is low fat milk good for kidney patients

Milk Alternatives

Why are milk alternatives a superfood?

• Milk alternatives can be lower in phosphorus and potassium than cows milk unless they have additives.
• Soy milk is high in protein.
• Almond milk is a good source of vitamin E and antioxidants.
• Nut and seed-based milks contain monounsaturated and polyunsaturated fats, which benefit heart health.
• Oat milk has more riboflavin (vitamin B2) and vitamin B12 than low-fat cows milk.
• Plant-based milks are a great alternative if you are lactose-intolerant or have high cholesterol levels.
• There are also yogurt, frozen desserts, and cheeses that are made from plant-based milks.

Milk alternatives and kidney disease

Milk alternatives have varying amounts of potassium and phosphorus. The type and how much you may have each day will depend on your stage of kidney disease or the type of dialysis you receive. Use the chart below and ask your kidney dietitian how to choose milk alternatives that will fit your kidney diet plan.

Chronic kidney disease (CKD) and transplant

Most people with CKD or kidney transplant do not have to limit milk alternatives due to potassium or phosphorus unless directed by their kidney dietitian. Find a kidney dietitian.

Hemodialysis (3 days per week)

Potassium and phosphorus can be a concern for some milk alternatives depending on your lab results. Ask your kidney dietitian how much and which type of plant-based milk is best for you.

Daily home and nocturnal hemodialysis or peritoneal dialysis

These types of dialysis can remove more potassium. You may consume milk alternatives for more dietary potassium if they do not have phosphorus additives. If you are on peritoneal dialysis and need more protein, soymilk is a protein-rich alternative.

Kidney stones

Soy, almond, and cashew milks have a high oxalate content and may be restricted if you have a history of calcium oxalate kidney stones. Consult your doctor or kidney dietitian for more information on oxalate-containing foods.

Common plant-based milk brands

Serving size: 1 cup

Source: Manufacturers website

*Contains added phosphates. If consuming this item, take phosphate binder(s) if prescribed by your doctor.

Want to save this information for later?

For more information, contact the National Kidney Foundation

Toll-free helpline: 855.NKF.CARES or email: [email protected]

The National Kidney Foundation wishes to thank its Council on Renal Nutrition (CRN) for the development of this fact sheet.

*This content is provided for informational use only and is not intended as medical advice or as a substitute for the medical advice of a healthcare professional.

Is Milk Good for Kidney Disease? What You Need to Know

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Milk has long been recognized as a polarizing food in many ways, including in kidney disease and the renal diet. Many have wondered, is milk bad for kidneys? What about the different stages of kidney disease? There are several factors that contribute to the answer to this question. Phosphorus, potassium, and protein all play a role in kidney health, especially with the different stages of kidney disease. And with so many choices when it comes to milk, it can become very confusing to figure out the best type of milk for kidney disease. In this article, we will review the different milk options and which is the best milk for kidney disease.

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Milk and Kidney Disease

Milk is part of the dairy food group. It is a well-known good source of calcium.

It is also a source of phosphorus and potassium. Due to concerns around these nutrients, some consider milk bad for kidneys as it makes it harder to control potassium or even phosphorus.

Its important to know that everyone has different dietary needs. This is especially important for people with chronic kidney disease.

Protein

Many people with kidney disease that are not on dialysis need to limit protein. This is because too much protein can be hard on the kidneys.

The protein amount in milk will vary based on the type of milk. Types of milk highest in protein include cows milk and soy milk.

The lowest protein milk options include oat milk and rice milk.

Phosphorus

Phosphorus is a mineral found as an organic and inorganic substance in foods.

Organic phosphorus means it is naturally occurring, whereas inorganic phosphorus is added to foods.

Cows milk and milk products have organic phosphorus because it is an animal product.

They may also have inorganic phosphorus in the form of additives. Label reading for phosphorus additives is very important when it comes to limiting phosphorus in the renal diet.

Potassium

Milk is also a source of potassium. Varying types of milk will have different amounts, based on the main ingredient of the milk or milk alternative.

The highest potassium milk options include cows milk and canned coconut milk.

The lowest potassium milk options are cashew milk, rice milk, and ready-to-drink coconut milk.

Calcium

As mentioned earlier, cows milk is known as a good source of calcium. Some people with kidney disease need to eat less calcium in their diet and some need to eat more.

An example of someone who would need more calcium is a person with calcium oxalate kidney stones.

An example of someone who may need to limit calcium is someone on dialysis.

The highest calcium milk is coconut milk and cows milk. Many plant-based milk options are also fortified with calcium, which may provide extra calcium.

Is milk bad for kidney stones?

Kidney stones are painful and something no one wants to experience. Soy milk is bad for kidney stones due to the oxalate content of 20mg per cup.

There is no known value for the oxalate content of almond milk. However, since almonds are very high in oxalates, its wise to choose an alternative plant-based milk.

Better milk options for kidney stone prevention include oat milk, rice milk, or coconut milk.

Milk may be beneficial for kidney stones, depending on the type of kidney stones and the type of milk.

For calcium oxalate stones (the most common type of kidney stones) a diet with adequate calcium is very important in kidney stone prevention.

However, there are many different ways we can get calcium in our diet that does not require milk.

Getting enough calcium from either dairy or non-dairy sources is still shown to be helpful in the prevention of kidney stones.

Another reason milk may actually be helpful for kidney stone prevention is that it will be counted as part of your fluid needs. Its important for those that currently have, are at risk, or have a history of kidney stones to get plenty of fluids throughout the day.

Shopping for the best milk for kidney disease

Shelf-stable milk vs. refrigerated milk

Milk can be found either cold or at room temperature in the grocery store. Depending on your shopping preference, you may prefer to have some cold milk on hand and shelf-stable milk available for emergencies.

Regardless of where you find your favorite milk, its important to follow these guidelines when it comes to choosing the best milk for kidney disease.

Label reading for additives

It is especially important to read the ingredients list to weed out any milk that has phosphorus additives. If you are looking for low potassium milk, know that added potassium additives can contribute to potassium in your diet.

Additives can be found in both shelf-stable and refrigerated milk options. Its good practice to read labels when looking for your best milk for kidney disease.

Low potassium milk for kidney disease

There may be a benefit in choosing low potassium milk or low phosphorus milk for kidney disease.

For many people with early-stage kidney disease, low potassium milk may not be necessary. Instead, start by focusing on avoiding additives. This can help protect kidney health.

Some with late stages (stage 4 and stage 5) may have high potassium levels.

Excessive potassium in the blood can be very dangerous. If your doctor has discussed concerns about your potassium levels, choosing low potassium milk may be a great way to help control potassium levels.

There are many different types of milk. They can be found in the refrigerated dairy section of the grocery store. Shelf-stable milk can be found in the center aisles with other pantry foods.

Animal Milk Options

Just like plant-based milk options, there are animal milk options available. The options will vary based on your geographical location and cultural food preferences.

Next are some details about the most common animal options of milk for kidney disease.

Cows Milk

One of the most common types of milk is cows milk. There are several types of cows milk to choose from, with different amounts of fat. Here is a table that includes the different types of cows milk, based on fat content.

Dietary information was obtained from the USDA Food Database using a 1 cup serving size. Amounts may differ significantly based on brand and product.

The acidity of cows milk is just in the acid range, with a pH value of around 6.7 to 6.9. (A neutral pH level is 7).

Cows milk is not considered low potassium milk. An 8-ounce cup of cows milk has approximately 375 milligrams of potassium. If potassium control is a concern, limiting cows milk to 1 cup per day may help.

The phosphorus content of cows milk is also fairly high. There are approximately 250 milligrams of phosphorus per 8-ounce serving. Even organic phosphorus from cows milk will be absorbed by 60-80%.

Additionally, powdered or dehydrated milk often contains several phosphorus additives of which can be entirely absorbed by the body.

Calcium has been traditionally viewed as a benefit in drinking milk. Notably, a glass of cows milk has over 300 milligrams of calcium approximately 30% of the recommended daily intake for an adult.

However, it is possible that a well-rounded, plant-based diet can also provide calcium.

Buttermilk

Buttermilk is fermented cow milk. Bacteria are added to the milk to induce fermentation. Traditional buttermilk is considered a probiotic food due to the fermentation process, where that tangy taste comes from.

However, the typical buttermilk you find in the grocery store is generally cultured buttermilk. Cultured buttermilk is made from the leftover liquid from making butter.

Dietary information was obtained from the USDA Food Database using 1 cup serving size. Amounts may differ significantly based on brand and product.

Buttermilk can be used as kidney-friendly milk. However, the traditional buttermilk may not be a good option for those that are immunocompromised.

This is because unpasteurized milk is not recommended after transplant due to the risk of getting ill from the bacteria.

Goat Milk

Another more common animal milk is goat milk. Its commonly used in India but is becoming more popular in the United States as an alternative for those with allergies or digestive issues with cow milk.

Nutritionally, goat milk is quite similar to cow milk. Per 8-oz cup, goat milk has:

• 168 calories
• 8 grams protein
• 327 milligrams calcium
• 271 milligrams phosphorus
• 498 milligrams potassium

As you can see, goat milk is higher in potassium than cow milk. Those on a potassium restriction may need to limit goat milk in their diet.

However, because of the higher mineral content, goat milk is an alkaline milk option. Goat milk has a PRAL score of -0.5. Because of this reason, goat milk is a more kidney-friendly animal milk option.

Read more about PRAL and how understanding this protects your kidneys here.

Plant Milk Options

Coconut Milk

Coconut milk can be a great substitution for cows milk in many ways.

This is not seen as milk bad for kidneys as it is derived from plants, making it naturally lower in phosphorus. There are two types of coconut milk available.

Canned coconut milk

Canned coconut milk is traditionally used in cooking. You may add it to soups, stews, or even baked goods. Canned coconut milk has a light coconut flavor that can either be hidden or emphasized depending on the recipe youre using.

A cup of canned coconut milk has:

• 445 calories
• 48 g fat
• 5 g protein
• 497 mg potassium
• 217 mg phosphorus
• 40 mg calcium

However, its not commonly used as a beverage given that it is very thick and heavy. Canned coconut milk is most commonly used in cooking.

Its a great option to add additional calories to a meal, which can provide more satiety. While the potassium level seems high, it doesnt contribute very much per serving.

Assume a recipe that makes 4 servings uses 1 cup of canned coconut milk. That means per serving, the canned coconut milk adds just 125 milligrams of potassium but also adds 112 calories.

You can find canned coconut milk in the grocery stores center aisles and even online. One of the coconut milk that does not have additives is kidney-friendly milk is Thai Kitchen organic lite coconut milk.*

The full-fat option* is also available (and I love that it has a resealable cap!).

Try using canned coconut milk in your next curry. It adds a boost of calories and flavor to make your meal more satisfying.

Carton coconut milk

Carton coconut milk, or ready-to-drink coconut milk, can be used in recipes like oatmeal, smoothies, or just poured into a glass. Its thinner consistency is due to the water-to-coconut ratio being higher.

Ready-to-drink coconut milk has

• 70 calories
• 5 g fat
• 1 g protein
• 90 mg potassium
• 17 mg phosphorus
• 460 mg calcium

Due to the high water content of coconut milk, ready-to-drink coconut milk can make for low-potassium milk for dialysis patients.

Coconut milk can be a part of a plant-based diet and is absolutely okay for kidney disease.

Check out Real Coco organic original coconut milk* for a kidney-friendly coconut milk option.

Almond milk

Almond milk is one of the most common plant-based milk alternatives. A cup of unsweetened almond milk has:

• 35 calories
• 2.5 g fat
• 1 g protein
• 180 mg potassium
• 68 mg phosphorus
• 395 mg calcium

Its considered a low potassium milk when compared to the higher potassium cows milk.

The phosphorus in almond milk is quite low compared to cows milk. Its a low phosphorus milk due to the fact that phosphorus from plant sources is not easily absorbed.

Some examples of kidney-friendly almond milk include:

Oat milk

Oat milk is being seen more and more often as a plant-based milk option. Many restaurants even now offer oat milk as a plant-based milk substitute, including coffee shops!

Per 8 ounce serving, oat milk has:

• 130 calories
• 5 g protein
• 2 g fat
• 131 mg potassium
• 150 mg phosphorus
• 18 mg calcium

Many oat milk options have phosphorus or potassium additives. Therefore, it is very important to read labels to find kidney-friendly oat milk.

Some examples of kidney-friendly oat milk include:

Be careful in choosing your oat milk as many include phosphorus or potassium additives.

Cashew milk

Cashew milk is a great plant-based milk option for kidney disease. More creamy than almond, but still made from a nut, cashew milk has

• 30 calories
• 1 g protein
• 2.5 g fat
• 50 g potassium
• 48 mg calcium

The phosphorus content of cashew milk is difficult to find. But by sticking to guidelines of no phosphate additives, less phosphorus will become absorbed.

Some examples of kidney-friendly cashew milk include:

Soy milk

Soy often gets a bad reputation in the diet. Many have heard that soy causes cancer or affects hormone balances.

The facts are that soy provides protection against cancer. Soy also has no proven connection to affect hormone levels in men.

That being said, soy milk can also be a great option for milk for kidney disease. One cup of unsweetened soy milk provides:

• 105 calories
• 4 g fat
• 6 g protein
• 298 mg potassium
• 105 mg phosphorus
• 300 mg calcium

Soy milk can be an excellent choice of milk for dialysis patients as the potassium level is no higher than cows milk. The phosphorus content is lower and still provides plant-based protein.

Some examples of kidney-friendly soy milk include:

Rice milk

Rice milk is one of the oldest recommended plant-based milk for kidney disease. This is due to the low nutrient content of the rice used to make rice milk.

One cup of rice milk has:

• 115 calories
• <1 g protein
• 2 g fat
• 66 mg potassium
• 137 mg phosphorus
• 288 mg calcium

An example of kidney-friendly rice milk is Rice Dream classic rice milk.*

Be sure to get the classic and not enriched. Enriched milk often includes additives.

Hemp Milk

Hemp milk is made from hemp seeds. The ingredient is a source of healthy fats which can help with satiety.

One cup of hemp milk has:

• 60 calories
• 3 g protein
• 7 g fat
• 101 mg potassium
• 317 mg phosphorus
• 283 mg calcium

Hemp milk has more phosphorus compared to other plant-based options.

Its also especially important to read the label for additives as hemp milk can have phosphorus or potassium additives.

Comparison Chart of Milk for Kidney Disease

Here is a table to compare the different options when adding milk to the renal diet.

Dietary information was obtained from the USDA Food Database using 1 cup serving size. Amounts may differ significantly based on brand and product.

Homemade milk

Homemade plant-based milk that is good for your kidneys can be a simple process with the right tools and ingredients!

Take 1 cup of raw almonds (like these*) and soak in a bowl of filtered water overnight or for at least 4 hours.

Drain almonds and add to a high-powered blender (this is our fave blender at home*) along with 2 cups of filtered water.

Blend on high until smooth. Add in an additional 2 cups of filtered water and blend again until smooth.

Filter into a pitcher or jar using a cheesecloth* or fine mesh strainer to remove the almond meal. Milk will keep for up to 1 week.

Instead of almonds, try rolled oats or raw cashews. If using rice, soak rice in hot water for 2 hours first.

Summary

With so many plant-based milk options available, shelf-stable or refrigerated, even people with kidney disease can find milk that is good for kidney disease.

The best type of milk will depend on the individuals health goals. This may be to keep potassium controlled, limit protein, or avoid phosphorus additives.

Cows milk is typically higher in protein, potassium, and phosphorus compared to plant-based milk alternatives.

One of the most common plant-based milk that is kidney-friendly is rice milk. This is because it is low in most nutrients, especially when phosphorus and potassium-additive free.

If you want to keep milk in your renal diet, first determine with your nephrologist or primary care doctor what is most important to your health. A renal dietitian can help you learn how to add this creamy, cold beverage into your day.

Jen Hernandez is a registered dietitian and board-certified specialist in renal nutrition. She has nearly a decade of experience with kidney disease patients in all stages - from stage 1 through kidney transplant. Jen writes on the blog of Plant-Powered Kidneys to help reach and teach more kidney patients about how they can enjoy more foods in a plant-based diet while protecting kidney health.