Dante Carrillo
Calcium is an essential mineral for maintaining good health, especially for those with kidney disease. The recommended daily calcium intake for those with chronic kidney disease (CKD) is different from the general population and should be determined on a case-by-case basis. A renal diet typically involves a low-phosphorus diet, as high phosphorus and calcium levels can lead to vascular calcification. To increase calcium intake, one can consume dairy products, rhubarb, spinach, blackstrap molasses, and fish like sardines and salmon. However, it is important to monitor calcium levels and consult with a renal dietitian to ensure a balanced diet.
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What You'll Learn
- Eat foods with added calcium, e.g. cereals, crackers, juices, and milk substitutes
- Consume foods that naturally contain calcium, e.g. spinach, salmon, and rhubarb
- Discuss with a renal dietitian to understand which foods contain calcium
- Read food labels to identify foods with more than 10% calcium
- Take calcium supplements, but only if prescribed by a doctor
Eat foods with added calcium, e.g. cereals, crackers, juices, and milk substitutes
If you are on a renal diet, it's important to monitor your calcium intake. According to the National Kidney Foundation (NKF) clinical practice guidelines, the total calcium intake for people with renal disease should not exceed 2,000 mg daily. This includes calcium from your diet, any supplements, and calcium-based phosphorus binders.
To increase your calcium intake, consider eating foods with added calcium, such as:
Cereals
Some cereals have added calcium. Check the nutrition labels and ingredients to identify these. Processed or packaged cereals may be more likely to have added calcium.
Crackers
Like cereals, some crackers may contain added calcium. Read the labels and look for calcium in the ingredients. Crackers are a convenient snack and can be paired with calcium-rich toppings, such as sardines or salmon canned with bones, to further boost your intake.
Juices
Some juices, particularly those in powdered form, can be a source of added calcium. Again, checking the labels and ingredients is essential to identify these options.
Milk substitutes
Milk substitutes, such as soy or almond milk, often have calcium added to them. These can be a great alternative to dairy milk, especially if you are also managing kidney disease, as dairy products tend to be high in phosphorus.
While increasing your calcium intake, it is crucial to monitor your phosphorus levels as well. Many calcium-rich foods, such as dairy products, are also high in phosphorus, which may not be recommended for a renal diet. Consult with a renal dietitian and your doctor to ensure your diet meets your individual requirements.
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Consume foods that naturally contain calcium, e.g. spinach, salmon, and rhubarb
Spinach, salmon, and rhubarb are excellent sources of calcium. Spinach is a dark green, leafy vegetable that is rich in calcium. However, it contains oxalates, which can decrease calcium absorption. Despite this, spinach still provides a good amount of calcium and is also linked to a reduced risk of kidney stone formation by decreasing the absorption of oxalates.
Salmon, particularly the canned variety with bones, is an excellent source of calcium. It also contains vitamin D, which aids in the absorption of calcium. Canned salmon provides about 181 milligrams of calcium per 3-ounce serving.
Rhubarb is another food that naturally contains calcium. It is high in fiber and vitamin K, and while it does contain oxalates that may reduce calcium absorption, it still provides a good amount of this mineral. A cup of raw rhubarb contains approximately 105 milligrams of calcium.
In addition to these foods, there are other natural sources of calcium that can be incorporated into your diet. Sardines, for example, are small fish that have high levels of selenium, a mineral that can prevent and reverse mercury toxicity. They provide about 27% of the daily value (DV) of calcium per can.
Other calcium-rich foods include yogurt, which offers up to 34% DV in a cup. Beans, specifically winged beans and white beans, are also good sources, providing 19% and 12% DV per cooked cup, respectively. Dark green, leafy vegetables like cooked kale, collard greens, and broccoli are excellent sources of calcium as well. A cup of cooked kale provides more calcium than a cup of milk, with 177 milligrams. Broccoli, whether raw or cooked, also boosts your calcium intake, with a cup of raw broccoli containing about 35 milligrams and a cup of cooked broccoli offering 76 milligrams.
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Discuss with a renal dietitian to understand which foods contain calcium
If you are on a renal diet, it is important to discuss with a renal dietitian to understand which foods contain calcium. They can help you identify calcium-rich foods to include in your diet or high-calcium foods to avoid, depending on your levels.
Calcium is essential for good health, especially when you are on dialysis. While dairy products are well-known sources of calcium, they are also very high in phosphorus and are therefore not good choices for people with kidney disease who require a low-phosphorus diet. In addition to dairy, other foods that naturally contain calcium include rhubarb, spinach, blackstrap molasses, sardines, and salmon canned with bones. Calcium is also added to a wide array of processed or packaged foods, such as cereals, crackers, breads, juices, and powdered drink mixes. Milk substitutes like soy or almond milk may also be fortified with calcium.
Your dietitian can help you interpret food labels, as nutrition facts often do not provide information on calcium content. By planning your meals and grocery shopping ahead of time with this knowledge, you can achieve healthy calcium levels in your body. It is also important to note that portion size is a crucial factor when determining what to eat.
If you are experiencing high calcium levels, your doctor and dietitian may recommend limiting foods that are naturally high in calcium. They can also advise you on the best time to take any prescribed supplements. Regular blood tests will help monitor your calcium and phosphorus levels.
The recommended amount of calcium for those with kidney disease varies depending on the source and individual factors. The Kidney Disease Outcomes Quality Initiative (KDOQI) recommends a range between 8.4 to 10.2 mg/dL, while other sources suggest aiming for around 1000 mg/day. According to the National Kidney Foundation (NKF), total calcium intake for people with renal disease should not exceed 2000 mg daily.
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Read food labels to identify foods with more than 10% calcium
Reading food labels is an important skill for anyone on a renal diet who wants to increase their calcium intake. While calcium is found naturally in dairy products, these foods are also high in phosphorus, which is not recommended for people with kidney disease. Therefore, it is important to identify foods with more than 10% calcium to meet your daily calcium needs.
Firstly, it is important to note that food labels are not required to list the calcium content, so its absence does not mean the food is calcium-free. Talking to a renal dietitian can help you understand which foods contain calcium. In addition, processed or packaged foods such as cereals, crackers, or breads, juices, and milk substitutes like soy or almond milk may have added calcium.
When reading a food label, look for the calcium content listed in milligrams (mg) per serving. Many food packages will also include a claim about their calcium content, so understanding these claims will help you select calcium-rich foods. For instance, a product with a %DV of 37% for sodium is considered a HIGH sodium product as it has more than 20% DV for sodium. Similarly, you can use %DV to identify foods with more than 10% calcium.
According to the National Kidney Foundation (NKF), the total calcium intake for people with renal disease should not be greater than 2,000 mg daily, including calcium from the diet, supplements, and calcium-based phosphorus binders. Based on studies, it is recommended to aim for around 1000 mg/day to achieve a neutral calcium balance and prevent adverse effects.
In summary, reading food labels and understanding the calcium content can help you make informed choices to increase your calcium intake while on a renal diet.
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Take calcium supplements, but only if prescribed by a doctor
Calcium supplements can be a quick and effective way to increase your calcium intake when on a renal diet. However, it is important to note that these should only be taken if prescribed by a doctor. This is because the decision to prescribe calcium supplements depends on several factors, including the baseline calcium intake of the individual and their overall health.
Your doctor will measure and evaluate your calcium, phosphorus, vitamin D, and parathyroid hormone (PTH) levels to determine your calcium status. They will also consider your dietary calcium intake and make recommendations to help you meet the recommended intakes. For instance, your doctor may advise you to eat more calcium-rich foods or suggest taking supplements.
If your doctor prescribes calcium supplements, it is important to follow their instructions carefully. Ask your renal dietitian to discuss the best time to take the supplements and how they may interact with your diet. For example, calcium is best absorbed when taken with food, so you may be advised to take the supplements with meals.
It is worth noting that calcium recommendations for people with chronic kidney disease (CKD) differ from those for the general population. As kidney function declines, patients may retain more calcium, leading to high calcium levels in the body (hypercalcemia). Therefore, it is crucial to work closely with your healthcare team, including your doctor and renal dietitian, to monitor your calcium levels and make any necessary adjustments to your diet or supplement regimen.
Additionally, it is important to be mindful of your dietary choices when trying to increase your calcium intake on a renal diet. While dairy products are naturally rich in calcium, they are also high in phosphorus, which is not suitable for people with kidney disease. Instead, focus on low-phosphorus foods to maintain a healthy range of calcium and phosphorus in your body.
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Frequently asked questions
The recommended calcium intake for people with renal disease is between 800 and 1200 mg/day. The exact amount should be determined by a doctor on a case-by-case basis.
Calcium is found naturally in dairy products, rhubarb, spinach, black strap molasses, sardines, and salmon canned with bones. Calcium is also added to many processed or packaged foods such as cereals, crackers, and soy or almond milk.
Reading nutritional labels can help you identify foods that are high in calcium. It is also important to be aware of portion size when determining your calcium intake.
If your calcium is low, a dietitian can coach you on calcium-containing foods to include in your diet.
