In the advanced stages of chronic kidney disease, your treatment team may recommend further restrictions. At this point, or if you feel unsure about your diet, a specialized dietician will help you to find a diet that is right for you. We have put together an overview of the various specific topics to give you an idea in advance of what the possible adjustments may mean in everyday life.

But please remember: with the exception of salt, there is no point in restricting your diet as a preventative measure, and you could run the risk of malnutrition

Protein is an important nutrient for muscle maintenance. However, in the case of kidney disease, care should be taken to ensure a balanced protein intake, as too much protein can favour the progression of the disease. A healthy balance is therefore required to support your muscles but not put additional strain on your kidneys. Make sure you eat protein regularly, but avoid eating too much at once (protein excess).

It is also recommended to alternate between plant-based protein (such as lentils, beans, tofu or tempeh) and animal protein (meat, fish, eggs and dairy products). Nutritionists can discuss your individual protein requirements with you. Further information on proteins can be found in the Swiss food pyramid.

When kidney function is already severely impaired, the two micronutrients phosphate and potassium can no longer be excreted sufficiently in the urine. If this is the case, the diet should be adjusted accordingly. Your treatment team will inform you in good time whether you need to follow a diet low in phosphate and/or potassium.

It is important to know that preventive restrictions on potassium and phosphate do not bring any positive benefits.

Therefore, do not restrict your phosphate and potassium intake until you have been advised to do so by a specialist.

Phosphate is one of the main components of the skeleton. High phosphate levels in the blood do not produce symptoms, but over the long term cause bone disease (renal osteodystrophy) and calcification of the blood vessels. Phosphate occurs naturally in all animal foods, whole meal cereals, cocoa and nuts. However, this does not mean that you should avoid these foods. If you avoid these foods you could become deficient in various micro- and macronutrients. However, artificial phosphate supplements should be avoided as they are absorbed by the body twice as fast as naturally occurring phosphate. Artificial phosphate additives can be found in sausage products, processed cheese, ready meals and cola drinks (including the light or zero versions).

You should therefore check these products for phosphate-containing additives in the list of ingredients.

The following E-numbers and names stand for phosphate additives and are authorized in Switzerland:

Note: some organic products do not contain phosphate additives. Check the list of ingredients for a suitable alternative.

Potassium is important for muscle activity and the transmission of nerve impulses If the kidneys are functioning well or kidney disease is not yet advanced, a potassium-rich diet is beneficial for blood pressure and the kidneys. In advanced kidney disease, however, the kidneys can no longer excrete enough potassium and the potassium content in the blood rises. In addition, specific medications and hyperacidity of the blood can further increase the potassium content. An excess of potassium in the blood is dangerous as it has an inhibitory or paralysing effect on the muscles and can disrupt normal heart rhythms.

Potatoes, vegetables, fruit (especially dried fruit, fruit and vegetable juices), mushrooms, nuts, pulses, chocolate and cocoa, milk and yoghurt as well as some ready-made products are rich in potassium. You do not have to give up these products completely, even if you have advanced kidney disease. If your potassium levels are high, avoid concentrated foods such as dried fruit or fruit and vegetable juices. Choose either salad or vegetables for your meals, but do not eat both.

However, please do not limit your potassium consumption without a recommendation from your treatment team. With a low potassium diet, the guideline for fruit and vegetable consumption is 3 portions of vegetables/salad or fruit per day. One portion = 1 handful, e.g. 1 apple, 2-3 apricots, a handful of berries.

Potassium is also water-soluble. This means that you can partially reduce the potassium content of foods by cooking them. Peel and cut potassium-containing foods into small pieces, soak or cook them in plenty of fresh water and then pour the (cooking) water away.

Medication support can help to reduce phosphate and potassium intake and is sometimes also used for dialysis patients (see Phosphate and potassium-reduced diet for dialysed patients). If such support seems useful, you can discuss this with your treatment team and your doctor may prescribe appropriate treatment.