Kidney-Friendly Foods from Pennsylvania

“Virtue, liberty, independence.” That is Pennsylvania’s motto, and it’s lived up to it by being an important place in American history and one where diversity is plentiful. The City of Brotherly Love (Philadelphia), The Sweetest Place on Earth® (Hershey), the Steel City (Pittsburgh) and Pennsylvania Dutch Country (Lancaster County) are just some of the areas that make Pennsylvania culturally rich and a great travel destination. Just ask the more than 12.6 million people who call this state home.

The Keystone State played an integral part in the formative years of the United States. In the late 1600s, English settler William Penn envisioned a colony of religious tolerance, participatory government and of course, brotherly love. After the Declaration of Independence was signed a century later, the state’s town of York was for a time the capital of the new nation. When the Civil War broke out in the 1800s, Pennsylvania was a place of freedom for Southern slaves. The Underground Railroad made its way up to Pennsylvania as well as to other free states and into Canada. After the Battle of Gettysburg was fought in Pennsylvania, President Abraham Lincoln declared the United States’ “new birth of freedom” in his Gettysburg Address in 1863.

Flash forward to today and you’ll find a large European influence in the state, including Italian, German, English, Irish, Polish, Croatian, Ukrainian and Hungarian backgrounds, all melting into something that’s become uniquely Pennsylvanian. Even the landscape is diverse. Take in the vast views of the Pennsylvanian countryside. You’re bound to come across a mountain laurel (the state flower) or hemlock (the state tree). For those seeking pleasure in rural areas, Punxsutawney is the cozy town that famously hails groundhog “Punxsutawney Phil” as its official weatherman every year on Feb. 2. According to tradition, if Phil sees his shadow, the U.S. has six more weeks of winter, and if he doesn’t, spring will come early. It’s a fun celebration filled with food and music.

For people seeking a big city experience, look no farther than Philadelphia and Pittsburgh, the two best-known cities in this northeastern state. See the Liberty Bell and Betsy Ross’ original American flag, or go on a walking tour of Pittsburgh’s Allegheny West historical neighborhood. From museums and professional sporting events to shopping centers and restaurants, visitors and residents alike can stay busy exploring these great urban areas. Located in the center of the state is the capitol city of Harrisburg, which also boasts many entertainment venues, dining experiences and historical buildings that will transport you back in time.

From spring well into summer, enjoy the music and arts festivals all around the state, including the Bloomsburg County Fair, The Rittenhouse Row Spring Festival, The Gettysburg Festival, The Carlisle Bike Fest and Pittsburgh International Children’s Festival.

The more adventurous traveler can explore the numerous hiking trails of the Poconos. Whitewater rafting, fishing, mountain biking, horseback riding, golfing and skiing are only some of the activities Pennsylvania’s recreation areas have to offer. Whatever the season, this state has a sport for it.

All those activities can build up an appetite, and if it’s one thing Pennsylvanians take pleasure in, it’s a good meal. In a place that enjoys milk as its state beverage (perhaps to wash down some Hershey’s milk chocolate or a warm potato dish), it may be difficult for kidney disease and dialysis patients to enjoy Pennsylvania food staples. But you can make at home.

“The cuisine of Pennsylvania is a mosaic of flavors and cultures that is as diverse as its citizens,” says Anne. “It is not uncommon to experience foods from several European regions served together nearly 140 years after the first waves of immigration began. The recipes we’ve included are just a splash of the flavors brought to this region and are favorites of the dietitians in Pennsylvania.”

Although recipes can be modified for dialysis patients, Jean from Johnstown says it can sometimes be difficult to get her patients to change their eating habits. “Encouraging patients to get their labs within the desired levels and then keeping them on track with the diet, while enjoying their food and trying to keep it interesting, can be challenging,” she says. “Traditional regional recipes either have cheese or tomato sauce, and every meal has potatoes as a staple item.” Because of the high potassium and phosphorus content in dairy products, tomatoes and potatoes, these foods are usually limited for people on the kidney diet. So it’s no surprise that a Philly cheesesteak is not very kidney-friendly!

But Jean is pleased to report that many of her patients have overcome such obstacles: “A patient becomes attentive to our nutritional suggestions and they then apply it to their daily diet to improve their health.”

Cristin grapples with the challenge of helping kidney patients improve their phosphorus levels and fluid gains while still enjoying regional cuisine. To give her patients new and healthy recipe ideas, Cristin says she takes everyday favorites and makes them kidney-friendly.

According to Cindy, the most challenging aspect of the renal dietitian’s job is helping people find the balance that will keep their labs in healthy range. “I hate to say you can never eat a certain food. We work together to juggle intake so favorite foods, comfort foods and regional preferences can be included in the dialysis diet,” she says.

The most rewarding part of the job is seeing a patient’s energy level, lab values and outlook on life improve, says Cindy. “I try to remain positive even when circumstances are frustrating or when I’m not achieving the results I’d hoped,” she admits. “I take a deep breath, adopt a slightly different approach and move ahead.”

Cindy says it’s the diverse people of Pennsylvania that make her home state special. “We live in a community where our heritage is a primary focus, with many religious, regional, ethnic and familial influences,” she says. “I enjoy learning about my patients’ families and cultures, and I think patients have a wealth of knowledge that can enhance variety in the renal diet.”

Cindy also praises her teammates for helping make work so rewarding: “My DaVita unit is strong because of my teammates’ approach to patient care, service excellence and fun. Shared heritage is a key factor in our worksite becoming another family. Each season brings us new projects, and I love the change from one season to another in western Pennsylvania. A new season is almost like starting a new year!”

With a new season come new recipes to make for the kidney diet. The dietitians are proud to share the unique flavors of Pennsylvania while still keeping the daily intake within the kidney dietary guidelines. “There isn’t a cuisine on earth that is without need for modification to make it more kidney-friendly,” says Anne.

And that includes Pennsylvania cuisine — enjoy!

Pennsylvania menu for a dialysis diet 


  • 1 plain bagel with 1 tablespoon reduced-fat cream cheese
  • 2 teaspoons jam
  • 8 ounces coffee with 2 tablespoons nondairy creamer
  • 1 poached egg
  • Black pepper


  • 1 medium apple


  • 1-1/2 cup Italian Wedding Soup
  • Mrs. B’s Pierogies (3)
  • 1 slice Italian bread spread with 2 teaspoon olive oil, 1 teaspoon parmesan cheese, and a dash of garlic powder, toasted under the broiler until golden
  • 8 ounces clear soda or pop (In western Pennsylvania, clear soda is known as “pop” and in eastern Pennsylvania it is known as “soda.”)




  • 1/2 cup vanilla ice cream
  • 1/2 cup sliced strawberries

Pennsylvania menu nutritional analysis


Calories: 400
Protein: 16 g
Carbohydrate: 48 g
Fat: 16 g
Cholesterol: 244 mg
Sodium: 626 mg
Potassium: 192 mg
Phosphorus: 196 mg
Calcium: 53 mg
Fiber: 1.9 g
Fluid: 1 cup


Calories: 575
Protein: 28 g
Carbohydrate: 65 g
Fat: 21 g
Cholesterol: 104 mg
Sodium: 528 mg
Potassium: 484 mg
Phosphorus: 266 mg
Calcium: 110 mg
Fiber: 2.7 g
Fluid: 1 cup


Calories: 553
Protein: 31 g
Carbohydrate: 73 g
Fat: 15 g
Cholesterol: 123 mg
Sodium: 383 mg
Potassium: 892 mg
Phosphorus: 377 mg
Calcium: 85 mg
Fiber: 6 g
Fluid: 1 cup


Calories: 293
Protein: 5 g
Carbohydrate: 44 g
Fat: 10 g
Cholesterol: 41 mg
Sodium: 99 mg
Potassium: 330 mg
Phosphorus: 169 mg
Calcium: 142 mg
Fiber: 3.8 g
Fluid: 1/2 cup

Day Total

Calories: 1821
Protein: 80 g
Carbohydrate: 230 g
Fat: 62 g
Cholesterol: 512 mg
Sodium: 1636 mg
Potassium: 1898 mg
Phosphorus: 1008 mg
Calcium: 390 mg
Fiber: 14.4 g
Fluid: 3-1/2 cups

The above contains average nutrient values for menu portions. Your actual intake may vary based on portions and brand differences.

Your individual nutrient needs may be higher or lower than this sample menu. Always consult your dietitian and refer to your individualized meal plan to determine the amounts to eat.