Chronic kidney disease (CKD) is a progressive condition where the kidneys lose their ability to filter waste and excess fluids from the body. There are five stages of CKD, and noticeable symptoms don’t generally start to show until stage 3.

In stage 3, adjusting your diet becomes essential to slow further kidney function decline and help manage symptoms. Your doctor may or may not suggest restricting certain foods or nutrients during this stage, and you will likely have many questions about which foods are ok to eat, in what amounts, and in what combinations.

Knowing what to eat during each stage of chronic kidney disease is one of the biggest challenges to people living with the condition. While your renal dietitian can help you craft customized meal plans for your tastes and needs, here are some general ideas for kidney-friendly meal plans for people with stage 3 CKD.

An eGFR between 30 and 59 defines stage 3 CKD. Some experts further divide stage 3 into subsets: 3a (45-59) and 3b (30-44), with eGFR numbers indicating your percentage of remaining kidney function. Mild symptoms may appear in stage 3a, and this is often when many people with CKD receive their diagnosis. In fact, this is the first stage at which a diagnosis can be confirmed with a blood test alone.

Discuss the best nutrition options for your specific case and stage with your renal dietician. Image from Shutterstock.

In stage 3, the kidneys still remove a moderate amount of excess fluid, potassium, and metabolic waste. The treatment goals during stage 3 are to slow the progression of CKD and preserve remaining kidney function. These goals can largely be achieved by managing:

• Blood pressure,
• Glucose, and
• Weight.

Your doctor may or may not recommend limiting certain foods or nutrients at this point, but they will likely:

• Monitor your calories. Adequate calories can either prevent weight loss if you’re at a desirable weight or provide extra calories if you are underweight.
• Suggest certain types of fats. If you have heart disease or high cholesterol, you should avoid saturated and trans-fats, which are abundant in fast and highly processed foods.
• Watch for fluid retention. If you develop high blood pressure, swelling in your hands or feet, sudden weight gain or shortness of breath, you may be retaining excess fluid that your kidneys are unable to flush. Your doctor may suggest restricting fluid intake.
• Monitor your sodium, phosphorus, potassium, and protein intake. Depending on your eGFR, you may need to start limiting your phosphorus, potassium, and protein intake, as your kidneys may not be able to process and eliminate excess, which can then build up in your blood. Too much sodium can also cause fluid retention, raise your blood pressure, and interfere with blood pressure medications. This is more likely to be the case in stage 3b.

It’s helpful to work with a registered renal dietitian, because as the stages of CKD change, so will your diet.

To help get you started, here are some generalized meal plan options for people with “mild” CKD, designed by registered dietitians. Your own doctor and dietitian can help you individualize your meal plans going forward.

Day 1

• Breakfast. Oatmeal with cinnamon, milk, raspberries, and a tablespoon (Tbsp) of sliced almonds.
• Lunch. Tortilla wrap with tinned salmon (rinsed). Season with lemon juice, black pepper, fresh dill, and green onion.
• Dinner. BBQ shrimp over rice, and frozen mixed vegetables with olive oil drizzle.
• Snacks. Fresh veggies with hummus or apple slices with plain (no sugar or salt) peanut butter.

Day 2

• Breakfast. Chia seed pudding made with almond or soy milk, berries, cinnamon, and vanilla extract.
• Lunch. Egg salad sandwich with a fresh green salad, simple olive oil and red wine vinegar dressing, and fresh mint.
• Dinner. Small portion of grilled steak with white rice and baked cauliflower, corn, carrots, and garlic.
• Snacks. Fresh veggies with hummus, or 5 ounces (oz) of Greek yogurt with fresh berries and cinnamon.

Day 3

• Breakfast. Oatmeal with milk, berries, and a dash of maple syrup. Add a boiled egg on the side for protein.
• Lunch. Leftover steak in a lettuce wrap with tomato and 1 Tbsp of shredded cheese. Fresh honeydew melon on the side.
• Dinner. Kidney bean burgers and a fresh green salad. Use condiments like ketchup, mustard, and mayo sparingly, as they are often high in salt, sugar, and potassium.
• Snacks. Fresh veggies with hummus, or fresh plums with a handful of cashews.

Day 4

• Breakfast. Egg omelet with bell peppers, broccoli, 1 Tbsp of shredded mozzarella, pinch of parsley, and 1 slice of rye bread.
• Lunch. Chickpea (garbanzo bean) soup with celery, red cabbage, carrot, onion, garlic, rosemary, and olive oil drizzle.
• Dinner. Pasta with extra lean ground beef, fresh tomatoes, garlic, onion, and parsley.
• Snacks. Fresh veggies with hummus, or clementines with a handful of cashews.

Day 5

• Breakfast. Sourdough toast, ¼ avocado (mashed), lemon juice, sliced hard-boiled egg, fresh tomato, and basil leaves.
• Lunch. Shredded kale, Brussels sprouts, almonds, raspberries, chicken breast, with olive oil and balsamic vinegar dressing. Garnish with fresh mint.
• Dinner. Air-fried salmon with a side of couscous and a salad of fresh greens.
• Snacks. Fresh veggies with hummus, or apple slices with natural plain peanut butter.

Day 6

• Breakfast. Egg omelet with asparagus, bell peppers, parsley, and 1 slice of rye toast.
• Lunch. Tuna salad with celery, olive oil, onions, and whole wheat English muffin.
• Dinner. Lentil stew with carrots, shredded cabbage, onion, fresh dill, and cherry tomatoes. Serve over rice (optional).
• Snacks. Grapes and walnuts, or 5 oz of plain Greek yogurt with blueberries.

Day 7

• Breakfast. Smoothie made with kale, plain almond butter, strawberries, and soy milk.
• Lunch. Curried chicken lettuce wraps with fresh cilantro and lemon, and a side of fruit.
• Dinner. Stir-fried shrimp with carrots, peas, and cauliflower. Serve over white rice and dress with sesame oil, grated ginger, and garlic.
• Snacks. Fresh veggies with hummus, or fresh pear slices with plain peanut butter.

Most people in stage 3 CKD can still eat a moderate amount of lean animal protein, though plant-based options are encouraged by many experts and supported by mounting research. Whole foods that are unprocessed or minimally-processed are important, particularly fresh fruits and vegetables. Check with your doctor and renal dietitian, however, to determine which ones are safest for you, and in what amounts. Check out alternative sample meal plans here, and more targeted meal plans here.