Is Dairy No Longer An Option Now That I Have Kidney Failure?-Dairy products and the pre-dialysis diet

Individuals with kidney disease should be careful with dairy products, since many contain large amounts of phosphorous. Diseased kidneys have difficulty processing phosphorous, and high levels can speed the loss of kidney function, as well as cause blood levels of calcium to drop.  If you are in stages 2 - 4, you probably don't have to worry a lot about how much phosphorus you are drinking or eating, but caution is advised.  Your doctor will tell you when you need to start working on limiting phosphorus as well as other minerals.  Most people are limiting dairy because of the need to limit protein in addition to the phosphorus levels.-dairy products and the pre-dialysis diet

When calcium in the blood decreases, the bones release more calcium and phosphorous in a vicious cycle. When bones release calcium, they become deficient, creating bone deterioration which causes them to become brittle, and more susceptible to fracture. In addition, joints can become enlarged and/or painful. If this happens, it's always best to look to supplement your diet with something like calcium carbonate powder because this can improve your calcium levels and help promote healthier bones and teeth.

The release of calcium in the bloodstream creates all kinds of havoc if levels get too high, including constipation, decreased alertness, and abnormalities of the heart rhythm. The combination of high levels of calcium and phosphorous also create hardened deposits in various parts of the body, especially in the arteries and heart valves.  Obviously this is a bad thing, and your doctor or nephrologist will be testing your blood levels on a regular basis to ensure it doesn't get out of hand.

Dairy products and the pre-dialysis diet

Although there are various methods to manage the level of phosphorous in your blood, such as phosphate-binding medicines, one of the best approaches is to decrease the amount of phosphorous you eat.

So what kinds of foods have high levels of phosphorous?

As mentioned earlier, dairy products top the list. If you're a milk and cheese lover, this might sound ominous, but the fact is, there are many dairy products that you can still enjoy. You just have to pick the right ones, in the right amounts.

Opinions vary, but some experts feel that 800-1200 mg of phosphorous a day for the pre-dialysis diet is a good goal. Of course, this varies per individual, and you should always follow your doctor's and renal dietitian's advice for your particular situation.

So what kinds of dairy and how much? Usually half a cup of milk, half a cup of yogurt, or one ounce of cheese per day. Limit yourself to one serving per day. And watch your intake of low-fat milk, since it can actually contain higher levels of calcium and phosphorous than whole milk.  If you are looking to increase your calories, you might want to choose 2% or whole milk instead of low fat milk.

There are some great alternatives to regular dairy products today, including soy milk and nondairy creamer. Rice milk and almond milk are also good, but you have to be careful about the amounts of potassium, phosphorous and protein in milk alternatives. Be sure to check labels on these products to see what's hidden that could be bad for your kidneys.-dairy products and the pre-dialysis diet

Can't find potassium and phosphorous listed? That's a common problem, since, unfortunately, those are two ingredients that food manufacturers aren't required to spell out. You can check out the listings of phosphorus and potassium amounts in foods using our quick guide: Potassium and Phosphorus Lists

If you love milk, here's a list of milk alternatives that will help you to both satisfy your cravings and protect your kidneys.-dairy products and the pre-dialysis diet

Rice Milk

• Rice Dream® Rice Drink Original Classic
• Rice Dream Rice Drink Vanilla Classic

Nondairy Creamer

•   Nestle® Coffee-Mate®, Original Fat Free
•   Nestle®  Coffee-Mate®, Original Low Fat
•   Nestle®  Coffee-Mate®, Original
•   Rich's® Coffee Rich®, Regular and Fat Free
•   Mocha Mix® Original

Soy Milk

•   Edensoy® Light Vanilla Soy Milk
•   Edensoy® Light Original Soy Milk
•   Pacific Select™ Soy Low Fat Plain
•   Pacific Select™ Soy, Low Fat Vanilla

Almond Milk

•   Almond Breeze®, Unsweetened Original
•   Almond Breeze®, Unsweetened Vanilla
•   Pacific Organic Almond Unsweetened Low Fat Original
•   Pacific Organic Almond Unsweetened Low Fat Vanilla
•   Pacific Organic Almond Original
•   Pacific Organic Almond Vanilla

For the other-than-milk dairy foods that are low in phosphorous (less than 110 mg per serving), here are some additional options:

• Brie (1 oz)
• Cream Cheese (2 Tbsp)
• Feta Cheese (1 oz)
• Ice cream (½ cup)
• Half & Half (½ cup)
• Grated Parmesan Cheese (2 Tbsp)
• Sour Cream (2 Tbsp)
• Whipping Cream (½ cup)

If you want more choices, these are moderately high in phosphorous (110-160 mg per serving), so you'll have to watch your totals:

• Cheddar Cheese (1 oz)
• Cottage Cheese (½ cup)
• Custard (½ cup)
• Fat-free cream cheese (2 Tbsp)
• Mozzarella cheese (1 oz)
• Provolone Cheese (1 oz)
• Pudding – instant, made with milk (½ cup)

If you're a dairy lover, you can still enjoy some of your favorite things by knowing your options, and making careful choices. Read labels, keep track of totals, and take control of your diet and your kidney disease one day at a time.

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