Is Sourdough Bread Good For CKD Patients

Bread is a staple in the American Diet. But deciding what type of bread to eat with your kidney diet can be downright confusing. Do you choose white or wheat and still stay within your dietary restrictions for chronic kidney disease? It really comes down to your specific kidney-friendly diet guidelines (following a low sodium kidney diet) for different nutrients such as potassium or phosphorus.

Sourdough bread with Broccoli and cheese soup

Today we ask: is sourdough bread good for chronic kidney disease patients? In this article, we will explore the potential benefits and drawbacks of incorporating sourdough into one's diet for kidney disease (managing your kidney disease).

We'll discuss what makes sourdough different from other types of breads and how those differences may interact with managing chronic kidney disease (CKD) through diet. 

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What Is Sourdough Bread?

Sourdough bread is a type of bread that is made through a fermentation process using naturally occurring yeasts and lactic acid bacteria. It is known for its distinct tangy flavor, chewy texture, and a slightly sour taste, hence the name "sourdough."

The fermentation process begins by combining flour and water to create a starter or "sourdough culture." This starter contains wild yeasts and lactobacilli bacteria naturally present in the environment or obtained from previous batches of sourdough.

Over time, the yeasts and bacteria in the starter consume the sugars in the flour, producing carbon dioxide gas, which causes the dough to rise, and lactic acid, which contributes to the sour taste.

The use of sourdough as a leavening agent has been practiced for thousands of years and is believed to have several benefits. One advantage is that the fermentation process breaks down complex carbohydrates, making the bread easier to digest and potentially reducing the bread's glycemic index. Sourdough bread also tends to have a lower pH, which can help inhibit the growth of harmful bacteria and improve the bioavailability of certain nutrients.

In addition to its unique flavor and potential health benefits, sourdough bread is often appreciated for its extended shelf life compared to bread made with commercial yeast. The acidity created during fermentation acts as a natural preservative, contributing to its longevity.

Sourdough bread can come in various forms, including loaves, baguettes, rolls, and more. It can be made with different types of flour, such as wheat, rye, or a combination, resulting in a range of flavors and textures (nut flours for kidney disease).

Overall, sourdough bread stands out for its distinctive taste, long fermentation process, potential health benefits, and cultural significance in the world of bread-making.

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Sourdough bread with rough skin on a rustic wooden table.

What Are The Healthy Benefits Of Sourdough Bread?

Sourdough bread is known for having a high nutrient content, including B vitamins, magnesium, and iron. Plus, it's more easily digestible than other kinds of bread, helping to ease gastrointestinal symptoms. It's also lower in gluten, which may be beneficial for those with celiac disease.

Furthermore, the fermentation process of sourdough helps to slow down the digestion of carbohydrates, making it a good choice for those who need to regulate their blood sugar levels. All of these benefits make sourdough bread a healthier option especially when trying to maintain specific diets such as a diabetic diet or a kidney diet plan. 

Nutrient Content

It's no surprise that sourdough bread is gaining popularity as an excellent source of carbohydrates. It contains much lower levels of sodium than regular white or wheat breads, plus extra fiber content and fewer carbohydrate content per slice, making it an excellent choice for those with CKD (low sodium low potassium recipes for the holidays).

Not only does this type of bread help to keep your blood sugar in check since its glycemic index is generally lower than traditional loaves, but you'll be getting the added benefit of probiotic bacteria which can aid digestion.

In addition, sourdough bread has been found to have higher lactic acid levels compared to other types of bread products, which potentially helps in promoting a healthy gut flora.


Sourdough bread is often regarded as having better digestibility compared to bread made with commercial yeast. The fermentation process involved in making sourdough bread helps break down complex carbohydrates and proteins, making them easier for the body to digest.

The wild yeasts and lactobacilli bacteria in the sourdough culture produce enzymes that break down these components, breaking them into simpler forms that the body can absorb more readily. This enzymatic activity during fermentation also contributes to the development of a more porous and open crumb structure, which further aids digestion.

Additionally, the lower pH of sourdough bread, resulting from lactic acid production, may help promote the growth of beneficial gut bacteria and inhibit the growth of harmful bacteria, further enhancing digestibility. These factors collectively contribute to the reputation of sourdough bread as being more easily digestible and potentially more gentle on the digestive system.

Blood Sugar Regulation

The benefits of sourdough bread don't end with digestion. It can also help with blood sugar control, making it a great choice for those managing diabetes or trying to avoid blood sugar spikes. Unlike other types of bread, its glycemic index is much lower, meaning it won't cause the same amount of sudden rises and falls in your blood sugar that you'd get from white flour products.

And because it's made up of whole grains, there are plenty of dietary fibers present too which helps slow down how quickly sugars enter your bloodstream after eating. However, some loaves even contain high potassium content which can be a challenge for those on a diet for kidney disease (high potassium foods to avoid).

Nutritional Profile Of Sourdough Bread

Protein content in sourdough bread is higher compared to other types of bread, so it's a great option for those looking for a high protein diet. It is also a good source of fiber, which is beneficial for cardiac health. So, for CKD patients, sourdough bread can be a good option. Plus, it's got a great flavor, making it a tasty choice too!

Protein Content

The protein content of sourdough bread can vary depending on the specific bread recipe and ingredients used. A medium slice of sourdough bread made with white flour contains approximately 8 grams of protein, which can be considered a moderate amount.

For patients with chronic kidney disease (CKD), protein management is crucial due to the impaired kidney function's impact on waste product removal. In the early stages of CKD, a moderate protein intake is generally recommended to minimize the strain on the kidneys. The protein content in sourdough bread can contribute to meeting daily protein requirements while providing a tasty option.

However, as CKD progresses, protein restriction becomes more significant to prevent the accumulation of waste products. In later stages, patients may need to limit their intake of protein-containing foods, including sourdough bread. The individual's specific protein needs should be determined in consultation with a renal dietitian based on their stage of CKD, kidney function, and overall nutritional requirements.

Sourdough bread, with its moderate protein content, can be incorporated into a kidney diet plan for patients who are not on strict protein restriction. It offers a flavorful and versatile choice compared to other protein sources. However, it is crucial to consider the overall protein intake from other sources throughout the day to ensure that protein limits are not exceeded (Protein for CKD Patients by stage).

It is important for CKD patients to work closely with a renal dietitian to determine their specific protein goals, monitor their nutritional status, and make appropriate dietary adjustments. Regular consultations and individualized guidance will ensure that protein intake, including that from sourdough bread, aligns with the patient's CKD management plan and supports their overall health and well-being.

Fiber Content

The dietary fiber content of sourdough bread can differ by the specific bread recipe and ingredients used. One medium serving of sourdough bread made with white flour contains approximately 2 grams fiber per slice. While this may be a modest amount compared to some high-fiber foods, it still contributes to the overall fiber intake of a CKD patient.

Dietary fiber plays an important role in the management of chronic kidney disease (CKD). It aids in maintaining bowel regularity, preventing constipation, and promoting overall gastrointestinal health. Additionally, fiber can help control blood sugar levels, improve cholesterol levels, and support weight management.

For patients with CKD, dietary fiber is particularly important due to the increased risk of constipation and cardiovascular complications associated with the disease. However, it is essential to consider the individual's overall dietary needs and restrictions, as high-fiber diets may not be suitable for all CKD patients, especially those with advanced stages of the disease or other specific medical conditions.

Incorporating sourdough bread, with its modest fiber content, into the diet of CKD patients can contribute to their overall fiber intake. However, it is crucial to maintain a well-balanced and individualized approach to fiber consumption in consultation with a renal dietitian.

The dietitian can assess the patient's specific needs, stage of CKD, and other dietary considerations to provide appropriate recommendations for achieving optimal fiber intake while considering any dietary restrictions.

More Nutrition Facts

Sourdough bread, besides protein and fiber, contains several other essential nutrients that can be beneficial for patients with chronic kidney disease (CKD). The presence of selenium, folate, thiamine, niacin, riboflavin, manganese, iron, and copper in sourdough bread can contribute to a well-rounded nutritional profile.

Selenium is an antioxidant mineral that helps protect cells from damage. Folate, thiamine, niacin, and riboflavin are B vitamins necessary for energy production, nerve function, and red blood cell formation. Manganese is involved in bone health and metabolism, while iron is essential for oxygen transport in the body. Copper is required for the production of red blood cells and maintenance of connective tissues.

For patients with CKD, obtaining a variety of nutrients becomes important as they may be at a higher risk of deficiencies. Sourdough bread, with its nutrient composition, can help provide these essential vitamins and minerals.

However, it's crucial to consider an overall healthy diet and individualized needs. Patients with CKD should work closely with a renal dietitian to ensure that sourdough bread, along with other food choices, aligns with their specific nutritional requirements, stage of CKD, and any dietary restrictions or considerations.

While sourdough bread can contribute to a balanced kidney-friendly diet for CKD patients, it should be consumed in moderation and as part of an overall meal plan designed to meet their specific nutritional needs.

The recommended portion size of sourdough bread for CKD patients can vary depending on individual dietary requirements and stage of kidney disease. However, as a general guideline, it is often considered that 1 medium slice of sourdough bread corresponds to 1 serving.

A medium slice of sourdough bread typically weighs around 2 ounces (59 grams). However, it's important to note that the thickness and weight of slices of bread can vary based on personal preferences, specific recipe used, as well as the brands of bread for store bought options.

For CKD patients, portion control is crucial to manage their nutritional needs and to prevent excessive intake of certain nutrients, such as protein, sodium, and phosphorus. It is recommended that CKD patients work closely with a renal dietitian to determine the appropriate portion size of sourdough bread based on their specific dietary requirements and restrictions.

The renal dietitian will take into consideration factors such as the patient's stage of CKD, lab results, and individual goals when determining the ideal portion size. They will also consider the patient's overall nutritional needs, including protein intake limits, sodium and phosphorus restrictions, and any other specific dietary considerations.

In some cases, CKD patients with more advanced stages of kidney disease or specific dietary requirements may need to adjust the portion size of sourdough bread to align with their individual needs.

The renal dietitian can provide tailored guidance to ensure that the portion size of sourdough bread and other foods supports the patient's overall dietary plan and promotes optimal management of their kidney disease.

Baker man holding a round sourdough bread

How To Choose A Healthy Sourdough Bread

For CKD patients looking to choose a healthy sourdough bread, here are some tips to consider:

  1. Read the Ingredients List: Look for sourdough bread made with simple and wholesome ingredients, such as unbleached flour, water, salt, and naturally fermented sourdough starter. Avoid breads with additives, preservatives, or high sodium content.
  2. Check Protein and Phosphorus Content: Pay attention to the protein and phosphorus content per serving as written on the nutrition facts label. Opt for bread with moderate protein levels, as excessive protein can strain the kidneys. Choose bread with lower phosphorus content, as high phosphorus levels can be harmful to kidney function.
  3. Fiber Content: While sourdough bread may not be exceptionally high in fiber, a modest amount can be beneficial for CKD patients. Consider whole-grain bread options for higher fiber content, promoting digestive health.
  4. Sodium Levels: Maintaining a low sodium diet is critical for CKD patients. Select sourdough bread with lower sodium content to help manage blood pressure and fluid retention.
  5. Portion Size: Stick to appropriate portion sizes. A medium slice is typically one serving, but should be adjusted based on individual dietary needs and restrictions.
  6. Whole Grains: If possible, choose whole-grain sourdough bread over refined white flour to gain additional nutrients and promote heart health. However, watch out for phosphorus content when it comes to whole grain products.
  7. Certified Organic: Organic sourdough bread may reduce exposure to pesticides and other harmful chemicals.
  8. Consult a Renal Dietitian: Seek guidance from a renal dietitian who can provide personalized advice on choosing the best sourdough bread based on individual dietary needs, stage of CKD, and overall health goals.

Remember that moderation is key, and CKD patients should consider their entire dietary plan when incorporating sourdough bread into their meals. Always monitor lab results and consult with healthcare professionals to ensure the diet aligns with their specific health requirements and CKD management.

How Does White And Whole Wheat Bread Compare Nutritionally To Sourdough?

Here is a table comparing the carbohydrate, protein, and fat content of white bread, whole wheat bread, and sourdough bread per serving size: 

Bread TypeCarbohydrates (g)Protein (g)Fat (g)
White Bread1321
Whole Wheat Bread1732
Sourdough Bread1840.6

In terms of carbohydrate content, sourdough bread has the highest amount with 18 grams per serving, followed by whole wheat bread with 17 grams, and white bread with 13 grams. This is because sourdough and whole wheat breads typically retain more of the natural grain components, including bran and germ, which contribute to higher carbohydrate levels.

Regarding protein content, sourdough bread has the highest protein content with 4 grams per serving, followed by whole wheat bread with 3 grams, and white bread with 2 grams. Sourdough bread often contains higher protein levels due to the fermentation process, which can enhance protein availability.

In terms of fat content, whole wheat bread has the highest fat content with 2 grams per serving, followed by white bread with 1 gram, and sourdough bread with 0.6 grams. However, it's important to note that the fat content in bread is generally low and can vary depending on the specific recipe and ingredients used.

It's worth mentioning that the nutritional composition of bread can vary based on brand, recipe, and serving size. Additionally, the specific nutritional needs and dietary goals of individuals may influence their choice of bread. For example, those with certain medical conditions or dietary restrictions may opt for bread with lower carbohydrate or fat content.

When selecting bread, it's beneficial to consider the overall nutritional profile, including fiber content, vitamins, and minerals. Whole wheat and sourdough breads often contain more grams of fiber compared to white bread, which can promote digestive health and provide a greater feeling of satiety.

It is recommended to consult with a healthcare professional or registered dietitian to determine the most suitable bread choice based on individual nutritional needs, dietary goals, and any specific medical conditions.

Alternative Breads Instead Of Sourdough Bread

For CKD patients looking for bread selections as alternative to sourdough bread, white bread, or wheat bread, there are several choices available that can provide different nutritional benefits.

Here are some types of bread for kidney disease patients worth considering:

  1. Sprouted Grain Bread: Sprouted grain bread is made from whole grains that have been sprouted, which can increase nutrient availability and digestibility. It often contains higher grams of fiber, vitamins, and minerals compared to traditional bread.
  2. Rye Bread: Rye bread is made from rye flour and has a distinct flavor. It is generally lower in carbohydrates and higher in fiber compared to white bread, making it a suitable choice for managing blood sugar levels and promoting digestive health.
  3. Gluten-Free Bread: For individuals with CKD who also have gluten sensitivity or celiac disease, gluten-free bread made from alternative grains like rice, quinoa, or almond flour can be a suitable option. These breads are designed to be free from gluten-containing grains like wheat, barley, and rye.
  4. Low-Sodium Bread: CKD patients often need to limit sodium intake. Some specialty breads are available that are specifically designed to be lower in sodium content. These breads can help manage blood pressure and fluid retention.
  5. Low-Protein Bread: Individuals with CKD in advanced stages or with specific protein restrictions may require bread options that are lower in protein content. These breads are often made with alternative flours and grains with reduced protein levels.
  6. Homemade Bread: Making bread from scratch at home allows for more control over the ingredients and customization according to individual needs. By using whole-grain flours, alternative sweeteners, and reducing sodium content, CKD patients can create bread that suits their specific dietary requirements.

When choosing shopping at the bread aisle, it is important to consider individual nutritional needs, dietary restrictions, and personal preferences. Make sure to carefully read nutrition labels to make sure that you are choosing kidney-friendly bread (read labels carefully as a kidney patient).

Working with a renal dietitian is highly recommended, as they can provide guidance and help tailor the bread choices to align with the patient's specific CKD stage, nutritional requirements, and overall health goals.

It's also worth noting that portion control (portion control for CKD patients) remains important when it comes to bread consumption, regardless of the type chosen. CKD patients should be mindful of the serving sizes and overall carbohydrate, protein, and fat intake from bread, as part of a well-balanced meal plan.

What Other Carbohydrates Are Low In Potassium For CKD Patients?

White rice is a great low-potassium carbohydrate option for CKD patients, as is quinoa, buckwheat, and tapioca. Other low-potassium carbs include polenta, cauliflower rice, millet, amaranth, barley, spelt, teff, oats, sweet potatoes, pumpkin, and corn. All of these are good options for CKD patients, so they can get their carbohydrate intake while on a low potassium diet. 

White Rice

White rice can be a beneficial low-potassium carbohydrate source for CKD patients. It is a naturally low potassium food, making it a suitable option for individuals who need to limit their potassium intake. Additionally, white rice is easily digestible, which can be advantageous for individuals with compromised kidney function. It provides energy without putting excessive strain on the kidneys.

However, it is important to note that white rice is also lower in fiber compared to other whole grains. CKD patients should consider incorporating other high-fiber foods into their diet to maintain overall digestive health. It is always recommended to consult with a renal dietitian to determine the appropriate portion sizes and to ensure that white rice, along with other dietary choices, aligns with the specific nutritional needs and goals of the individual.


Quinoa is another great alternative to white rice for those on a low-potassium diet. It's packed with nutrition and contains few carbohydrates compared to other grains. Quinoa substitutes are widely available, so it can be added as an ingredient in various recipes without sacrificing flavor or texture. The quinoa nutrition profile provides vitamins, minerals, and fiber, making it an excellent choice for CKD patients looking for a low-potassium carbohydrate option (is quinoa good for kidney disease?).

When preparing quinoa, it's important to look out for potential side effects like nausea or bloating since some people may find that their bodies don't respond well to the grain. With proper preparation and knowledge of any possible adverse reactions, however, quinoa can provide a tasty and nutritious solution for anyone trying to limit consuming foods with high potassium content. 


Buckwheat is a great alternative for CKD patients looking to reduce their potassium intake. It's high in fiber and contains fewer carbohydrates than other grains, making it an excellent choice for those with kidney issues. Not only that, but there are plenty of delicious ways to enjoy buckwheat, from pancakes to crepes to noodles or porridge!

Even the flours used can be substituted into recipes without sacrificing flavor or texture. And best of all? Buckwheat is easy on the digestive system, so you won't have to worry about any unpleasant side effects. With its versatility and nutrition profile, buckwheat could become an essential part of your low potassium diet.

FAQs for Wheat Bread on a Renal Diet

Does Sourdough Bread Have Gluten?

Yes, sourdough bread typically contains gluten. Gluten is a protein found in wheat and other related grains like barley and rye. Sourdough bread is made from wheat flour, and during the fermentation process, wild yeast and bacteria break down some of the gluten proteins, which can make it easier to digest for some individuals with mild gluten sensitivities.

However, it is not entirely gluten-free and is not recommended for those with celiac disease or severe gluten intolerance. People with gluten-related disorders should opt for gluten-free bread alternatives made from non-gluten-containing grains (eating whole wheat bread).

How Long Does Sourdough Bread Last?

The shelf life of sourdough bread can vary depending on various factors such as storage conditions and the specific recipe used. Generally, sourdough bread has a longer shelf life compared to regular bread due to its natural acidity, which helps inhibit the growth of mold and bacteria. When stored properly at room temperature in a cool and dry place, sourdough bread can stay fresh for about 2 to 4 days.

However, to extend its freshness, it is advisable to store sourdough bread in a bread box or a paper bag to allow for airflow, or refrigerate it for up to a week. Freezing sourdough bread can further extend its shelf life to several months.

Can Sourdough Bread Be Frozen?

Yes, sourdough bread can be frozen. Freezing sourdough bread is a convenient way to extend its shelf life and preserve its freshness. Before freezing, it is best to slice the bread if desired and wrap it tightly in plastic wrap or aluminum foil to prevent freezer burn. You can place the whole loaf in a freezer bag.

When ready to use, thaw the bread at room temperature or heat it in the oven for a few minutes to restore its texture and flavor. However, keep in mind that freezing and thawing may slightly alter the texture of sourdough bread, but it can still be enjoyed once thawed. You can also check out these renal diet freezer meals.

Does Sourdough Bread Raise Blood Sugar Levels?

Compared to some other types of bread, sourdough bread generally has a lower glycemic index, which means it has a slower and more gradual impact on blood sugar levels. The fermentation process in sourdough bread breaks down some of the carbohydrates, making them less quickly digestible. This can help prevent sharp spikes in blood sugar levels.

However, it's important to note that individual responses to food can vary, and factors such as portion size, accompanying ingredients, and personal metabolic factors can influence blood sugar response. Individuals with diabetes or specific blood sugar management concerns should monitor their blood sugar levels and consult with a healthcare professional or registered dietitian for personalized advice.

In Moderation, Sourdough Bread Can Be Consumed By Those With CKD

Sourdough bread can be a good option for chronic kidney disease patients, considering its potential health benefits and nutritional profile.

Sourdough bread is easily digestible, lower in gluten, and has a lower glycemic index compared to other types of bread, making it suitable for regulating blood sugar levels. It contains moderate protein and fiber content, contributing to a balanced diet for CKD patients.

However, portion control is essential, and individual dietary needs should be considered. CKD patients should work closely with a renal dietitian to determine the appropriate portion size and incorporate sourdough bread as part of an overall meal plan that aligns with their specific nutritional requirements and CKD management goals.

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