Promoting Kidney Health Through Nutrition and Lifestyle

Menaka Sarav, MD, uses the latest research in kidney nutrition to help individuals with all stages of kidney disease. At Yale School of Medicine, the assistant professor of medicine (nephrology) directs one of the few physician-led, multidisciplinary lifestyle and kidney nutrition programs in the country.

“When I see patients in my clinic, I try to help them understand, no matter what stage of chronic kidney disease they have, what processed and ultra-proceeded food are, and how to read food labels,” she says. “There are a lot of misconceptions about what is truly healthy and unhealthy.”

In a Q&A, Sarav discusses the importance of nutrition for kidney health, the connection between overall health and kidney health, and the risks of ultra-processed foods.

Nutrition and lifestyle play a critical role in managing kidney disease—across all stages, from early-stage kidney disease to transplant.

For example, if a person has mild to moderate kidney disease, the focus is on using nutrition and lifestyle to preserve kidney function and prevent further decline. At this stage, it is important to understand that the kidney, heart, and metabolism are all interlinked. Emerging research supports the benefits of a plant-forward, whole-food diet in promoting kidney, heart, and metabolic health—helping to slow disease progression.

For individuals with advanced kidney disease, the primary goal shifts to delaying the need for kidney replacement therapy, such as dialysis. Nutrition plays a key role in reducing the acid load on the kidneys and minimizing the buildup of toxins. Dietary plans are personalized to each patient, carefully balancing protein, potassium, sodium and phosphorus intake while preventing malnutrition. For example, research shows that reducing protein intake in the diet can help delay the need for dialysis—but this should always be done under the supervision of a medical team to ensure patients remain well-nourished throughout the process.

The most common causes of chronic kidney disease are diabetes and high blood pressure. Obesity also plays a big role because it can lead to both these conditions—and it can also stress the kidneys directly.

When blood sugar, blood pressure, or body weight are too high, the kidneys have to work harder. Over time, this can cause damage and scarring in the kidney.

Managing diabetes, weight, and blood pressure doesn’t just protect the kidneys—it also supports heart and overall health.

I wish more people understood how much everyday choices—like what we eat or how much we move—really matter for kidney health. Ultra-processed foods have additives and preservatives that may seem harmless, but over time, they can put extra strain on the kidneys, which work hard to remove things like excess salt and phosphorus.

Nutrition and lifestyle are at the heart of protecting your kidneys. Choosing to eat better or start moving more—even just a little bit—and sticking with it over the years can make a huge difference. Small steps now can add up to big changes later.

Nephrology is one of ten sections in the Yale Department of Internal Medicine. Committed to excellence in patient care, research, and education, the section’s faculty and trainees aim to be national and international leaders in academic nephrology. To learn more, visit Nephrology.