Kidney disease often requires following a special diet that limits certain foods. For kidney patients, nuts may be a food to enjoy in moderation. Some nuts have more phosphorus, potassium, or sodium than recommended on a renal diet, while others can be kidney-friendly. Understanding which nuts are better choices can help kidney patients incorporate these nutritional powerhouses into their diet.
Can kidney patients eat nuts?
Yes, most nuts can be part of a kidney-friendly diet in moderation. Nuts are packed with nutrition like protein, healthy fats, fiber, vitamins, and minerals. They also contain phytonutrients that act as antioxidants to fight cell damage. Eating nuts may even help reduce inflammation and lower cholesterol.
However, some nuts are higher in phosphorus, potassium, and sodium than others. Kidney patients likely need to limit nuts high in these minerals. Always check with a doctor or renal dietitian before adding nuts to the diet.
Best nuts for kidney patients
Some great nut choices for those with kidney disease include:
Almonds – Almonds are lower in phosphorus than many other nuts, with only about 100 mg phosphorus per ounce. They offer calcium, vitamin E, and protein. Limit to a 1-2 ounce serving.
Cashews – Cashews contain magnesium, zinc, and antioxidants. An ounce has roughly 150 mg phosphorus, so enjoy a 1 ounce serving.
Pistachios – Pistachios offer protein, fiber, and nutrients like thiamine, copper, and manganese. One ounce has about 125 mg phosphorus.
Walnuts – Walnuts provide omega-3 fatty acids, magnesium, folate, and antioxidants. They are relatively low in phosphorus, with 1 ounce containing about 100 mg.
Pecans – Pecans have antioxidants like vitamin E along with healthy fats. Just 1 ounce contains under 100 mg phosphorus.
Peanuts – Peanuts are technically legumes but have a similar nutrition profile to nuts. They are high in protein, fiber, magnesium, and vitamin E. Limit to a 1-2 ounce serving.
Pine nuts – Pine nuts contain iron, magnesium, zinc and some B vitamins. One ounce has around 150 mg phosphorus.
Nuts to avoid or limit for kidney patients
Some nuts may need to be limited or avoided on a renal diet. Nuts highest in phosphorus, potassium, or sodium include:
Brazil nuts – Very high in phosphorus at over 250 mg per ounce. Should be avoided.
Almonds – High in phosphorus at about 200 mg per ounce. Limit to 1-2 nuts.
Cashews – About 150 mg phosphorus per ounce. Stick to a 1 ounce serving.
Pistachios – Roughly 125 mg phosphorus per ounce. Enjoy 1-2 ounces at most.
Walnuts – Lower in phosphorus but high in potassium at 125 mg per ounce.
Pecans – About 100 mg phosphorus per ounce but also high in sodium.
Macadamia nuts – Higher in phosphorus at over 150 mg per ounce. Eat just a few.
Health benefits of nuts for kidney patients
Adding kidney-friendly nuts into the diet offers many benefits for those with chronic kidney disease or on dialysis. Some top benefits include:
Protein – Nuts provide plant-based protein needed to maintain muscle mass. This helps combat protein energy wasting in kidney disease.
Fiber – The fiber in nuts helps manage blood sugar and cholesterol levels. Fiber also promotes bowel regularity.
Nutrients – Nuts contain a variety of vitamins, minerals, antioxidants and phytonutrients to help fight disease.
Fatty acids – Nuts have monounsaturated and omega-3 fats that are heart-healthy and anti-inflammatory.
Blood pressure – Eating nuts may help lower blood pressure in those with hypertension.
Blood sugar – Despite their fat, nuts do not raise blood sugar and may even improve insulin sensitivity.
Inflammation – Nutrients in nuts have anti-inflammatory effects to help manage chronic inflammation common in kidney disease.
Cholesterol – The plant sterols in nuts can help lower LDL or “bad” cholesterol.
Portion size for nuts with kidney failure
It’s important to watch portion sizes for nuts when following a renal diet. The recommended serving size is usually 1-2 ounces of nuts per day. This equals:
– 24 almonds
– 18 cashews
– 30 pistachios
– 14 walnut halves
– 20 pecan halves
– 20 peanuts
– 2 tablespoons of nut butter
Weighing nuts on a food scale or measuring with cup measures can help control portions. Only take a pre-portioned serving to avoid overeating nuts.
Those on dialysis may be able to eat more nuts since dialysis removes excess phosphorus, potassium, and sodium. Check with your dietitian.
Soaking and blanching nuts to remove phosphorus
To further reduce the phosphorus content of nuts, consider soaking and blanching before eating them. Here is the process:
1. Soak nuts in water for 8-12 hours before eating
2. Drain and rinse soaked nuts
3. Boil nuts in water for about 1 minute
4. Drain and blot dry with paper towels
5. Roast nuts in oven at low heat if desired
This process can remove 15-50% of phosphorus from nuts. Blanching also helps reduce phytic acid content in nuts that can hinder mineral absorption.
Best ways to eat nuts on a renal diet
Here are some simple, tasty ways to enjoy nuts on a kidney diet:
– Sprinkle chopped nuts onto a salad.
– Use nut butter instead of mayo or cheese in a sandwich.
– Add slivered nuts to cooked grains like oatmeal or quinoa.
– Mix nuts into Greek yogurt with fruit for a parfait.
– Make homemade trail mix with allowed nuts and seeds.
– Bake with nut flours or meals in kidney-friendly recipes.
– Add a sprinkle of chopped nuts onto fish, poultry or vegetables.
– Make homemade granola bars or energy bites with allowed nuts.
– Use nut milk instead of dairy milk.
– Roast or toast nuts to enhance their flavor before eating.
Kidney-friendly recipes with nuts
These recipes include nuts that tend to be lower in phosphorus, potassium and sodium:
Almond crusted chicken – Chicken breasts coated with almond flour/meal and baked.
Curried cashew spinach salad – Baby spinach, diced mango, cashews, curry vinaigrette.
Pistachio cranberry quinoa – Cooked quinoa tossed with chopped pistachios, dried cranberries.
Waldorf salad – Chopped apples, celery, walnuts, lemon juice dressing.
Pecan crusted tilapia – Tilapia fillets coated with chopped pecans then baked.
Peanut chicken stir fry – Chicken and veggies sautéed in peanut oil with ginger and garlic.
Pine nut pesto – Make pesto with basil, pine nuts, garlic, olive oil to top chicken or fish.
Almond butter banana smoothie – Blend banana, almond butter, ice, and milk for a kidney-friendly shake.
Health risks of eating too many nuts with kidney disease
While nuts can be included on a renal diet, it’s important to keep portions small and limit high phosphorus nuts. Consuming too many nuts can put strain on the kidneys and raise levels of certain minerals to an unsafe range. Possible effects include:
Higher phosphorus – Excess phosphorus can leach calcium from bones and cause bone disease. It also deposits in soft tissues.
Increased potassium – Too much potassium can cause dangerous heart arrhythmias and serum levels must be closely managed.
Elevated sodium – Sodium increases fluid retention and raises blood pressure. Kidney patients are advised to limit added sodium.
Weight gain – Nuts are high in calories from fat and portions add up quickly. This can lead to weight gain.
Gastrointestinal issues – Too many nuts may cause nausea, bloating, or constipation in some individuals.
To prevent adverse effects, kidney patients should follow serving recommendations and choose nuts lower in problem minerals. Work closely with a renal dietitian when adding nuts to the diet.
Conclusion
Kidney patients need not avoid nuts completely. Enjoying small portions of certain nuts can fit into a renal diet and provide valuable nutrition. Focus on nuts like almonds, cashews, pistachios, and walnuts that are not too high in phosphorus, potassium, or sodium. Always soak and blanch nuts first to reduce phosphorus. Incorporate nuts in moderation along with other kidney-friendly foods to promote health for chronic kidney disease and dialysis patients.