Best Milk For CKD

If you have chronic kidney disease (CKD) you’ve probably googled what to eat and found lists that say no more milk and you should use almond milk instead. But, is that really what your body needs? 

One of the most common questions is around dairy products. So, let’s break down what the most kidney-friendly milk products are.

What to consider with milk and CKD

You probably grew up hearing that milk and dairy products were important for you because of calcium. And that they would help keep your bones strong. While this is still true with CKD, there are some other considerations that we need to keep in mind when choosing milk products or non-dairy beverages like almond, oat or other choices.

The main reason you’ve read that almond milk is better than cow’s milk for you is because it is lower in phosphorus, potassium and protein. But everyone’s needs are different, so it is important to understand which products to choose for us. 

So, let’s dive into the best milk for CKD.

Protein

Cow’s milk has 8 g protein in 1 cup of milk. With CKD, you’re likely following a low protein diet, so this can be a significant amount in your diet. Non-dairy milks like almond or oat have less protein, around 1 g per cup. But soy milk has higher amounts of protein. 

Choosing a non-dairy milk can help keep you in your protein targets. But it is not necessary to choose. Tracking your foods can help you determine if you are meeting or exceeding your protein needs.

Phosphorus

With CKD, phosphorus builds up in our blood. Too much phosphorus can cause weakened bones. While milk is a good source of phosphorus, sometimes we may want to limit to help keep our bones strong and prevent calcification or hardening of our blood vessels. 

One cup of cow’s milk has 237 mg phosphorus. If we are on a phosphorus restriction, this can be a significant amount. 

Non-dairy beverages have less phosphorus naturally but they often have added phosphorus in the food label (check out this post for more information). Foods that have added phosphorus should be avoided when we have CKD. Our body absorbs 100% of this phosphorus and can lead to weakened bones. Foods with added phosphorus can be identified with the letters “PHOS” in the ingredient list.

So, what should you do? If you choose to have non-dairy beverages, always read the ingredients and avoid added phosphorus. Remember to check often because manufacturers can change the food labels often.

Calcium

Healthy kidneys can take that vitamin D we absorb from the sun and calcium foods that are fortified with vitamin D and change it to an active form. That active vitamin D then helps us absorb calcium. With CKD, the kidneys aren’t able to make active vitamin D as well. So we are at risk of a low calcium. But with CKD we may also develop a high calcium. Being aware of your bloodwork is important to help you make nutrition changes. 

Cow’s milk and non-dairy beverages both have the same amount of calcium in them, around 300 mg per 1 cup. Choosing either choice will help you meet your calcium needs per day.

Potassium

The potassium content of non-dairy milk varies, soy milk tends to be the highest. And some may even have potassium additives like potassium citrate or dipotassium phosphate if you are on a potassium restriction avoiding potassium additives can help. With potassium now on the food label you can compare choices to find a low potassium option if needed. But remember, not everyone needs a potassium restriction.

Fat

Heart disease and kidney disease are common. So it is important to choose low fat products (2% Milk Fat or less) if consuming cow’s milk. That being said, non-dairy beverages are often a great low fat alternative to cow’s milk.

Sugar

Non-dairy beverages come in sweetened and unsweetened flavours. With CKD, it is important to limit added sugars to help control our blood sugars but also reduce inflammation. So if you’re choosing a non-dairy beverage look for unsweetened options.

The verdict

Consider calcium, phosphorus, potassium, protein, fat and sugar content when choosing milk or a milk alternative. Working with a renal dietitian, like Emily, can help you plan meals that meet your blood work while preserving your kidney function. 

Here are my favourite non-dairy beverages:

  • Almond Milk
    • Silk – original, chocolate, unsweetened vanilla, vanilla
    • Earths Own – unsweetened original, original, unsweetened vanilla, vanilla
  • Cashew Milk
    • Silk – original, unsweetened original unsweetened vanilla
    • Earths Own – unsweetened original
  • Coconut Milk
    • Silk – original, unsweetened original, unsweetened vanilla
  • Oat Milk 

Got milk questions?

If you’re looking to feel empowered and supported with your nutrition needs, working with a dietitian can help you gain confidence and understand your kidney-friendly diet.

Want to work together? Connect with Emily here.Want to learn more about Emily? Learn more here.

Published by Emily Campbell, RD CDE MScFN

Emily Campbell, RD CDE MScFN is a Registered Dietitian and Certified Diabetes Educator. She specializes in renal nutrition helping those with chronic kidney disease. Emily holds a Master's degree in Foods and Nutrition and is a co-chair of the Southern Ontario Canadian Association of Nephrology Dietitians.

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