Which Nuts are Good for Kidneys?

My favorite kinds of snacks can be quickly grabbed on my way out the door and keep me full.

Nuts!

But, there’s a lot of confusion around nuts, CKD and which nuts are good for kidneys. So, let’s talk about it.

Why do we worry about nuts and kidney disease?

Most nuts are an easy and excellent source of several vitamins and minerals. But, some nuts tend to be a bit higher in phosphorus and/or potassium which can be problems in the later stages of kidney disease. 

Phosphorus in Nuts

You may have read that all kidney patients are supposed to limit phosphorus. Well, that’s not entirely true for all people with kidney disease. 

In the later stages of CKD when the kidneys stop filtering out phosphorus, it can build up in the blood. This build up can cause bone disease and damage to the blood vessels. 

Your doctor may recommend limiting how much phosphorus you eat, or they may recommend that you take a medication called a phosphorus binder to keep your body from absorbing as much phosphorus as you eat. 

Recent research(1) has shown that phosphorus from plant sources (like nuts) is not absorbed as well as phosphorus from animal sources or from additives like those in colas.

That means that nuts are not to be feared as they once were. And a plant-heavy diet with emphasis on plant-based proteins(2) has been linked to a lower acid load in the blood which relieves stress on the kidneys.

Potassium in Nuts

Some nuts may be high in potassium. In the later stages of CKD, the kidneys don't filter potassium very well and your doctor may talk to you about limiting your potassium intake.

Unfortunately, potassium from nuts is still absorbed very well by the body. So, it's important to make sure that you're talking to your doctor and dietitian and asking questions so that you know how your kidneys are functioning and how you can best take care of them.

Why Are Nuts Good for People with Kidney Disease?

Nuts tend to be rich in healthy fats, protein, and fiber. They are also low in carbs, so they make a great snack for people with diabetes.

Nuts tend to have high amounts of copper, magnesium, manganese, and zinc as well which can help with turnover of healthy bone cells, metabolism, enzyme development, and immune health.

It's important to remember that nuts are an excellent snack, but that they can also hold a lot of sodium. Try to keep each serving under 200mg of sodium if your doctor wants you on a low sodium diet.

Which Nuts are Good for Kidney Disease?

1. Macadamia nuts - 1 oz has about 200 calories, 2g of protein, 2g of fiber, and is an excellent source of Vitamin B1, Copper, Magnesium, Manganese and is low in Potassium
   

2. Peanuts - 1 oz has about 170 calories, 7g of protein, 2g of fiber, and is an excellent source of Vitamins B1, B3, and E, and Copper, Magnesium, and Manganese.
   

3. Pecans - 1 oz has about 200 calories , 3g of protein, 3g of fiber, and is an excellent source of Vitamin B1, Copper, Magnesium, Manganese, Zinc, and is low in Potassium.
   

4. Walnuts - 1 oz has about 185 calories, 4g protein, 2g fiber, and is an excellent source of Omega-3 fatty acids, Vitamin B6, Magnesium, Manganese, Copper, Zinc and is low in Potassium
   

5. Hazelnuts - 1 oz has about 180 calories, 4g protein, 3g fiber, and is an excellent source of Vitamins B1, B6, and E, and Copper, Magnesium, Manganese, and is low in Potassium

A Note About Low Potassium Nuts

You doctor may have talked to you about limiting your potassium intake. There are nuts, like walnuts, hazelnuts, and macadamia nuts, that are low in potassium.

However, it’s important to remember that they are only low in potassium if you limit to 1 serving size, which is 1 ounce or about 1 small handful. 

Peanuts and Kidney Disease

Peanuts can be an easy and affordable source of protein and fiber on a kidney diet.

I often see peanuts on the "High Potassium Foods" lists that roam the internet and I want to address that.

A “High Potassium" food has 200mg or more per serving of potassium. Peanuts and peanut butter are literally right at 200mg per serving.

However, it’s important to note that beef, pork, and chicken are all even higher in potassium than peanuts. So, if you’re craving a PBJ sandwich for lunch, then peanut butter is probably a good choice.

But, if you’re watching the big game with some wings or a burger, then peanuts are not a good choice.

Make an Appointment with a Renal Dietitian

The renal diet can be complicated and confusing. But, really, it's all about balance and understanding what will work for your body, your budget, and your life. That’s why it’s so important to speak with a Renal Dietitian who can help to figure out what works best for you and your labs.