With lupus, the immune system attacks healthy cells anywhere in the body. When lupus attacks the kidneys, it’s called lupus nephritis. The kidneys are the body’s primary filtration system, so your diet directly impacts your kidney (renal) health. Your kidneys are responsible for regulating the electrolytes in your bloodstream, processing protein, and removing toxins.
People with lupus nephritis need to be particularly mindful of what they eat and drink to avoid additional kidney damage and other complications. The severity of your condition will determine how strict you must be with nutrition. This article provides general suggestions that you can discuss with your nephrologist or registered dietitian nutritionist when deciding what to eat. It’s crucial to follow your doctor’s advice when planning your diet with lupus nephritis.
Focusing on the ingredients you can have rather than those you need to avoid can help you maintain a positive outlook and find joy in cooking.
Impaired kidney function may seem to limit the variety of foods available to you. Adding heart-healthy unsaturated fats to your meals and snacks is a good way to keep your calories up and maintain a healthy weight. In particular, anti-inflammatory omega-3 fatty acids are beneficial for autoimmune diseases because they promote healthy immune function. You can get omega 3s from plant sources, such as nuts and seeds, and from animal sources, including salmon or fatty fish.
Researchers have found that flaxseed offers protective effects against lupus nephritis. For example, it can delay the spillage of protein into the urine (proteinuria), and it can preserve glomerular filtration rate, which is a key indicator of kidney function. Flaxseeds can be added to granola, cereal, yogurt, baked goods, or smoothies. The fiber in flaxseeds can make them difficult to digest, so you can grind them up to release their maximum benefits.
Other ideas to boost your intake of healthy fats include:
Fruits and vegetables are essential for good health. Many fruits and vegetables contain the nutrient potassium, which helps to keep cell fluid at the right level. Unfortunately, too much potassium can be dangerous if your kidneys aren’t functioning at full capacity. Choosing lower-potassium options will give you vitamins, minerals, antioxidants, and dietary fiber while protecting your kidneys.
Examples of lower-potassium fruits (with less than 150 milligrams per half cup) include:
Vegetables that aren’t too high in potassium include:
Spacing your intake throughout the day will give your kidneys more time to process potassium from food, so your blood levels are less likely to spike suddenly. It’s important to keep in mind that whole grains, beans, and legumes also contain potassium, so you should be mindful of your total potassium intake from multiple sources.
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Learning what to eat when you have lupus nephritis may seem overwhelming at first. But with the support of a dietitian or other expert who specializes in kidney health, you’ll be well on your way to understanding your limits with certain foods.
Here are some ways to cut back on sodium:
Restaurant meals and takeout food usually have more sodium than you’d add when cooking for yourself. Check menus ahead of time to see if there are any low-sodium options, or ask your server if your food can be prepared with minimal salt.
Your doctor may advise that you cut back on protein from meat and dairy products to minimize strain on your kidneys. Depending on the status of your kidney function, you may not need to cut them out completely. However, choosing smaller portions will let you enjoy your favorite dishes and get essential amino acids while doing less kidney damage. If you do need to minimize or cut out animal products, there are many plant-based alternatives available in the supermarket.
High-potassium fruits and vegetables can be tricky for impaired kidneys to handle. People with lupus nephritis should be aware of which plant-based foods are highest in potassium so they can balance their intake with other foods.
High potassium fruits (more than 250 milligrams per half cup) include:
High potassium vegetables include:
Cooked veggies and fruit juices are more concentrated in potassium than fresh fruits or veggies. For example, cooked leafy greens such as spinach have a lot more potassium per cup than the same portion of fresh. Ask your renal dietitian about cooking methods (like boiling and discarding the cooking water) to extract some potassium.
Sometimes doctors put people with kidney issues on a potassium binder. This is a special type of medication that will reduce the load of potassium your body absorbs from food. You can ask your doctor if potassium binders are a good option for you and how they will affect your dietary choices.
People with lupus nephritis may need to consider other dietary recommendations, including monitoring phosphate intake and restricting fluid intake.
Different amounts of the mineral phosphorus are found in various foods and beverages. Phosphorus is necessary for strong bones and teeth and other functions of the body. However, too much phosphorus can build up in the blood if the kidneys aren’t functioning properly. High phosphorus levels can weaken bones and cause high blood pressure, among other problems.
Phosphorus occurs naturally and is also added to many packaged foods and beverages as a preservative. Lunch meat, frozen meals, and some sodas have added phosphorus.
You may be advised to take a phosphate binder or restrict your intake of phosphorus depending on your kidney function.
Normally, drinking plenty of water is helpful for the kidneys. However, having lupus nephritis may mean that your body takes longer to filter out water. If you’re required to restrict fluids, you can cope with dry mouth by chewing gum, sucking on hard candy, or rinsing your mouth with water.
If you’re confused about what to eat, don’t hesitate to reach out for help from your health care team. Adjusting to a new way of eating takes time, so be patient with yourself as you focus on progress, not perfection.
MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 205,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus. More than 14,000 members have lupus nephritis.
Have you had to make changes to your diet because of lupus nephritis? What challenges have you experienced, and what works well for you? Share your thoughts in the comments below, or start a conversation by posting on MyLupusTeam.