Dairy Options When You’re on Dialysis

The reduction in dairy products that comes with a renal diet is often one of the biggest adjustments
for people trying to follow a renal diet. While most dairy products are tough to fit in to the diet, there are a few options out there.
This issue’s article will walk you through the dos and don’ts in this category.

Milk~~ All natural milks (cow – regular and low fat, goat’s milk, sheep’s milk, etc.) are quite high in
phosphorus and potassium. So these are best left out of your diet most of the time.
Other types of milk include soy milk, almond milk and rice milk.
Soy milk has similar amounts of phosphorus and potassium to regular milk, making it a poor option also.

Almond milk is low in phosphorus and contains about 40% less potassium than cow’s milk,
making it a better choice, in small amounts.

Rice milk is low in both phosphorus and potassium as long as it does not contain added “tricalcium phosphate”.
This makes rice milk the best option, but check that ingredients list for “tricalcium phosphate” before you buy.

Non-dairy creamers used to make a good substitute for milk, but most brands now contain added phosphorus.
Check with your dietitian to see if there are any brands sold in your area that do not contain added phosphorus.

Cheese~~ When milk is turned into cheese, liquid, known as whey, is removed.
The whey contains most of the potassium that was in the milk. This means that cheese is much lower in potassium than milk.
On the other hand, removing the whey from milk concentrates the phosphorus, making cheese higher
in phosphorus than milk ounce for ounce. This makes cheese another dairy food you should avoid most of the time.
But there are a couple of exceptions that you can consider.

Cottage Cheese is lower in phosphorus than most cheeses ounce per ounce, but you should still
work closely with your dietitian if you want to include it in your diet.

Cream cheese is the other exception. An ounce of cream cheese contains much less phosphorus than
an ounce of other cheeses, making it a better option for people trying to follow a renal diet.

Yogurt~~ Like the milk used to make it, yogurt is also loaded in potassium and phosphorus.
It generally should be avoided when you are following a renal diet.
Some grocery stores now carry yogurt made from coconut milk, soy milk, almond milk and rice milk.
Unfortunately, most of these contain added phosphorus, making them not much better than regular yogurt.

Ice cream & frozen yogurt~~ Both ice cream and frozen yogurt contain some phosphorus,
and frozen yogurt is quite high in potassium.
A better option is sherbet, which contains about half as much potassium and phosphorus as ice cream.
Berryflavored sorbet (such as strawberry or raspberry) is another good option.

Sour cream~~ Sour cream can be used in small portions (no more than 1 ounce, or two Tablespoons)
in a renal diet without increasing your potassium and phosphorus intakes substantially.

Heavy cream~~ While certainly a fattening food, heavy cream is actually fairly low in
phosphorus and potassium relative to other dairy products.
For those of you who need to gain a little weight, this is a great option to increase your calories.
Half and half contains much more milk than heavy cream, so it is higher in phosphorus and potassium
than heavy cream, making it a poor choice.

Phosphorus and Potassium Content of Selected Dairy Foods:
Source: USDA National Nutrient Database

Ice cream, ½ cup: 69 mg Phosphorus, 131 mg Potassium
Frozen yogurt, ½ cup: 88 mg Phosphorus, 231 mg Potassium
Sherbet, ½ cup: 30 mg Phosphorus, 71 mg Potassium
Heavy Cream, 2 Tablespoons: 19mg Phosphorus & 22 mg Potassium
Half & half, 2 Tablespoons: 28mg Phosphorus & 39 mg Potassium
Sour cream, 2 Tablespoons: 33 mg Phosphorus & 41mg Potassium
Cream Cheese, 2 Tablespoons, 31mg Phosphorus, & 40 mg Potassium
Cottage Cheese, ¼ cup (2 oz.), 92 mg Phosphorus, 47 mg Potassium
Cheddar cheese, 1 ounce, 145 mg Phosphorus, 28 mg potassium
Mozzarella cheese, 1 ounce, 131 mg Phosphorus & 24 mg Potassium
Parmesan cheese, 1 ounce, 197 mg Phosphorus, 26 mg Potassium