Ann Haibeck, RD, LDN
High blood pressure and diet: What’s the connection?
Kidney patients often experience elevated blood pressure, also known as hypertension. Your doctor may prescribe medication to treat your blood pressure, but your food choices can be just as important as taking your medication. Salty and highly processed foods often provide more salt (sodium) than we need in our diets, which can increase blood pressure readings. High blood pressure can put excess stress on blood vessels, including those that lead to the kidneys and other vital organs.
The American Heart Association recommends eating no more than 2,300mg of sodium per day, with 1,500mg per day or less being ideal. The National Kidney Foundation recommends 2,500mg to 3,800 mg of sodium daily for patients on dialysis with high blood pressure, with a recommended upper limit of 5,000mg daily. As you can see, official sodium recommendations can vary widely, so it’s important to ask your healthcare providers how much sodium is appropriate for you to consume.
What Foods Have Sodium?
Table salt (sodium chloride) is a common source of sodium for kidney patients. Not adding salt to your food can reduce the amount of sodium that you consume. See the table for how much sodium is in different amounts of table salt.
Some Common Foods
Any food that is processed is likely to be high in sodium. This includes foods that are boxed, canned, or “ready-made,” including canned vegetables, crackers, cookies, deli meats, some breads, rice mixes, soup mixes, noodle mixes, and frozen meals. These foods list sodium on the nutrition facts label, and can still fit into a balanced diet; be mindful of portion sizes to moderate the amount of sodium you consume. Plain dry rice, noodles, and dried legumes tend to be lower in sodium.
What about Sea Salt?
By volume, sea salt and table salt have the same amount of sodium because sea salt granules are larger than table salt granules. However, by weight, sea salt and table salt actually have the same amount of sodium. Therefore, using sea salt instead of table salt will not necessarily reduce your sodium intake.
Can I Use Salt Substitutes?
Many salt substitutes simply replace sodium chloride with potassium chloride, which can give you extra potassium that you may not need in your diet. This can be harmful to some kidney patients. Read the ingredients label on any salt substitute or low-salt spice blend that you are interested in, and avoid those that contain potassium chloride. Try this DIY spice blend that is sodium-free!
Strategies to Reduce Sodium Intake
Home cooked meals from whole food ingredients will help you minimize sodium intake. Additionally, reading the Nutrition Facts label on food containers can guide you in choosing the lowest-sodium foods. Even “low sodium” or “reduced sodium” foods can contain significant amounts of sodium. A good rule of thumb is to choose foods with less than 200mg of sodium per serving. If you do choose canned beans or vegetables, rinse them with water before using them to remove some of the salt.
Special Considerations for People with CKD
When choosing fruits, vegetables, beans, and legumes as a low-salt part of your diet, remember that some items in these food categories can be high in potassium or phosphorus, which is not beneficial for kidney patients. Low potassium fruits include berries, apples, cherries, grapes, and pineapple. Low potassium vegetables include green beans, carrots, celery, romaine lettuce, and radishes. Low potassium legumes include chickpeas, fava beans, and lupin beans.
White rice, noodles, and breads tend to be lower in phosphorus and potassium compared with whole grain products, and therefore are better choices for people with chronic kidney disease.
Reducing your salt intake, eating fewer processed foods, and choosing more fresh and whole foods can help to lower your blood pressure and improve your overall health. Be mindful of your overall nutrient intake of phosphorus, potassium, and protein when making any changes to your diet. Always follow guidelines from your healthcare providers regarding the intake of these nutrients.
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