Calories: A Guide to Adding or Limiting Them on the Kidney Diet

By DaVita® Dietitian Linda M. Harvey

If you have Stage 3 or 4 chronic kidney disease (CKD), your nephrologist (kidney doctor) may advise you to make some changes in your diet. If you are not at a healthy weight, the doctor may suggest that you either gain or lose a few pounds, depending on your condition. Maintaining a healthy weight can help people with kidney disease control and prevent more health problems. When excess weight is lost, blood pressure and blood sugar usually improve. This may delay or prevent more kidney damage. When people need to add calories to their diet, they can halt malnourishment and muscle loss and can gain more energy for everyday activities.

When making changes in diet or lifestyle, studies have shown that changing only one or two things at a time works best. Then, when they become habits, more changes can be made.

Calories give us energy from the food we eat. There are calories in most foods, but there are higher amounts in fast or fried foods, desserts, and snacks like donuts, chips and sodas.

Limiting calories on the kidney diet

Here are some guidelines to help limit calories:

  • “Eat like a king at breakfast, a prince at lunch and a pauper at supper.”
  • Eat more fresh fruits and vegetables.
  • Eat a salad every day.
  • Use low fat or fat free dressings.
  • Have unbuttered popcorn instead of snack chips.
  • Eat regular meals and snacks if you need them, to control cravings.
  • Omit juices and sodas.
  • Don’t eat after 8:00 p.m.
  • Use a smaller plate for your meals.
  • Share a meal when eating in a restaurant.
  • Eat only when you are hungry, not out of boredom.
  • Increase your activity level to help burn calories.

Reading labels helps. Look for these key words for foods that are lower in calories:

  • baked
  • broiled
  • grilled
  • in its own juice
  • non-fat or low fat
  • lean
  • marinara
  • poached
  • roasted
  • steamed
  • stir-fried

Adding calories on the kidney diet

On the other hand, if you need to gain weight, your doctor and dietitian may recommend that you:

  • Use “good” fats liberally.
  • Sauté foods in canola or olive oil.
  • Add low-salt dressings to salads and vegetables.
  • Add homemade low-salt gravies to meats.
  • Include two or three snacks in addition to meals.
  • Drink beverages that contain calories.
  • Combine cream cheese with mayonnaise and herbs and use as a vegetable dip.
  • Spread cream cheese on crackers and top with jam or jelly.
  • Use whipped cream or whipped topping on fruits and desserts.
  • Treat yourself to a high-calorie dessert each day if you don’t have diabetes.

Below are cooking descriptions that are usually higher in calories:

  • basted
  • buttered
  • crispy
  • fried
  • in gravy
  • pan-fried
  • sautéed
  • smothered

Ask your dietitian about the kidney-friendly ways you can add calories to your diet. For instance, gravy may be high in calories but the commercial kind is high in sodium. Your dietitian may recommend a kidney-friendly nutrition drink or bar to help provide extra calories.

Kidney diet recipes

There are many recipes on for you to try. These recipes are all good for kidney diets, and they are coded for carbohydrate control, and renal and renal diabetic food choices. The Chicken Fruit Salad recipe is my personal favorite. Here are a few more recipe suggestions:


Limiting or adding calories when you’re on the kidney diet can be challenging. But by using this guide, you can make the proper decisions for your kidney diet prescription. Your dietitian can also help you map out the number of calories you need per day so you can maintain a healthy diet with kidney disease.