Baguettes in a basket with title: The Best Bread for Kidney Disease over top of image

The Best Bread For Kidney Disease

There are few foods as demonized and confusing as bread. Especially when it comes to kidney health. White or wheat? Is whole grain better? Read on to get the truth about the best bread for kidney disease.

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Is Bread Good For Kidney Disease?

In short, yes! Bread and other healthy carbohydrates are an important part of a healthy diet for kidney disease.

You may be thinking “But doesn’t bread have carbs?”. Answer: yes! Bread is a wonderful source of carbohydrate, and this is a GOOD thing!

Carbs have been demonized, perhaps partially due to the “keto” diet craze. But carbohydrates are actually a critical part of a healthy diet for kidney disease.

Bottom line: Bread is good for kidney disease! But, you want to make sure you choose mostly healthy, fiber-rich bread (more below!). And, that you eat bread and other carbohydrates as part of a balanced diet.

A Quick Nutrition 101 Lesson

To understand why bread and carbohydrates are an important part of a kidney friendly diet, we need to go back to Nutrition 101.

We get calories from 3 main sources: carbohydrate, fat and protein. Alcohol also contributes calories, but that doesn’t usually contribute a significant amount!

In general, diets that are lower in protein are easier on kidneys. (1) If we reduce the calories from one of these 3 groups, the proportion of calories must increase from another. Our bodies need calories to function!

For kidney health, it is usually best to reduce calories from protein, increase calories from carbohydrate and continue to eat a moderate amount of calories from fat. Very high fat diets can contribute to heart disease, which is a big concern for people with kidney disease.

If you are a numbers person, this is how this all breaks down. Here is an example for someone who weighs 175 pounds (79.5 kilograms) and needs about 2,000 calories. If this person had stage 3 Chronic Kidney Disease, they might need:

  • 50 grams of protein (10% of calories)
  • 300 grams of carbohydrate (60% of calories) – this is about 20 slices of bread!
  • 67 grams of fat (30% of calories)

Please check with your dietitian to know exactly how much protein, carbohydrate and fat is right for you! A kidney friendly diet is different for everyone.

Bread for People with Kidney Disease & Diabetes

I know what many of you are thinking. What if I have both diabetes AND kidney disease? Then surely I should stay away from bread?

Nope! Bread is absolutely okay for people with diabetes too! Again, the key is portion size, choosing bread with plenty of fiber, and what you eat with it.

Of note, a very low protein diet may not be the best choice for people with both kidney disease and diabetes. Ask your dietitian what is best for you.

Learn more about a diabetic renal diet!

The Whole Grain Bread Dilemma

A Google search (or, an outdated handout at your doctor’s office), may lead you to believe that white bread is the best bread for kidney disease. This can be really frustrating and confusing, since whole grain bread is usually a healthier option.

Traditionally, white bread was recommended for people with kidney disease because it has less potassium and phosphorus. But, this recommendation was a little narrow minded and we know much more now!

There has been a big change in in the recommendations for people with kidney disease. In 2020, the National Kidney Foundation and The Academy of Nutrition & Dietetics released updated nutrition guidelines for people with Chronic Kidney Disease. These guidelines recommend taking the absorption of phosphorus from different food sources into consideration.

Only about 30% of the phosphorus in plant foods, like whole grains, beans, nuts, seeds and lentils, is absorbed. Compare this to phosphorus in meat and dairy, whereabout 80-90% of phosphorus is absorbed. Even worse, phosphorus from food additives is nearly 100% absorbed. (2) (3)

On the potassium front, not everyone with kidney disease needs to limit potassium.

So, gone are the days of recommending white bread for kidney disease. Whole grain IS the best bread for kidney disease! It may be slightly higher in phosphorus, but most of it isn’t absorbed anyway!

Tips for Finding the Best Bread for Kidney Disease

As always, the key to finding kidney friendly foods is to look at the nutrition label. Here are my keys to finding the best bread for kidney disease!

Tips for finding kidney friendly bread. Cartoon loaf of bread with arrows. Arrow captions include: less than 175mg sodium per slice, no "PHOS" ingredients, less than 5g added sugar per slice, 100% whole ingredients and at least 3g fiber per slice

Whole Grain Ingredients

The marketing industry is really good at making bread look like it is good for you, when that may not be the case.

Look for ingredients that are “100% whole grain…”. Examples are:

  • 100% whole grain wheat
  • 100% whole grain rye
  • 100% brown rice

Fiber

One of the biggest benefits of bread for kidney disease is fiber! Fiber can help control blood sugar, which in turn helps protect your kidneys. Fiber is also good for gut health. We are learning more and more about how the gut and kidneys are connected. (4)

I recommend looking for bread with at least 3 grams of fiber per slice.

Sodium

A low sodium diet is key to nearly any kidney-friendly diet. Most people should limit sodium to 2,300mg per day. (5)

Bread is a surprising source of sodium in the American diet. Up to 10% of the sodium we eat in the United States comes from bread. (6)

Look for bread with no more than around 175mg sodium per slice.

Phosphorus

Again, phosphorus that occurs naturally in whole grain bread is not a concern. However, some breads have phosphorus food additives in them. We DO care about this added phosphorus.

Avoid bread that has any “PHOS” ingredients in it.

Sugar

Some bread has a surprising amount of added sugar.

Watch out for sugar ingredients in bread. Remember, sugar is sugar. Here are some ingredients that are masquerading as sugar:

  • Granulated sugar
  • Cane sugar
  • Brown sugar
  • Molasses
  • Honey
  • High fructose corn syrup
  • Beet sugar
  • Syrups (like barley malt syrup or rice syrup)
  • Agave
  • Sucrose
  • Maltose
  • Dextrose
  • Galactose

Aim for bread with no more than 5 grams of added sugar.

Top 3 Best Breads for Kidney Disease

Ezekiel Sprouted Whole Grain Bread*

This bread has 3 grams of fiber per slice and only 75mg of sodium. No phosphorus additives here!

Brownberry Whole Grain Health Nut Bread*

This brand is commonly available in grocery stores across the United States. Brownberry bread tends to be phosphate additive free and a good whole grain option.

Dave’s Killer Whole Grains & Seeds Bread*

If you love seeds and visible whole grains in your bread, this bread is for you! All of these nuts and seeds give this bread a whopping 5 grams of fiber per slice.

Is Sourdough Bread Good for Kidney Disease?

I get this question a lot. Sourdough bread is quite tasty, but isn’t necessarily good for kidney disease.

“Sourdough” refers to the process of making the bread, not the nutritional value. Rather than yeast, sourdough bread gets it’s rise from fermentation. This fermentation gives sourdough bread that slightly funky, sour flavor.

Typically, sourdough bread is made from white flour. It isn’t better for you than plain old white bread. As always, check the nutrition facts label to look for bread with plenty of fiber!

Is Rye Bread Good For Kidney Disease?

Another common question. Don’t be fooled by it’s dark color. Similar to sourdough, rye bread is not necessarily made with whole grain flour.

Most rye bread is made from rye flour that has had the fiber-containing parts of the kernel removed. This is the same process wheat goes through to make white flour.

However, you can find whole grain rye bread! Look for “whole grain rye flour” in the ingredients.

Other Healthy Carbohydrates for Kidney Disease

Remember, bread isn’t the only healthy carbohydrate for kidney disease! There are plenty of tasty options!

  • Whole Grain Pasta
  • Brown or Wild Rice
  • Quinoa
  • Farro
  • Kamut
  • Barley
  • Wheat Berries
  • Popcorn
  • Oatmeal
  • Fresh or frozen fruit

Happy Eating!

Melanie

15 thoughts on “The Best Bread For Kidney Disease”

  1. Sorry am only having issues concerning to much protein which is my kidney are licking protein can I eat bread and what else can I add to it

    1. Melanie Betz MS, RD, CSR, CSG

      Popcorn is my favorite snack! I had some last night, in fact! I love to make it on the stove with canola oil and just a pinch o salt. It really is delicious, I promise!

      1. Florence A Harris

        I love popcorn, it’s one of my favorite snacks I pop it on the stove with a pinch of salt or sugar. My second favorite snack is strawberries.

  2. I’m in stage 3 CKD and am terribly stressed every day by the conflicting limits of different foods and “good” or “bad” for you information that is supposedly correct. For every informative article (as well as diet info. from my Nephrologist…), I can find a differing opinion saying DO NOT eat that, when I was told DO eat those certain foods! WHERE is the final, absolute correct foods listing? I bought sweet potatoes because they were listed as GOOD for CKD…next article or listing I saw, they were listed on the “AVOID” list and NOT on the “ENJOY” list, which was one suggested foods list comparison I thought was well-defined and very simple to understand. My next appointment is with a Therapist to try to make my mind accept my situation…???

    1. Melanie Betz MS, RD, CSR, CSG

      Hi Char! I know it can be SO utterly confusing and frustrating trying to figure out what is “best” to eat for CKD. There is SO much conflicting information out there. I think part of the reason there is so much conflicting info is that there is NO one single “kidney diet” – healthy eating for your kidneys really needs to be individualized to your lab values and past medical history.I would HIHGLY recommend working with a dietitian individually to help you understand what is best for YOU! I have some dietitians who work with clients on my resources page. Because you have stage 3 CKD, I’d also highly recommend checking out Jen Hernandez’s online program- Plant Powered Kidneys. She helps you understand how to interpret your own labs and tailor your diet to them. I hope that helps!

  3. Hi Melanie,
    Thanks so much for your helpful perspective on bread and for reiterating that the old advice about whole grains doesn’t apply any more. I feel like this can’t be emphasized enough since the old info is still prominent and often the first thing a newly-diagnosed person discovers on the internet.
    I did want to point out that in your example of what a 170 lb person in stage 3 would need, your macros add up to 110%. I’m curious to see the corrected estimates.
    Thanks for your great work,
    Anne

    1. Melanie Betz MS, RD, CSR, CSG

      Hi Anne! Thank you so much for your comment. And my apologies for that error! I just corrected the macronutrient breakdown – I lowered the fat to 30% of calories for an even 100%. I hope this helps!

  4. Foods to eat with Kidney problem was a great article, especially the breads. I have for a year trying to find what bread to eat. I would look in the recipe books to see what breads were used, but that was not too accurate.

    Love your articles.

  5. Can you prioritize grains for a low oxalate diet? Are the ones above all okay if I limit to one cup a day? I’ve been limiting to oat bran, wild rice and barley snd I’m getting a little tired of them :). I miss the quinoa and kamut and even the farro . And I’ve been sticking to red lentil pasta instead of whole grain – which is better?

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