Bread is a staple in many diets across the world and in some of the easiest meals. There are several considerations for kidney patients to think about when selecting the best bread for kidney disease. And while bread is considered a high-sodium food, that doesn’t mean there aren’t kidney-friendly options available. This article will discuss the nutrients in bread that kidney patients should be aware of. We will also provide you with several well-known bread options that are kidney-friendly and found in many grocery stores.
Table of Contents
Bread 101
Bread is defined as a food, usually baked, and made from a flour or meal. It is often moistened, kneaded and fermented. (1)
Bread is usually made of a flour or meal, leavening agent, water and salt. From this basic list of ingredients, you can make a seemingly endless list of types of bread.
Other ingredients that may be added include fat sources like oil and butter, fruits and vegetables, sugar or other sweeteners, and spices and herbs.
Bread Nutrition Comparison
There are a ton of different types of bread from around the world.
Below are some different types of bread:
- White bread
- Wheat bread
- Whole grain bread
- Multigrain bread
- Rye bread
- Oat bread
- Sourdough bread
- Gluten-free bread
- Sprouted Grain bread
- Challah
- Pumpernickel
- Soda Bread
- Milk Bread
- Arepa
However, not all bread is created nutritionally equal.
Take a look at how well your favorite bread stacks up against other types.
Bread Nutrition Comparison Table
All of the information below was gathered from the USDA nutrient database. If you are looking for a specific type of bread, use this database for reliable nutrition information.
Type of Bread(1 regular slice) | Calories(kcals) | Protein(g) | Carbohydrate(g) | Fiber(g) | Potassium(mg) | Phosphorus(mg) | Sodium(mg) |
---|---|---|---|---|---|---|---|
White Bread | 76 | 3 | 14 | <1 | 33 | 32 | 134 |
Whole Wheat Bread | 80 | 4 | 14 | 2 | 81 | 67 | 146 |
Whole Grain White Bread | 86 | 4 | 16 | 3 | 46 | 37 | 172 |
Multigrain Bread | 95 | 5 | 16 | 3 | 83 | 82 | 137 |
Rye Bread | 83 | 3 | 16 | 2 | 53 | 40 | 193 |
Oat Bread | 71 | 3 | 12 | 1 | 44 | 42 | 106 |
Sourdough Bread (1 oz) | 77 | 3 | 15 | <1 | 33 | 29 | 171 |
Gluten-free Bread | 84 | 2 | 14 | 1 | 30 | 20 | 144 |
Sprouted Grain Bread | 80 | 5 | 15 | 3 | 81 | 73 | 75 |
Challah | 89 | 3 | 15 | 1 | 36 | 33 | 118 |
Pumpernickel | 65 | 2 | 12 | 2 | 54 | 46 | 155 |
Soda bread | 82 | 2 | 16 | <1 | 75 | 32 | 113 |
Milk bread | 121 | 3 | 24 | 1 | 49 | 42 | 148 |
Arepa (98g) | 215 | 5 | 36 | 2 | 86 | 115 | 265 |
Benefits of Bread for Kidney Patients
Despite recent trends that claim that bread is “bad,” bread can be beneficial to your kidney friendly diet.
In fact, including whole grains as part of a healthy diet has been shown to reduce the risk of death in people with chronic kidney disease. (2)
Bread is a source of carbohydrates- the primary source of energy for our brain. Additionally, bread is rich in vitamins and minerals such as B-vitamins.
These nutrients are necessary for an adequate kidney-friendly diet.
Bread can provide flavor and a sense of satisfaction from your meals. This is often thanks to the fiber from whole grains in bread.
Bread can also help kidney patients add calories, iron, healthy fats and more nutrients.
Reduce Blood Pressure
Two well-studied diets, the DASH (Dietary Approaches to Stop Hypertension) and mediterranean diets, both focus on whole grains as a foundation for a healthy diet.
These diets have been shown to help reduce blood pressure – a top cause of kidney disease and common challenge for kidney patients (3).
Whole Grains vs. Refined Grains
Do they all mean the same thing? Is one better than the other?
It can be hard to understand the difference between these seemingly identical names for bread. However, there is a difference.
Whole grain and whole wheat bread both use all 3 parts of the grain.
This means that all of the nutrients are still in the bread.
However, whole grain means that another grain can be added, such as quinoa, rice or barley.
Whole wheat means that a product uses only wheat kernels.
They are both equally nutritious and can have a place in your kidney-friendly diet.
Multigrain, on the other hand, uses more than one type of grain. However, it does not have to use all parts of the grain (aka refined grains can be used).
Be sure to look for 100% whole grain or 100% whole wheat on the food label to ensure that you are getting the maximum nutritional benefits from your bread.
You can do this by looking at the first ingredient listed. It should be either whole grain or whole wheat.
How to Choose the Best Bread for Kidney Disease
There are some types of bread that are better than others.
But determining the best bread for kidney disease may be easier than you thought.
To determine if a bread is kidney-friendly or not, turn the package over to the nutrition label and ingredients list.
Let’s dive into what to look for.
Sodium
Who knew that bread was a significant source of sodium? It’s actually considered one of the biggest offenders in a high sodium diet. (4)
Bread is considered a very high “salty foods” to limit.
However, there are plenty of types of bread that have a kidney-friendly amount of sodium.
Look for bread that has less than 140 milligrams of sodium per slice. This is considered low sodium.
Many breads have a sodium content as low as 85 milligrams per slice, or even lower.
Phosphorus in Bread
First, let’s discuss whether or not kidney patients should include whole grain bread.
For a long time, kidney patients were told to avoid whole grain bread and whole grain products because of the phosphorus content.
It is true that whole wheat bread does have more phosphorus than white bread. (5, 6)
However, whole grain bread contains organic phosphorus.
Organic vs. Inorganic Phosphorus
Organic phosphorus is the phosphorus that is found naturally in foods.
Additionally, our bodies don’t absorb it very well. Only about 30-70% of organic phosphorus is absorbed (7).
Furthermore, we absorb more phosphorus from animal sources than plant sources. (7)
This means that whole grain bread can and should be a part of your kidney friendly diet.
Even with high phosphorus levels, removing whole grains will not be a high priority.
In fact, a study published in 2024 found that dialysis patients with high phosphorus levels had lower phosphorus levels after eating calcium-enriched bread. (8)
Here are other things to look at when it comes to high phosphorus.
Yeast vs Baking Powder
When possible, find recipes for bread using yeast instead of baking powder as the rising agent for the bread.
Yeast is kidney-friendly. It helps the bread to rise.
Baking powder, however, is not as kidney-friendly. This is because one of the main ingredients of baking powder is a phosphate additive.
One teaspoon of baking powder has approximately 344 milligrams of phosphorus. This is equivalent to about half a days’ worth of phosphorus for a kidney patient. (9)
Granted, a recipe that calls for that much baking powder will be for many servings, so dividing that by the number of servings is important to consider.
The point is that if baked goods with baking powder are consumed frequently, it may increase phosphorus levels for kidney patients.
Too many phosphates in our ingredients can be difficult for the kidneys to manage.
If you are using a bread recipe with baking powder, you can substitute it for a kidney-friendly rising agent: baking soda plus cream of tartar.
Replace 1 teaspoon of baking powder with a ½ teaspoon of baking soda and ½ teaspoon cream of tartar.
Potassium
Did you know that manufacturers can also add potassium to foods?
Some people with kidney disease need to follow a potassium restriction. Therefore, limiting potassium additives can be helpful. (10)
Be on the lookout in the ingredients section for the bread for any potassium additives.
Bread, like most foods, will likely have a small amount of potassium. And even for kidney patients on a potassium restriction, whole grain breads with potassium can still be enjoyed.
This is thanks to the fiber from the bread. Getting enough fiber helps us with a healthy gut.
A healthy gut also supports potassium removal from the body. (11)
Learn about potassium and the kidney diet here.
Fiber
Depending on the type of bread, it can be a great source of fiber.
Fiber can help with (12):
- better digestion
- bowel movement regularity
- blood sugar control
- heart health
- kidney health
An item can be labeled as a good source of fiber if it has 3 or more grams of fiber per serving.
Whole grain and whole wheat breads tend to have more fiber.
This is because when white bread is made, the bran and the germ layers are removed from the grain kernel.
We are left with just the endosperm to make up the white bread.
The bran and germ that are removed during this process contain much of the fiber and other nutrients.
Added Sugar
Bread can have added sugar. Added sugar is any form of sugar that is added to a food during processing.
Limiting the amount of added sugar you take in can help manage blood sugars and take care of heart health which helps take care of your kidneys. (13)
Be sure to check the nutrition facts label to see if your bread contains any added sugars.
Ideally, aim for 0 grams (g) of added sugar in bread.
However, less than 5g of added sugar per serving or slice can also fit.
Protein
Although bread is not typically thought of as a significant source of protein, certain types of bread can add up in protein.
Multigrain breads and sprouted grain breads are the highest in protein per slice, each with 5 grams.
Some kidney patients require a high protein diet, while some require a low protein diet.
For many people with kidney disease, it may be beneficial to limit the amount of protein consumed. (14)
Be sure to talk with your dietitian about how much protein you need.
If you do need to follow a low protein diet, there are some breads out there for you.
Gluten-free breads are typically lower in protein. They can be helpful when following a low-protein diet.
However, it is still important to be mindful of the sodium. Some can have over 300 milligrams of sodium per slice. That means a simple sandwich could be about a third of the daily sodium recommendations for a kidney patient.
Best Bread for Kidney Disease and Diabetes
Can people with diabetes and kidney disease still have bread? It may seem like the answer is no from what you may hear or read online.
However, there are definitely types of bread that can fit into a renal diabetic diet.
In fact, bread has been shown to support glycemic control for people with type two diabetes. (15)
Fiber
An important nutrient in bread that can be helpful for people with kidney disease and diabetes is fiber. Fiber can help keep blood sugars at a stable level and can keep us feeling fuller for longer. (16)
Getting enough fiber throughout the day with consistent meals and snacks is a great way to support healthy blood sugars.
Try to aim for a bread with at least 3 grams of fiber per slice when possible.
However, don’t worry if your bread choice is a little bit lower. Try to add other fiber-rich foods to boost the fiber content of your meal or snack with bread.
For example: Did you know that two tablespoons of peanut butter have about 2 grams of fiber? (17)
Added Sugar
Next, be sure to double check that there is no added sugar. Added sugars can be surprisingly common when shopping for bread in the grocery store.
It may be harder to control blood sugar spikes when there is too much added sugar in a product.
Food For Life breads can be a great option.
With a higher fiber content and no added sugars, this may be an option to discuss with your dietitian.
Best Brands of Bread for Kidney Disease
Check out our top brands of bread that we regularly recommend to our clients.
Best White Bread for Kidney Disease
White bread may not have much fiber, but sometimes there’s just no beating a good, classic white bread.
Sara Lee offers a white bread made with whole grains. This means the bread contains fiber. And best of all, it has just 95 milligrams of sodium in two slices.
Rye Bread for Kidney Patients
Rye bread can often be a great bread option for kidney patients who need to avoid wheat.
Dimpflmeier Bakery offers a Light Rye Bread with only 110 milligrams of sodium per slice.
Whole Wheat and Whole Grain Breads
This is our most common category of breads for kidney patients that we recommend. These recommendations are generally based on the sodium content and without phosphates.
Here are several brands and breads to choose from:
Sara Lee®
- Delightful ® White bread made with whole grains
- 100% Whole Wheat
- Delightful® Soft & Smooth ® Wheat Bread
Dave’s Killer Bread®
- 100% Whole Wheat Thin Sliced
- 21 Whole Grains and Seeds Thin Sliced
- Good Seed Thin Sliced
- Powerseed Thin Sliced
- Sprouted Whole Grains Thin Sliced
Oroweat ®
Food for Life ®
Gluten-Free
As mentioned earlier, gluten-free breads may be a good option for a kidney patient on a low protein diet.
Many gluten-free breads can be very high in sodium. Here are some suggested lower sodium, gluten-free breads for kidney patients.
Canyon Bakehouse ® (Gluten-free!)
Food For Life ®
Don’t forget to shop your grocery store’s own brand to see what is available to you locally.
Homemade Kidney-Friendly Bread
While it’s not required, you may be interested in baking your own bread at home. Here are some guidelines to help you make the best kidney-friendly bread in your own kitchen.
Low-Sodium Bread
It’s important to review the nutrition information when looking at bread recipes. This is how you can determine if a bread will be low in sodium (and other kidney-friendly ingredients and nutrients).
A low-sodium bread should have less than 140 milligrams of sodium per slice.
When you make bread from scratch at home, you will be slicing it yourself. A slice of bread is generally 1/2 inch thick.
Baking bread in a 9×5 inch loaf pan will produce about 16 slices of bread.
Here is a low-sodium bread recipe from AllRecipes that uses two loaf pans to create 24 slices of bread with only 98 milligrams of sodium per slice.
Summary
The truth about whether or not bread is healthy to eat for kidney patients (or anyone for that matter) is confusing.
Some websites say that bread is completely bad, while others say that kidney patients can only have white bread and not whole grain.
Then a different site may say the exact opposite.
In reality, it matters more about the type of bread, the way that it is processed and what is added (or not added) to it.
Look for breads with 140 milligrams of sodium or less per slice, 1-3 grams of fiber per slice, and no phosphate additives (i.e. baking powder).
Breads high in fiber and other nutrients can be great additions to a kidney friendly diet.
Wheat bread, rye bread, even white bread can be good for kidney patients. So when it comes to adding bread to our renal diet, use these guidelines to choose the best bread that you enjoy.
Jen Hernandez is a registered dietitian and board-certified specialist in renal nutrition. She has nearly a decade of experience with kidney disease patients in all stages - from stage 1 through kidney transplant. Jen writes on the blog of Plant-Powered Kidneys to help reach and teach more kidney patients about how they can enjoy more foods in a plant-based diet while protecting kidney health.
I am making homemade sourdough bread using just 1/8 teaspoon of salt. I am believing that this is a good bread for a renal diet. Am I correct?
suzanne
Hi Suzanne, Thank you for your comment. Check out our blog on The Best Bread for Kidney Disease here >>>.
Hi Jen ,
It amazing the amount of information you gather to help us with our food choices .You are awesome and generous.
As I like to make my own bread, would their be a recipe that is nutritious thereby wholesome for me to make while at level 3b (38 eGRM ) . Thanks in advance
Andrea
Hi Andrea, Thank you for the positive feedback. Check out this blog on bread here >>>. Baking any of the 6 bread choices in the renal diet list would be a good choice. I’ll get back to you if I find a good recipe.
I just found out that I am pre diabetes and I have kidney disease. I have always made my bread using regular flour and now I find out I should make it with whole wheat flour. Is that okay or should I use whole grain. I am very confused.
It seems to be different on each website. I really do appreciate all your help it can be really difficult.
I’m sorry to hear that, Kelly. Whole grain/whole wheat and regular (white) flours can be great options. Have you checked out our other article about flour types? https://www.plantpoweredkidneys.com/best-flour-for-kidney-disease/
I hope this information helps. It can definitely be overwhelming! The key is to find resources (like us 😉) that emphasize all the things you can and should have… not just a list of things to avoid.
I make my own bread made with King Arthur whole wheat flour. Can you tell me what the nutrition is and if this is acceptable.
Here’s the link I found for King Arthur Whole Wheat Flour: https://fdc.nal.usda.gov/fdc-app.html#/food-details/2011323/nutrients
In general, this can easily fit into a renal diet. Whole grains, including whole wheat flour, is a great way to get in healthy carbohydrates. 😊
Hi. I have stage 2-3 kidney disease according to my Dr. I also have wheat n grass allergies so I am limited to flours which I can bake with.
I have come up with my own blend that seems to work well which includes quinoa, buckwheat, potato starch, n tapioca starch. I haven’t looked into what the potassium nor sodium count is but it really has worked perfectly as a 1 to 1 for all my baked goods. Rice, sorghum, oats, etc are all in the grass family.
Are these flours safe for me or do I just need to live a live with no breads nor sweets???
Allergies on top of CKD is rough and quite a challenge. I definitely feel that breads and sweets can and still should be included (adjusted for allergies, of course). As long as they’re safe for your allergies, they’ll be able to fit into a kidney-friendly diet. 💚
Hello Jen
I was wondering about granary bread which I can buy here in U.K. I have read a few articles that say it is very good for kidney diet, please do you have any advice about this , thank you so much for all your information and advice it’s just invaluable
Jenn
Hi Jenn 😊 I’d suggest looking for the lower sodium options in your store. I am not familiar with particular brands, but that doesn’t matter so much as the nutrition information for what’s available. Find the ones lowest in sodium and without phosphate additives (including baking powder) and that will be a winner. Good luck and let me know what you find!
I like Italian bread. Is it good for me? I’m a 3a with a GFR of 59.3.
Hi Lizette! Italian bread is a type of white bread. It can absolutely fit into a renal diet. My suggestion is to review the nutrition and ingredients labels for the considerations addressed in the article above- particularly sodium. See how low of sodium you can find for the options you have available to you. Enjoy!
Hi Lizette-
I’ve just been found to be CKD3a. I’m overwhelmed by this diet change. I live in the US, Seattle area. What’s the best bread you have found, and are using?? I bought Ezekiel bread, EXPENSIVE! I now know I need white bread. I’d appreciate any finds you have found to help me navigate a kidney friendly diet.
Thank you! Geri