UH Rainbow Pediatric & Adolescent Health Professionals

Sodium and Fluid Restriction for Children with Kidney Failure

A low-sodium diet or salt restriction may be used to help prevent or reduce fluid retention in your child's body. The amount of sodium or salt allowed in your child's diet depends on your child's health condition. Your child's healthcare provider or dietitian will figure out the amount of sodium allowed in your child's diet. It is often expressed in milligrams (mg) per day. Some common sodium restrictions include 2,000, 3,000, or 4,000 mg per day. With most sodium-restricted diets, high-sodium foods are limited. And salt is not allowed when making food or at the table.

Foods high in sodium

Canned foods (vegetables, meats, pasta meals)
Processed foods (meats, such as bologna, pepperoni, salami, hot dogs, sausage)
Cheese
Dried pasta and rice mixes
Soups (canned and dried)
Snack foods (chips, popcorn, pretzels, cheese puffs, salted nuts)
Dips, sauces, and salad dressings

Foods low in sodium

Plain breads, cereals, rice, and pasta
Vegetables and fruits (fresh or frozen)
Meats (fresh cuts, not processed meats)
Milk and yogurt (these tend to be moderate in sodium)
Drinks, such as juices, tea, fruit drink or fruit punch, soda, and sports drinks have sodium so these may need to be limited

Low-sodium seasonings

The following low-sodium seasonings may be used more freely than those that are high in sodium:

Allspice

Basil

Bay leaf

Chili powder

Chives

Cinnamon

Cloves

Curry powder

Dill

Dry mustard

Extracts (vanilla)

Garlic (fresh)

Garlic powder

Ginger

Horseradish sauce

Lemon juice

Lime juice

Mace

Marjoram

Nutmeg

Onion (fresh)

Onion powder

Oregano

Paprika

Pepper

Rosemary

Sage

Tabasco

Tarragon

Thyme

Vinegar

The following seasonings are high in sodium, but they can be used in limited amounts.

Limit to 1 tablespoon per meal:

Barbecue sauce
Cocktail sauce
Ketchup
Mustard
Hot sauce
Low-calorie salad dressing
Steak sauce

How to reduce your child's salt intake

The following recommendations may help to reduce the amount of salt in your child's diet:

Don't use salt when cooking or at the table.
Cook with herbs and spices. Or if your child's healthcare provider allows it, use salt substitutes.
Seasonings with the word salt in the name, such as garlic salt, are high in sodium. When seasoning foods use fresh garlic or garlic powder. Use onion powder instead of onion salt. And try celery seed rather than celery salt.
Eat homemade meals using fresh ingredients. Don't eat canned, frozen, or packaged meals. When eating out, ask for dressings and sauces on the side. Ask the chef to hold the salt in food preparation.

Type of food	Allowed	Stay away from these foods
Milk, yogurt, cheese	Whole, 2%, or skim milk Cottage cheese, regular hard cheeses, tofu Puddings, custards, ice cream	Processed cheese, cheese spreads
Meat, fish, poultry	Fresh or frozen meats, poultry, fish Low sodium canned tuna or salmon Dried beans and peas Soybean or vegetable protein Peanut butter	Salted or canned meats, fish (sardines, herring, anchovies), or poultry Lunch meats (bologna, ham, corned beef) Cured meats (ham, bacon, sausage) Hot dogs, dried beef, jerky Commercially frozen entrees Kosher-prepared meats
Fruits	Fresh, frozen, or canned fruits, fruit juices	None
Vegetables	Fresh, frozen, or low-sodium canned vegetables	Sauerkraut, salted or pickled vegetables Vegetables cooked with salted meats Regular vegetable juices
Starches, breads, cereals	Potatoes, macaroni, spaghetti, noodles, rice Unsalted potato chips, low-sodium pretzels, unsalted crackers, unsalted popcorn, and nuts Whole-grain and enriched breads Pancakes, muffins, French toast, waffles, biscuits, cookies, cakes Whole-grain and enriched cooked or commercially prepared dry cereals	Potato chips, salted snack foods, or pretzels Commercially prepared rice and noodle mixes Salted breads, rolls, and crackers Salted popcorn and nuts
Miscellaneous	Chocolate, cocoa, horseradish, herbs and spices, such as onion powder, fresh garlic, garlic powder, celery seed Flavorings, such as vinegar, lemon juice, Tabasco Low-sodium condiments and seasonings Ketchup, chili sauce, barbecue sauce, mustard, gravy (limit to 1 tablespoon per day) Low-sodium canned soups, homemade soups	Commercially prepared meat sauces Monosodium glutamate (MSG) Onion salt, garlic salt, celery salt, seasoned salt Olives, pickles Relish, soy sauce, Worcestershire sauce Dehydrated soup or bouillon, canned soups
Fats	Butter, margarine, lard, shortening, vegetable oil, mayonnaise Salad dressing (limit to 1 tablespoon per day)	Salt pork, bacon fat, fat back More than 1 tablespoon salad dressing per day

Type of food

Allowed

Stay away from these foods

Milk, yogurt, cheese

Whole, 2%, or skim milk
Cottage cheese, regular hard cheeses, tofu
Puddings, custards, ice cream

Processed cheese, cheese spreads

Meat, fish, poultry

Fresh or frozen meats, poultry, fish
Low sodium canned tuna or salmon
Dried beans and peas
Soybean or vegetable protein
Peanut butter

Salted or canned meats, fish (sardines, herring, anchovies), or poultry
Lunch meats (bologna, ham, corned beef)
Cured meats (ham, bacon, sausage)
Hot dogs, dried beef, jerky
Commercially frozen entrees
Kosher-prepared meats

Fruits

Fresh, frozen, or canned fruits, fruit juices

None

Vegetables

Fresh, frozen, or low-sodium canned vegetables

Sauerkraut, salted or pickled vegetables
Vegetables cooked with salted meats
Regular vegetable juices

Starches, breads, cereals

Potatoes, macaroni, spaghetti, noodles, rice
Unsalted potato chips, low-sodium pretzels, unsalted crackers, unsalted popcorn, and nuts
Whole-grain and enriched breads
Pancakes, muffins, French toast, waffles, biscuits, cookies, cakes
Whole-grain and enriched cooked or commercially prepared dry cereals

Potato chips, salted snack foods, or pretzels
Commercially prepared rice and noodle mixes
Salted breads, rolls, and crackers
Salted popcorn and nuts

Miscellaneous

Chocolate, cocoa, horseradish, herbs and spices, such as onion powder, fresh garlic, garlic powder, celery seed
Flavorings, such as vinegar, lemon juice, Tabasco
Low-sodium condiments and seasonings
Ketchup, chili sauce, barbecue sauce, mustard, gravy (limit to 1 tablespoon per day)
Low-sodium canned soups, homemade soups

Commercially prepared meat sauces
Monosodium glutamate (MSG)
Onion salt, garlic salt, celery salt, seasoned salt
Olives, pickles
Relish, soy sauce, Worcestershire sauce
Dehydrated soup or bouillon, canned soups

Fats

Butter, margarine, lard, shortening, vegetable oil, mayonnaise
Salad dressing (limit to 1 tablespoon per day)

Salt pork, bacon fat, fat back
More than 1 tablespoon salad dressing per day

Sample plan for 3,000 mg sodium restriction

Breakfast	Lunch	Dinner
Orange juice (1/2 cup) Dry cereal (1/2 cup) Toast (1 slice) Margarine (1 tsp) Jelly (1 tbsp) Low-fat milk (1 cup)	Beef patty (3 oz) Hamburger bun (1) Mustard (1 tbsp) Ketchup (1 tbsp) Sliced tomato and lettuce Low-fat milk (1 cup)	Baked, breaded chicken strips, homemade (3 oz) Oven-baked French fries, homemade (1/2 cup) Green beans (1/2 cup) Dinner roll (1) Margarine (1 tsp) Apple juice (1 cup) Frozen yogurt (1/2 cup)

Breakfast

Lunch

Dinner

Orange juice (1/2 cup)

Dry cereal (1/2 cup)

Toast (1 slice)

Margarine (1 tsp)

Jelly (1 tbsp)

Low-fat milk (1 cup)

Beef patty (3 oz)

Hamburger bun (1)

Mustard (1 tbsp)

Ketchup (1 tbsp)

Sliced tomato and lettuce

Low-fat milk (1 cup)

Baked, breaded chicken strips, homemade (3 oz)

Oven-baked French fries, homemade (1/2 cup)

Green beans (1/2 cup)

Dinner roll (1)

Margarine (1 tsp)

Apple juice (1 cup)

Frozen yogurt (1/2 cup)

Morning snack	Afternoon snack
Banana Cereal fruit bar	Oatmeal cookies (2) Lemonade

Morning snack

Afternoon snack

Banana

Cereal fruit bar

Oatmeal cookies (2)

Lemonade

Definitions for sodium claims on food labels

The food label reads	What this means
Sodium-free	Less than 5 mg sodium per serving
Salt-free	Meets requirements for sodium-free
Low sodium	140 mg sodium or less per serving
Very low sodium	35 mg sodium or less per serving
Reduced sodium	At least 25% less sodium compared with the same product without reduced sodium
Light in sodium	50% less sodium per serving compared with foods with more than 40 calories per serving or more than 3 gm of fat per serving
Unsalted, no added salt, or without added salt	No salt is added during processing The product it resembles and substitutes for is normally processed with salt

The food label reads

What this means

Sodium-free

Less than 5 mg sodium per serving

Salt-free

Meets requirements for sodium-free

Low sodium

140 mg sodium or less per serving

Very low sodium

35 mg sodium or less per serving

Reduced sodium

At least 25% less sodium compared with the same product without reduced sodium

Light in sodium

50% less sodium per serving compared with foods with more than 40 calories per serving or more than 3 gm of fat per serving

Unsalted, no added salt, or without added salt

No salt is added during processing
The product it resembles and substitutes for is normally processed with salt