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Is Fish Good for Those with Kidney Disease?

Updated: 13 minutes ago


Fish is like a nutritional powerhouse for people with chronic kidney disease (CKD). Packed with vitamins, minerals, and good fats. There are tons of different fish to choose from, but some may be better than others. For example, sardines, mackerel, anchovies, salmon, and herring all tend to be very low in mercury (a metal that may have a mild impact on kidney health).


Why Fish May be Helpful for CKD


Fish is loaded with helpful nutrients such as iron, zinc, calcium, B vitamins, and more. It's also a good source of protein, which is important for your body, and naturally low in sodium, whether it's fresh or saltwater fish.


But the real star of the show is omega-3 fatty acids. These "good fats" can help lower your risk of heart disease, keep your blood pressure in check, and even boost your good cholesterol.  It is especially important for people with CKD, since high blood pressure can affect your kidneys.


Fish is also a great source of protein, which helps you feel your best, especially with CKD. Eating fish might even reduce protein leaking in your urine (called albuminuria) and slow down kidney damage in people with diabetes.  Just remember, the amount of protein you need might change depending on how advanced your CKD is. Talk to your doctor or a dietitian to figure out the right amount for you.


Getting the Most Out of Your Fish


Choosing the right kind of fish for CKD makes a big difference.  Fish sticks, pre-made meals, or fried fish from restaurants often use lower-quality fish, so you won't get all the good nutrients. Plus, these options tend to be loaded with salt and phosphorus, which are two things people with CKD need to limit. Fresh fish is the best choice.


How Much Fish?

This is a difficult question and the answer changes from person to person. In those with late stage kidney disease, they often need to somewhat limit their protein intake. With very low kidney function theoretically very high levels of protein from fish may increase uric acid levels in the body, leading to something called hyperuricemia. Very high uric acid can cause nausea, vomiting, fatigue, and weight loss. Furthermore, excessive protein may be hard on the kidneys and affect overall outlook. It is important to speak with a health professional to assess how much fish and overall protein to consume given your context.


Are There Studies on Fish and Kidney Disease?

Quite surprisingly, we found no studies that assess fish consumption in those with pre-existing kidney disease. However, we do have studies in the general healthy population assessing the impact of fish intake on kidney health.


Below are studies in the general population finding  improved kidney function in those with higher intakes of fish:


Here are the studies in the general population studies that have found lower kidney function in those with very high intakes of fish:


The above suggests there are about an equal number of studies finding that fish is beneficial to those finding it may be harmful. This does make it quite difficult to assess. Usually if one food or therapy is harmful most of the studies would show the same result of harm. When the results of studies are mixed from study to study most often the effect is just too small to assess. In other words, the change in kidney function was around 0 for all the studies above, with or without fish intake. So it is unlikely that fish makes a meaningful difference on kidney function when consumed in moderation. It is also important to keep in mind that these studies looked at very high intakes of fish. With moderate intakes of fish and seafood, it is likely the effects from person to person would be even smaller.


Conclusion

Fish generally improves a person’s overall cardiovascular health, longevity, energy levels and much more. Studies suggest that fish is safe in moderation for those with kidney disease and the benefits outweigh the risks. If you are concerned about figuring out which types of foods to eat and how much, reach out to Dr. Baker (ND) and he can create a custom diet plan that is tailored to your type of kidney disease, stage, and blood work (potassium, phosphorus, and urea levels).


References

[1] Long-Term Fish Intake Preserves Kidney Function in Elderly Individuals: The Ikaria Study November 2012Journal of Renal Nutrition 23(4) DOI:10.1053/j.jrn.2012.09.002

[2] Association of fish intake and survival in a cohort of incident dialysis patients Authors Nancy G. KutnerPatricia Ward ClowRebecca ZhangXavier Aviles Source InformationMay 2002, Volume39(Issue5)Pages, p.1018To - 1024 - American Journal of Kidney Diseases Link

[3] Kubo S, Imano H, Muraki I, Kitamura A, Noda H, Cui R, Maruyama K, Yamagishi K, Umesawa M, Shimizu Y, Hayama-Terada M, Kiyama M, Okada T, Iso H. Total protein intake and subsequent risk of chronic kidney disease: the Circulatory Risk in Communities Study. Environ Health Prev Med. 2023;28:32. doi: 10.1265/ehpm.22-00247. PMID: 37211392; PMCID: PMC10233334.

[4] Chandrasekaran, Sundhareshwaran1; Mookambika, R. V.1; Ashok, Vishnu G.2; Panicker, Priya Ravindra2; Nithya, G.2. Dietary patterns among chronic kidney disease patients and their impact on their clinical course: A longitudinal study from rural Kanyakumari. International Journal of Noncommunicable Diseases 8(2):p 104-109, Apr–Jun 2023. | DOI: 10.4103/jncd.jncd_48_22

[5] Associations of meat, fish and seafood consumption with kidney function in middle-aged to older Chinese: a cross-sectional study based on the Guangzhou Biobank Cohort Study

Ting Yu Lu1, Wei Sen Zhang2, Tong Zhu2, Chao Qiang Jiang2, Feng Zhu2, Ya Li Jin2, Tai Hing Lam3, Kar Keung Cheng4, http://orcid.org/0000-0002-0537-922XLin Xu1,3,4 https://doi.org/10.1136/bmjopen-2023-073738

[6]Association of dietary proteins with serum creatinine and estimated glomerular filtration rate in a general population sample: the CHRIS study

original Article Published: 05 August 2022 Volume 36, pages 103–114, (2023) Cite this article   https://link.springer.com/article/10.1007/s40620-022-01409-7

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The content of this website is intended for informational purposes and does not replace medical advice given to you by your personal doctor. Information on this site should not be used to diagnose or treat. Before starting any new dietary, exercise or lifestyle regimens you should consult your primary medical provider.

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