Some kidney patients struggle with taste changes and poor appetite, which makes it difficult to eat enough food to meet nutritional needs.

If you are eating less or have lost weight without planning to, simple changes to what you eat and drink may help you add more nutrition, have more energy, optimise your immune function, and prevent losing weight.

You may have previously been advised to restrict some foods in your diet, but if you have a small appetite or are losing weight, you may need to temporarily loosen some of these restrictions. However, it is still important not to add salt to your cooking or meals and to follow your fluid restriction if you have been given one.

If after reading this leaflet you would like further information, or have any worries, please ask to speak with your dietitian, nurse, or doctor.

Helpful hints

  • Eat little and often: aim for three small meals and two to three snacks a day.
  • Have your main meal at the time of day you feel your appetite is best.
  • Keep a store of easy to prepare foods e.g., Ready meals, long life milk, instant puddings, cereals, tinned foods, plain biscuits.
  • Try eating cold foods if the smell of cooking is putting you off eating.
  • Drinking before a meal can fill you up, so wait to drink after your meal.
  • Avoid foods that are labelled ‘diet’, ‘reduced/low fat’ or ‘sugar free’.
  • If you can, monitor your weight regularly but no more than once a week. You can weigh yourself at your GP surgery if you don’t have weighing scales at home.

Increasing your calorie and protein intake

You can add small amounts of high calorie ingredients to your normal food and drinks, which will help increase the nutritional content without increasing the portion size. This is known as food fortification.

Here are some food fortification ideas:

Add dairy products e.g., cheese, butter, ghee / oil, or milk to: soup, potatoes (especially mashed), pasta, rice, sauces, vegetables and eggs

  • Add single or double cream to: porridge, sauces, soup, potatoes, puddings, fruit, hot and cold milky drinks
  • *Add sugar, jam, or honey to: porridge, puddings, hot drinks, on top of toast, to glaze vegetables
  • Add oil, butter, ghee, or margarine to: potatoes, vegetables, eggs, rice, fish, meat, and in your cooking
  • Add grated cheese, croutons, rice, chickpeas, or lentils to ‘cream of’, lentil or meat-based soups (a maximum 150ml portion, once a day).
  • Eat protein (meat, fish, eggs, chickpeas, Quorn®, lentils or tofu) at least two times a day, and add it to salads/ soups/ side dishes.

Other food fortification ingredients you can use:

  • Salad cream
  • Mayonnaise
  • Stewed fruit
  • Creamy sauces
  • Ice cream
  • Golden syrup

Fortified meal ideas

Below are some meal and snack ideas that incorporate food fortification methods. Aim to have three meals and two to three snacks per day.

Breakfast ideas

  • Cereal or porridge with full fat milk plus sugar / jam / cream / yoghurt / honey/ blueberries. Avoid dried fruit and nuts as they are high in potassium.
  • Toast / croissant / English muffin / mini pancake with butter / jam / honey
  • Scrambled egg, unsmoked bacon, sausage with toast / bread/ crumpet+ butter
  • Glass of full fat milk with plain biscuits
  • Small pot of high protein/ full fat Greek yoghurt with honey or jam

Light meal ideas

  • Toast with scrambled egg / cheese / boneless tinned fish / unsmoked bacon / sausage.
  • Sandwich or roll with cheese / egg mayonnaise / tuna mayonnaise / meat.
  • Omelette with cheese / chicken and toast
  • Pasta and cheese bake / pasta with tuna and mayonnaise.
  • Tinned macaroni cheese / ravioli / stew / casserole and bread.
  • ‘Cream of’ soup (max 150ml) with bread and butter / sandwich.
  • Pita bread with hummus/ full fat cream cheese.
  • Lentil dal and paneer with rice or chapatti.

Puddings and sweet snacks

Avoid chocolate and nut / seed containing desserts, as they are high potassium.

  • Try to have a pudding once or twice a day with cream, ice cream, custard, or full fat yoghurt.
  • Thick and creamy yoghurt or high protein yoghurt.
  • Milky puddings e.g., rice pudding, custard, semolina-make these with full fat milk.
  • Sponge pudding / crumble / pie and custard or cream.
  • Trifle or mousse.
  • Ice cream / kulfi.
  • Plain biscuits and cakes (teacake, jam tarts).
  • Doughnut/ iced bun/ flapjack (without nuts/ dried fruit).

Savoury snacks

  • Crackers / breadsticks with butter, cream cheese, or dips (e.g., hummus).
  • Toast or bagel with butter or cream cheese.
  • Garlic bread.
  • Samosa.
  • Corn crisps (e.g., tortilla) / pretzels/ popcorn/ maize- best unsalted.

Fortified milk

You can add calories to milk by adding some cream to it and use this as you would use normal milk to get extra calories and protein into your diet (e.g., in milky drinks, cereals, puddings, and in your cooking).

‘Over the counter’ supplements

Nutritional supplements If you are underweight or have lost a large amount of weight, your dietitian or doctor may prescribe supplement drinks, for example Altraplen®, Ensure®, Nepro®, Fortisip®.

These supplement drinks contain energy, protein, vitamins, and minerals and are designed to be taken in addition to food to help prevent further weight loss and promote weight gain.

If you have a fluid restriction it is important to prioritise your supplement drinks over other drinks, e.g., water, tea, and coffee.

Tips for taking your supplements

  1. Try a variety of types, e.g., milkshakes or juice.
  2. Try a variety of flavours.
  3. They taste best when cold.
  4. Sip slowly throughout the day or split it into small shots which you drink just after your meals.
  5. Make juice supplements into ice lollies and milk-based supplements into smoothies; or add as sauce to cakes and puddings.

For people with diabetes

If you have diabetes, you will need to continue to avoid sugary foods. You can however still increase your energy intake by using more fats or oils. Important After one month, if you continue to lose weight and your appetite does not improve, it is very important to let your dietitian, hospital doctor or GP know.

Keeping active

Physical activity is important to support the maintenance of muscle mass and strength. It can also help improve your appetite. If you can, incorporate resistance-based exercise into your lifestyle. Please see the Kidney Beam website for exercise classes and programs specifically designed for kidney patients.

Further support

Please contact your GP practice if you are struggling with food shopping, meal preparation, or low mood which is affecting your appetite. They can signpost you to find further support such as meal delivery services, lunch clubs, or other support services.

After a month, if you continue to lose weight and your appetite does not improve, it is very important to let your hospital doctor or GP know.