"What drinks are good for kidneys?" And My Top 4 Kidney Friendly Alternatives to Water
Hydration is important when you have kidney disease, most especially during these long, hot summer days. Your doctor is probably telling you to drink plenty of water to keep your kidneys well hydrated and your blood and urine well diluted.
Water is pretty great. But, I’m sure that you’re wondering, what other drinks are good for kidneys?
Well, as it turns out, there are lots of options. You just have to know where to look!
Sodas and Alternatives
One of the worst things that you can do to your kidneys is drink cola products. I know that it sounds ridiculous, but dark colas like Coca-cola, Pepsi, and Dr. Pepper — and their generics — are loaded with highly absorbable phosphorus that the kidneys may struggle to get rid off. Root beer doesn’t typically have the phosphorus that other dark colas do, but it will vary by brand.
For that reason, I like to recommend lemon-lime sodas, lemonade, and flavored seltzers. Flavored seltzers can be an acquired taste, but they aren’t bad once you find a flavor that you like. Grapefruit and lemon seltzers are always in my fridge, but cherry and berry flavors can be good too!
Caffeinated Drinks and Kidney Disease
I know that you're asking yourself “Is coffee even good for kidneys?” But, it is!
Caffeinated beverages like coffee and tea can be a great way to get hydrated and stay perked up for the day. The antioxidants found in coffee have been linked to a decreased risk of developing certain types of cancer — see “Is Coffee Good for Kidney Disease?” —, while the catechins found in green tea have been linked to decreased inflammation and LDL (bad) cholesterol — see “Is Tea Good for Kidney Disease?”.
If you want to get crazy, you can do unsweetened green tea with a splash of lemonade or lemon flavored soda water for something that’s refreshing and loaded with catechins to subdue inflammation.
What Juice is Good for Kidneys?
Cranberry juice is a low potassium option for people living with the later stages of kidney disease who have to limit their potassium intake. One study found that people who drank 16 oz of cranberry juice daily did have a modest improvement in diastolic blood pressure (the bottom number). Though I would never recommend drinking 2 cups of juice, it is good to know that there is some positive benefit at work there. Even unsweetened cranberry juice has a significant amount of sugar in it at more than 30 g per cup and we know that excessive sugar intake can contribute to increased inflammation — which is not good for the kidneys.
So, I like to do half a glass (about a cup) of cranberry juice and top it off with soda water. I still get minimal health benefits and a fizzy drink that satisfies my thirst without a ton of sugar.
Milk for Kidney Health
Cow’s milk isn’t an ideal option for someone living with kidney disease primarily because of its protein content. One cup of cow’s milk has about 8 grams of protein. A splash of milk or half and half in your coffee probably won’t cause any problems. But, as part of a regular diet, it contributes to increased protein intake and will make it difficult to adhere to a protein restriction. It’s also a good source of potassium, animal-based — well absorbed — phosphorus, and potassium. So, I still don’t love it for a kidney diet. However, because it’s 2024, there are about a million plant-based milk substitutes that can be great for people living with kidney disease. I generally recommend almond milk, but you can see my full post on "Which Milk is Good for Kidney Patients?" here.
My Top 3 Favorite Kidney Friendly Drinks — That Aren’t Plain Water
A Cranberry Fizz! Just mix half a cup of unsweetened cranberry juice with a cup of soda water for about 15 grams of carbs and 12 oz of fluid. Pour over ice and you’re in for a refreshing treat!
A Watermelon Lime Splash! Freeze about a half cup of watermelon cubes and top with 1 can (about 12 ounces) of lime seltzer water. This is a low potassium food (it has less than 100 mg of potassium per serving!) and provides only about 5 grams of carbs and about 14 ounces of fluid if you eat the watermelon after and the low carb content makes it a great choice if you have diabetes!
A Green Half and Half! I know that you’ve heard of this before because I’m pretty sure that Starbucks and Arizona Tea do variations of it. But, that’s because it’s delish! Mix half a cup of lemonade with a full cup of unsweetened green tea. Pour over ice and now you have a slightly-sweetened glass of antioxidant-rich tea — for about 15 grams of carbs and 12 ounces of fluid — to cool you off on a hot day!
An Iced Coffee! Something about an iced coffee hits just right at about 2pm when I'm getting sluggish. I like to cold brew it in my fridge. I put the same coffee to water ratio that I normally use in my coffee maker into a pitcher and let it sit for 12h in the fridge. I strain it out and pour about 12 ounces over ice with about 2 Tbsp of half and half for 12 ounces of fluid and only about 1 g of carb.
The One Drink that I Never Recommend
I never recommend electrolyte drinks, especially the powders. It’s true that we lose minerals like sodium in sweat, so the logic of replacing the electrolytes and water together works. But there is so much sodium in the average American diet. It’s uncommon to find someone who isn’t an athlete who actually needs to supplement their sodium intake and after 4 years working with kidney patients, I can only recall a couple of times that a kidney patient has needed to supplement sodium to the extent that the powders do — the leading brand has more than 500 mg of sodium per serving!
I’ve actually seen primary care providers recommend them to dehydrated patients and the entire kidney care team clenches when we hear that. CKD prevents the kidneys from balancing electrolytes properly. So, too much sodium in someone with kidney disease can cause fluid retention, shortness of breath, and worsening kidney function.
So, if you’re curious about electrolyte supplements, please, please, please call your nephrologist to get the go-ahead first. If you need electrolytes like potassium or calcium — your kidney care team can help you to get those electrolytes without endangering your kidney function.
Wrap-Up
If your doctor is recommending that you get plenty of fluids — on the flip side, some kidney and heart patients have to restrict fluid and we’ll address that in another post soon! — there are lots of great options besides plain water! Tea, coffee, flavored seltzers, lemonade, and some types of milk can all help you to stay hydrated this summer! You should always ask your doctor or dietitian if you have questions about what you should be drinking, but hopefully this list can give you some ideas to get you started. Let me know what you want to talk about next below!
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