Evidence-Based Nutrient Recommendations

Kidney Disease


Vegetarian Diets and Prevention of Kidney Disease

A 2012 study on lacto-ovo vegetarians, without kidney disease, found the urine of vegetarians to have a 60% lower amount of two different sulfates that are thought to be toxic and are problematic for patients with kidney disease (Patel, 2012). The lower amounts were thought to be due to a combination of lower protein intake, higher fiber intake, and difference in bacteria in the digestive tract.

Vegetarian Diets for People with Kidney Disease

A 2017 review article addressed the pros and cons of plant-based diets for people with kidney disease (Gluba-Brzózka, 2017).

The National Kidney Foundation (NKF) recommends plant-based diets for people with chronic kidney disease (CKD). According to the NKF, “With careful planning, vegetarianism, or even part-time vegetarian eating, is not only safe, but also beneficial to kidney disease patients” (NKF, 2020). Beyond meeting nutrient needs, plant-based eating can confer benefits to those with CKD. For instance, soy intake in people with CKD has been associated with lower serum creatinine, phosphorus, and triglycerides (Gluba-Brzózka, 2017).

There have been a handful of clinical trials using a plant-based diet as an intervention for people with CKD. Results include lower serum phosphorus and with no change in serum albumin, which is a measure of protein status (Gluba-Brzózka, 2017).

As long as amounts of protein, sodium, potassium, and phosphorus are kept in check, a vegan diet can be suitable, and even beneficial, for people with CKD—and even for those on dialysis. People with CKD should always discuss their eating plan with their registered dietitian and follow their recommendations.

For patients on hemodialysis, speak to your doctor to ensure your vitamin B12 needs are met. Koyama et al. suggest receiving 500 µg of methylcobalamin intravenously after each dialysis (Koyama, 1997).

Resources for Vegetarians with Kidney Disease


Gluba-Brzózka, 2017. Gluba-Brzózka A, Franczyk B, Rysz J. Vegetarian Diet in Chronic Kidney Disease—A Friend or Foe. Nutrients. 2017 Apr 10;9(4).

Koyama, 1997. Koyama K, Yoshida A, Takeda A, Morozumi K, Fujinami T, Tanaka N. Abnormal cyanide metabolism in uraemic patients. Nephrol Dial Transplant. 1997 Aug;12(8):1622-8.

NKF, 2020. Maintaining a Vegetarian Diet with Kidney Disease. National Kidney Foundation. Accessed January 17, 2020.

Patel, 2012. Patel KP, Luo FJ, Plummer NS, Hostetter TH, Meyer TW. The Production of p-Cresol Sulfate and Indoxyl Sulfate in Vegetarians Versus Omnivores. Clin J Am Soc Nephrol. 2012 Apr 5. [Epub ahead of print]

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  • If you have a question about whether it's okay to cut supplements in half or combine supplements to achieve the dose we recommend, the answer is “Yes.” Be aware that nutrient recommendations are only estimates—it's not necessary to consume the exact amount we recommend every single day.
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  • We cannot provide personal nutrition advice for specific health conditions. If you need private counseling, here's a list of plant-based dietitians and we especially recommend VeganHealth contributor Taylor Wolfram, MS, RDN, LDN.
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