
Erik P. Castle, M.D.
Dr. Erik Castle is a board-certified urologist who joined the Mayo Clinic staff in Arizona in 2007.
Dr. Castle is an associate professor of urology at College of Medicine, Mayo Clinic, and a senior associate consultant in the Department of Urology, where he also is assistant residency coordinator.
He was an assistant professor in the Department of Urology at Tulane University in New Orleans from 2004 to 2006 after serving as a clinical instructor/fellow at Mayo Clinic in Arizona for one year.
Dr. Castle's research interests include prostate cancer, bladder cancer and kidney cancer. He is the director of the Desert Mountain Prostate Cancer Research Fund and is the principal investigator of Castle labs housed at the Samuel C. Johnson Medical Research Building at Mayo Clinic in Arizona. His basic science research is focused on novel secondary hormonal therapies of prostate cancer as well as genomics of prostate and bladder cancers.
His surgical expertise includes laparoscopic urology, robot-assisted radical prostatectomy with nerve sparing, robot-assisted radical cystectomy with neobladder, robot-assisted retroperitoneal lymph node dissection, robot-assisted partial nephrectomy and other robotic urologic oncology procedures. He has performed many of these procedures as demonstrations internationally. He is a member of the American Association of Clinical Urologists, the American Urological Association, the Endourological Society, and the Society of Laparoendoscopic Surgeons. He is past president of the international Society of Urologic Robotic Surgery. He is also the director of the international laparoscopic nephrectomy courses throughout Mexico on behalf of the American Urologic Association.
Tests and diagnosis (1)
- MRI: Is gadolinium safe for people with kidney problems?
Treatments and drugs (2)
- Kidney dialysis: When is it time to stop?
- Kidney donation: Are there long-term risks?
Lifestyle and home remedies (1)
- Renal diet for vegetarians: Which protein sources are best?
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Question
Renal diet for vegetarians: Which protein sources are best?
I have end-stage kidney failure. I'm not on dialysis, but I do follow a special renal diet and I'm a vegetarian. What are the best sources of protein for someone like me who must also limit phosphorus and potassium?
Answer
from Erik P. Castle, M.D.
The answer depends on what type of vegetarian you are. It also depends on your level of kidney function and how restrictive you need to be with protein, phosphorus and potassium.
Your kidneys are responsible for preventing too much potassium and phosphorus from building up in your blood. So it's important to have the right amount of potassium and phosphorus in your diet to avoid overwhelming your kidneys' ability to maintain healthy levels.
A proper renal diet is an essential part of any treatment plan for chronic kidney disease. Although a renal diet limits protein, you still need to eat some high-quality protein every day.
A vegetarian renal diet requires a specially tailored meal plan from a registered dietitian because vegetarian sources of protein also contain varying amounts of potassium and phosphorus. Your dietitian can help you choose the right foods in the right amounts.
Here's some basic information on:
- Phosphorus. In general, dairy foods are the main sources of phosphorus in the diet. So by limiting or avoiding dairy products, you may be able to control blood-phosphorus levels. You can make up for dairy products by choosing unenriched rice milk and yogurt made from rice-based products. Be sure to avoid enriched products because they typically have added phosphorus.
- Potassium. The majority of potassium comes from fruits, vegetables and dairy products. So by limiting the dairy in your diet and keeping the amount of fruits and vegetables in check — and choosing ones that are lower in potassium — you can control blood-potassium levels.
- Protein. In the chart below, you'll find some examples of protein sources, but follow your dietitian's recommendations.
Just as importantly, your meal plan should also include guidelines for other food groups, such as grains, fats and sweets. A meal plan from a registered dietitian will help you meet your needs for calories and other important nutrients.
| Type of vegetarian diet | Protein sources for renal diet |
|---|---|
| Vegan — allows only plant-based foods |
|
| Lacto-vegetarian — allows plant-based foods, milk, dairy products | Foods listed above plus:
|
| Lacto-ovo vegetarian — allows plant-based foods, milk, dairy products, eggs | Foods listed above plus:
|
| Pescatarian — allows plant-based foods and fish, but may or may not include milk, dairy products, eggs | Foods listed above plus:
|
| Flexitarian (semivegetarian) — primarily follows a plant-based diet, but occasionally eats small amounts of meat, fish, poultry, milk, dairy products, eggs | Foods listed above plus:
|
| Note: If you need to restrict sodium, avoid smoked fish, chicken and turkey, which are high in sodium. Look for unsalted varieties of canned tuna, salmon, chicken or turkey. Fresh poultry may be injected with sodium, so look for "natural" on the label, which indicates no added sodium. Always check product labels for sodium content — for example, ready-to eat foods, canned beans, vegan meats, and soy- and rice-based cheeses may be high in sodium. | |
MRI: Is gadolinium safe for people with kidney problems?
- Nutrition and chronic kidney disease. National Kidney Foundation. http://www.kidney.org/atoz/content/nutrickd.cfm. Accessed March 15, 2013.
- Vegetarian diet. American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Vegetarian-Diets_UCM_306032_Article.jsp. Accessed March 15, 2013.
- Protein (g) content of selected foods per common measure, sorted by nutrient content. USDA National Nutrient Database. http://www.nal.usda.gov/fnic/foodcomp/Data/SR20/nutrlist/sr20w203.pdf. Accessed March 15, 2013.
- Menu selection for vegan renal patients. The Vegetarian Resource Group. http://www.vrg.org/journal/vj2009issue4/2009_issue4_vegan_renal_patients.php. Accessed March 15, 2013.
- Vegetarian diets in chronic kidney disease. Vegetarian Nutrition. http://vegetariannutrition.net/docs/Renal-Vegetarian-Nutrition.pdf. Accessed March 15, 2013.
- Healthy eating tips: Tips for vegetarians. U.S. Department of Agriculture (USDA). http://www.choosemyplate.gov/healthy-eating-tips/tips-for-vegetarian.html. Accessed March 15, 2013.
- Nutrition for later chronic kidney disease in adults. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/NutritionLateCKD/index.aspx. Accessed March 15, 2013.
- Gonyea JE (expert opinion). Mayo Clinic, Rochester, Minn. March 19, 2013.
- Nelson JK (expert opinion). Mayo Clinic, Rochester, Minn. March 26, 2013.
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