When you have chronic kidney disease (CKD), you need to make changes in your diet. Sometimes these changes may make it more difficult for you to get enough calories to have enough energy each day. You may also need to gain weight so that you can stay healthy. This fact sheet will explain what you can do to make sure you get enough calories from your diet while still eating healthy.
What are calories?
Calories are the energy that comes from the food you eat each day. You need to eat enough calories to maintain your weight and level of energy. Calories in your food come from carbohydrates (sugars and starches), protein and fat.
Do I need more calories now that I have kidney disease?
You may need to increase your calories each day for the following reasons:
- A diet for CKD limits foods from some food groups. You may eat fewer calories because you must omit these foods.
- Some days you may not feel like eating your usual meals. This can gradually lead to weight loss.
- You may be underweight or have lost weight recently because of your kidney disease.
- Your body needs more calories if you are on dialysis.
What can I do to gain weight and increase calories?
It is important to eat the amount of food that your dietitian has recommended. If you are still losing weight, ask your dietitian how to increase your food choices and come up with a meal plan to help you gain weight and increase calories.
Eating 4 to 6 small meals during the day or 3 meals with 2-3 snacks may also be helpful. Exercise has been shown to help with increasing appetite and calorie intake as well. Talk with your healthcare team about starting an exercise program.
Do I need to worry about potassium, sodium or phosphorus in free foods?
Fats and simple sugars are considered free foods and contain only small amounts of potassium, sodium or phosphorus when used in the amounts listed to eat.
What if I have diabetes?
If you have diabetes and need to gain weight, it may be best for you to increase your calories from starches and vegetable fats. You may be able to eat some simple sugars, but talk with your dietitian before adding these foods. Your dietitian will help adjust your diet to meet your caloric needs.
What should I do if I am losing weight without trying?
If you continue to lose weight discuss your diet with your dietitian. You may need to increase your portions or include more free foods. There may also be other reasons for your weight loss, which you should discuss with your doctor. You can also ask your doctor about medicine that can help with increasing appetite.
Your dietitian may also recommend a special nutrition supplement that is not a free food. These supplements provide extra calories and protein and are usually used for a short time.
What if I have high cholesterol?
Select vegetable fats that are low in saturated fat, such as olive oil, canola oil, soft margarine and mayonnaise. Talk with your dietitian about how to choose the best lean cuts of meat. Some examples are chicken, turkey, fish, pork tenderloin and eye of round beef. It is important to remove all the visible fat from meat and skin from poultry and to use only vegetable oils and fats in the cooking.
Egg yolks have large amounts of cholesterol but can be eaten a few times per week. Egg whites have no fat and are a very good source of protein. Speak with your dietitian about using these foods in your diet
How long do I need to increase the calories in my diet?
You need to increase your calories until you can reach your normal healthy weight. This takes time, so be patient. Include free foods every day in addition to meats, vegetables, fruits, grains and breads. Dairy products can be allowed in small amounts. Your CKD dietitian will help you adjust your calories as your weight increases.
How can I use free foods in my diet?
Here are some tips for using these foods in your diet:
- Use honey or sugar on cereal and in beverages.
- Use syrup on pancakes, French toast, waffles and hot cereal.
- Eat candies such as gum drops, hard candy and lollipops at the end of a meal or as a snack.
- Use honey, jelly, jam, margarine or cream cheese on toast, bread, rolls and crackers.
- Instead of plain water, drink beverages that have calories.
- Add margarine to rice, hot cereal, noodles, vegetables and bread.
How can I add high-calorie foods to my diet?
Your dietitian will help you decide which high-calorie foods are best for you. Some general suggestions follow:
- Add sour cream, cream cheese or creamy sauces to eggs, noodles, rice and vegetables.
- Add low-salt dressings to salads.
- Dip vegetables in creamy or oil-based dressings.
- Add low-salt gravies to meats
- Instead of milk, use half and half, cream, or non-dairy creamer
- Eat desserts that are low in potassium, sodium and phosphorus, such as croissants, sweet rolls, plain wafer cookies, Rice Krispie® treats, cobbler or pie made with allowed fruits, and puddings made with non-dairy creamer, half and half or cream.
Some of these foods are high in saturated fat, which could raise your cholesterol. Discuss how to use them with your dietitian..
How many calories are in free foods?
Remember, these foods are not harmful to use because they leave few waste products in your blood. Talk with your dietitian before using them if you have diabetes or high cholesterol.
Each serving of the following foods has about 100 calories:
|Clear Soda||6 ounces|
|Kool-Aid (with sugar)||8 ounces|
|Fruit Ice, sorbet||4 ounces|
|Liquid non-dairy creamer||5 tablespoons|
|Vegetable oil||1 tablespoon|
|Hard candy||5 pieces|
|Candy corn||2 tablespoons or 1 ounce|
|Gum drops||3 large pieces|
|Jelly beans||15 pieces|
|Sugar, honey, syrup||2 tablespoons|
|Maple sugar||2 tablespoons|
|Jam, jelly, marmalade||2 tablespoons|
|Glucose polymer powder||4 tablespoons|
|Whipped topping (non-dairy)||8 tablespoons|
How many calories are in high calorie foods?
Each serving of these high calorie foods contains about 100 calories. Remember these foods contain some phosphorus and saturated fat and may need to be used in limited amounts. Talk with your dietitian before using them if you have high cholesterol./p>
|Cream cheese (1 ounce)||2 tablespoons|
|Sour cream||4 tablespoons|
|Half and half||5 tablespoons|
|Table cream||4 tablespoons|
|Whipping cream||2 tablespoons|
What if I have more questions?
If you have other questions, you should speak to your healthcare professional or dietitian. The dietitian can help you with a meal plan that will provide enough calories to help you gain weight or keep from losing weight.
If you would like more information, please contact us.
Reviewed by the Council on Renal Nutrition: April 2019
© 2019 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.