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

Answers from Erik P. Castle, M.D.

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.

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.

Being a vegetarian doesn't mean missing out on quality protein. There are plenty of good plant sources of proteins. However, a vegetarian renal diet requires a 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.

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.

Here's some basic information on:

  • Protein. In the chart, you'll find some examples of high-quality protein sources for vegetarians, but follow your dietitian's recommendations.
  • Phosphorus. If phosphorus is a concern, it's best to avoid foods high in inorganic phosphate, such as highly processed foods. Dairy foods are a main source of phosphorus in a typical diet. Dairy products can be replaced with unenriched rice or soy milk and yogurt. (Avoid enriched products because they typically have added phosphorus.)
  • Potassium. If you need to watch potassium, keep in mind that the majority of potassium comes from dairy products, fruits and vegetables. So by limiting dairy and choosing fruits and vegetables that are lower in potassium you can control your potassium level.
  • Sodium. If you need to limit sodium, cut back on the salt you add during cooking and at the table. Also be sure to check food labels. Many ready-to-eat foods, canned beans, vegan meats, and soy- and rice-based cheeses are high in sodium.

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 diet Protein sources
Vegan — allows only plant-based foods
  • Soy protein (tofu, tempeh, unsalted natto)
  • Wheat protein (seitan)
  • Nut butters (no more than 2 tablespoons, or about 28 grams, a day)
  • Soy milk or yogurt
  • Cooked dried 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
April 26, 2016