Sodium Intake in Chronic Kidney Disease (Predialysis and Dialysis)

Sodium is an essential mineral. In your body, sodium is the most predominant ion in your extracellular fluid and is subject to a tight regulation. Sodium consort with potassium (the main cation within the cells) to maintain a proper body water distribution and blood pressure. This means, the body needs a small amount of sodium:

  • To regulate blood volume and blood pressure 
  • To regulate acid/base balance 
  • To maintain a normal function of muscles and nerves

Why should you watch your sodium intake if you suffer from CKD?

In chronic kidney disease the kidneys excrete less water. This reduction already begins in predialysis and worsens with the progression of CKD. As less water is excreted, more water remains inside the body and may cause oedema and high blood pressure. Sodium acts as a ’fluid magnet’ and may promote or worsen this condition. Therefore it is necessary to reduce your sodium intake. This may not be easy, because sodium is a part of table salt (sodium chloride), which we are used to add to our meals in high amounts.

In dialysis stage another effect of sodium becomes important: It makes you thirsty. The more you limit your sodium, the easier is to follow the advised fluid restriction. Please ask your doctor and your dietician for further instructions.

What are the main sources of sodium in your diet?

Sodium is a mineral found in only small quantities in natural food. Sodium – unlike the other minerals – has a recognizable and popular taste. Due to this it is widely added to processed food and snacks (sometimes in high amounts).

Table salt is the main source of sodium in our nutrition.

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High sodium foods are:

  • Table salt 
  • Canned soups, broths, sauces 
  • Snacks (chips, nuts, cheese biscuits, popcorn, pretzels) 
  • Processed cheese 
  • Pickles, pickle juice, olives 
  • Soya sauce 
  • Ketchup 
  • Fast food/restaurant food (e.g. pizza, hamburger) 
  • Smoked and cured foods: bacon, ham, luncheon meats

Practical advice to reduce your sodium intake

  • Read labels! Look for products with less than 100 mg sodium per serving. 
  • Do not eat food, if table salt is one of the first five ingredients. 
  • Use herbs/spices for flavouring your food. 
  • Try to eat fresh foods that are naturally low in sodium. 
  • Bread is rich in table salt!

Recommended Intake

Content last updated
  1. Cano N, Fiaccadori E, Tesinsky P et al.: ESPEN Guidelines on Enteral Nutrition: Adult Renal Failure. Clin Nutr 2006; 25: 295–310.
  2. Fouque D, Vennegoor M, ter Wee P et al.: EBPG Guideline on Nutrition. Nephrol Dial Transplant 2007; 22 (Suppl 2): ii45–ii87 (last visited 20.04.2010)
  3. NKF: KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for 2006 Updates: Haemodialysis Adequacy, Peritoneal Dialysis Adequacy and Vascular Access. Am J Kidney Dis 2006; 48 (Suppl 1): S1-S322. (last visited 20.04.2010)