Eating a nourishing breakfast in the morning can help start your day off on the right foot. If you are trying to slow or stop the progression of your chronic kidney disease (CKD), you may be finding conflicting information on best breakfast choices for your renal (kidney) diet. There are plenty of options that can work, but I’ll discuss my three top breakfast choices for those with chronic kidney disease.

What makes a kidney friendly breakfast?

When trying to stop or slow the progression of your kidney disease, you’ll want a breakfast that is plant-focused. Think fruits, vegetables, whole grains, nuts/seeds, beans, healthy fats! Having a breakfast balanced with carbohydrate, fat and protein will ensure your meal will fill your belly and get you energized for the day!

Those with CKD should limit sodium, processed meats (bacon/sausage) and large portions of animal proteins. There are lots of plant-based breakfast meats on the market – but they may not be the best choice for every day. These meat-substitutes may contain phosphorus and/or potassium additives and often are high in sodium. 

Breakfast Idea 1 – Oatmeal

If you read oatmeal is not allowed with CKD, this is far from the truth! Regular old-fashioned oats are a simple, versatile and filling breakfast choice! I recommend buying plain oats over the flavored packets so you have full control over the sodium and added sugar. Steel cut oats are also a great option but take longer to make.

What makes oatmeal a kidney friendly breakfast?

Complex carbohydrates, likes oats, digest slower than simple carbs (like sugar) due to their fiber content which makes them a filling breakfast choice. Oats are a source of a type of soluble fiber, called beta-glucan, which is linked to many health benefits. Beta-glucan has been shown to reduce total and LDL cholesterol, aid in blood sugar control and feed the good gut bacteria.

You won’t have to worry about the potassium, phosphorus and sodium content of oats as they are considered low in all. Keep in mind that our body doesn’t absorb all of the phosphorus in plant-foods like oats. Studies show we only absorb 10-30% of the total phosphorus content as phosphorus in plants is bound to phytate which people do not have the enzyme to break down.

Not only are oats nutritious, they are very easy to make! Oats can be made on the stovetop or in the microwave for even faster cooking. Follow the instructions on the back on the package for recommended cooking instructions. Overnight oats are another great method of “cooking” oats that can be prepped ahead of time for a grab and go option.

What to add to your oatmeal

To prepare the oatmeal, I recommend using water or a plant-based milk, like almond, rice or oat milk. When choosing a plant-based milk, look for one that has no phosphorus additives. I actually prefer using water in my oatmeal.

Nuts and/or seeds are a great addition to your oatmeal for both crunch and nutrition. They provide heart healthy fats and are a source of plant-protein. A serving of nuts is 1 oz, or about a handful. Choose the nuts/seeds you like to eat!  

For more plant-goodness, add a serving of fruit (which is half a cup, or 1 small piece). Fruit will add vitamins, minerals and fiber. What fruit should you choose? The ones you like! If you are needing to restrict potassium, you may want to avoid dried fruit and other high potassium fruits like banana.

The finishing touches of your oatmeal can include a sweetener and spices. I prefer natural sweeteners such as maple syrup or honey. If you are looking for a sugar-free option you can use stevia or monk fruit. Spices not only add great flavor but they contain antioxidants! I love using spices such as cinnamon, ground ginger, allspice and nutmeg in my oatmeal.

Breakfast Idea 2 – Eggs!

You may be wondering if you need to say goodbye to eggs because of CKD. Good news, eggs can be part of a kidney friendly breakfast. Eggs are considered an animal protein which does need to be limited with CKD. The amount of animal protein recommended will depend on your stage of CKD, nutrition status and overall health goals. Your kidney dietitian can guide you on how much animal protein is right for you.

For those sticking with a plant-based diet, there is an “egg” option for you! Firm tofu can transform into scrambled eggs with a few special ingredients.

What makes eggs a kidney friendly breakfast?

Eggs are a convenient protein option that many people rely on for breakfast. We do need protein in our diet for survival – it’s just important to avoid too much protein, especially from animal products, when you have CKD stage 1-5. Either whole eggs or egg whites can be included in your breakfast. 

Egg yolks contain beneficial vitamins and minerals like vitamin B12, vitamin D, choline and folate. Egg yolk is a source of saturated fat and cholesterol, but dietary cholesterol actually has little to do with our blood cholesterol levels according to studies. A study published in 2022 showed that adding eggs to a plant-based diet did not result in increased inflammation or oxidative stress.it

If you choose to eat just the whites, that is A-Okay. Egg whites may have less calories, fat and phosphorus but also less vitamins and minerals. The whites of the egg is where most of the protein is. Keep in mind that a quarter cup of egg whites has 7 grams of protein, so the protein can add up quickly if you eat a large portion.

Plant-based egg options:

Looking for a completely plant-based egg substitute? There are several plant-based liquid “eggs” on the market, but they typically contain phosphorus additives which need to be limited with CKD.

Firm tofu is my top choice for plant-based scrambled egg substitute. A quick google search will bring up tons of vegan “scrambled egg” recipes to choose from (you’ll just have to adjust the sodium to suit your needs). Many tofu scrambles call for ingredients such as turmeric for color and nutritional yeast (for a nutty/cheesy flavor). A pinch of black salt (also called kala namak) adds a sulfur flavor quite similar to eggs. Yes, black salt will add sodium, but a small pinch is all you need if you opt for this ingredient.

What to add to your eggs

No matter what type of eggs you choose, whole, whites or tofu, adding vegetables will make your choice more kidney friendly! What vegetables are best to add? The ones you like the most! Include a full serving, which is half a cup chopped vegetables.

If you like adding cheese to your eggs, just be aware cheese counts as an animal protein and it will add some sodium. If choosing to add cheese, choose a natural one, like cheddar or swiss, rather than processed American cheese. Keep the portion of cheese to a minimum (1 oz or less). Amount and frequency of cheese in your diet all depends on your CKD stage, nutrition needs and labs.

There are plant-based cheese options you can purchase from the grocery store, but again, these options may not be much better than dairy based cheese. Like many plant-based alternatives, vegan cheese often contains phosphorus and potassium additives and can be high in sodium. Brands that are often free of phosphorus and potassium additives include Violife and Miyoko’s Creamery.

To round out your breakfast, you’ll want to add a healthy carbohydrate such as whole wheat toast. Choose a wheat bread that is lower in sodium (less than 140 mg per slice) and has 3 grams of fiber or more per slice. Ezekiel Sprouted Grain Bread and Pepperidge Farms 100% Whole Wheat are two good options.

Breakfast Option 3 – Smoothies!

For those who don’t want a heavy breakfast, smoothies are a great way to pack in a lot of nutrition. Store bought smoothies are often too high in protein, but when you make your own you’ll have full control of what goes in.

What makes smoothies a kidney friendly breakfast?

Fruits and vegetables are the cornerstone of a kidney friendly diet. They provide us with beneficial vitamins, minerals, antioxidants, phytochemicals and fibers. They also have an alkalizing effect which can help treat and prevent metabolic acidosis, a complication of CKD.

Smoothies can be a great way to get some potassium in our diet. Potassium is actually beneficial for CKD as it helps maintain a normal blood pressure and many people don’t get enough of it. For those who deal with high potassium, choose lower potassium fruits and vegetables in your smoothie. Working with a kidney dietitian can help you figure out your potassium needs and also address the root cause of your potassium.

Making smoothies sometimes takes some experimentation. I prefer to start with a ratio of 1 part fruit/vegetables to 1 part liquid as I like my smoothies thick. If I add a lot of mix-ins, I will add a little extra liquid until I get the consistency just right.

What to add to your smoothies

I prefer using frozen fruit in my smoothies as it gives it a creamy, frozen texture and there is no need to add ice. Choose a frozen fruit without any added sugar. Aim for at least one serving of fruit, which is half a cup or 1 small piece. The fruit you choose may depend on your potassium needs.

Vegetables can be added to your smoothie as well for more vitamin and minerals. I love using frozen riced cauliflower – the flavor is easily masked by the fruit. Half cup of riced cauliflower contains about 107 mg potassium. Fresh greens, like spinach or kale, also blend up nicely in smoothies, try adding a handful.

Your smoothie isn’t complete without some protein and healthy fat. Nuts and seeds supply both. I like using hemp hearts, flax seeds and chia seeds as they blend up very nicely. Nut butters can also be used.

Now let’s talk about what liquid to add. Fruit juices can add a lot of sugar. Using a plant-based milk is a great option, especially for those looking to keep animal protein low. As I mentioned above, be on the lookout for phosphorus additives. Coconut water is another good choice for those who don’t need to limit potassium. I prefer a mix of coconut water and almond milk to make my smoothie a little creamy with a subtle coconut flavor. Plain old water can also be used as your liquid.

Want to jazz up your smoothie some more? Add spices, coconut or top your smoothie with some granola. If you are looking to boost the calories, you can even add some plain plant-based yogurt. If your smoothie isn’t as sweet as you like, use honey, maple syrup or for a low sugar option stevia or monk fruit sweetener. 

Summary

When it comes to choosing breakfast on a renal diet, there are lots of great options. Breakfast should ideally contain all the macronutrients – carbohydrate, protein and fat – to keep your body fueled through the morning. You can’t go wrong with whole-food ingredients like grains, fruits/vegetables and nuts/seeds.

There are many other breakfast options that work great for those with CKD. Working with a kidney dietitian can help you build a breakfast that fits your nutrition needs and food preferences. Wonder how a kidney dietitian can help? Book a discovery call today!