Mayo Clinic Health Library

Question

Renal diet for vegetarians: Which protein sources are best?

I have end-stage kidney failure. I'm not on dialysis, but I do follow a special renal diet and I'm a vegetarian. What are the best sources of protein for someone like me who must also limit phosphorus and potassium?

Updated: 04-02-2013

Answer

The answer depends on what type of vegetarian you are. It also depends on your level of kidney function and how restrictive you need to be with protein, phosphorus and potassium.

Your kidneys are responsible for preventing too much potassium and phosphorus from building up in your blood. So it's important to have the right amount of potassium and phosphorus in your diet to avoid overwhelming your kidneys' ability to maintain healthy levels.

A proper renal diet is an essential part of any treatment plan for chronic kidney disease. Although a renal diet limits protein, you still need to eat some high-quality protein every day.

A vegetarian renal diet requires a specially tailored meal plan from a registered dietitian because vegetarian sources of protein also contain varying amounts of potassium and phosphorus. Your dietitian can help you choose the right foods in the right amounts.

Here's some basic information on:

  • Phosphorus. In general, dairy foods are the main sources of phosphorus in the diet. So by limiting or avoiding dairy products, you may be able to control blood-phosphorus levels. You can make up for dairy products by choosing unenriched rice milk and yogurt made from rice-based products. Be sure to avoid enriched products because they typically have added phosphorus.
  • Potassium. The majority of potassium comes from fruits, vegetables and dairy products. So by limiting the dairy in your diet and keeping the amount of fruits and vegetables in check — and choosing ones that are lower in potassium — you can control blood-potassium levels.
  • Protein. In the chart below, you'll find some examples of protein sources, but follow your dietitian's recommendations.

Just as importantly, your meal plan should also include guidelines for other food groups, such as grains, fats and sweets. A meal plan from a registered dietitian will help you meet your needs for calories and other important nutrients.

Type of vegetarian dietProtein sources for renal diet
Vegan — allows only plant-based foods
  • Soy protein (tofu, tempeh,natto)
  • Wheat protein (seitan)
  • Mycoprotein (Quorn)
  • Nut butters (up to 2 tablespoons — about 28 grams — a day)
  • Soy milk
  • Soy yogurt
  • Dried, cooked beans and peas
  • Unsalted nuts
Lacto-vegetarian — allows plant-based foods, milk, dairy products Foods listed above plus:
  • Low-sodium or reduced-sodium cottage cheese
Lacto-ovo vegetarian — allows plant-based foods, milk, dairy products, eggs Foods listed above plus:
  • Eggs
Pescatarian — allows plant-based foods and fish, but may or may not include milk, dairy products, eggs Foods listed above plus:
  • Fish, such as salmon or tuna
  • Shellfish, such as clams, crabs, lobster or shrimp
Flexitarian (semivegetarian) — primarily follows a plant-based diet, but occasionally eats small amounts of meat, fish, poultry, milk, dairy products, eggs Foods listed above plus:
  • Chicken
  • Turkey
  • Lean red meat
Note: If you need to restrict sodium, avoid smoked fish, chicken and turkey, which are high in sodium. Look for unsalted varieties of canned tuna, salmon, chicken or turkey. Fresh poultry may be injected with sodium, so look for "natural" on the label, which indicates no added sodium. Always check product labels for sodium content — for example, ready-to eat foods, canned beans, vegan meats, and soy- and rice-based cheeses may be high in sodium.

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