Eggs can be an affordable, protein- and nutrient-rich food to include in a healthy diet. However, kidney patients often get confusing and conflicting information as to if they can have eggs or not. In this article, we will review the nutrition in eggs relevant to kidney patients, health considerations, and other options if eggs are not recommended.
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Table of Contents
Nutrients in Eggs
In this next section, we will highlight the nutritional components of eggs that are often a concern for kidney patients.
Protein
Eggs are a good source of high-biological value (HBV) protein.
A high-biological value protein contains the essential amino acids that our body needs, but cannot make itself.
In fact, protein comparisons use egg whites as the standard for defining a HBV protein. And more research is looking at if kidney patients actually need to focus on HBV proteins versus getting the right amount of protein from more plants (1).
A large whole egg has about 6 grams of protein. An egg yolk contains a little less than 3 grams of protein. An egg white has a little more than 3 grams of protein.
Eggs in a Low Protein Diet
While eggs do not seem like a high protein food compared to other protein-rich foods, they can add up quickly.
Someone with late-stage CKD on a low-protein diet may need to avoid eggs entirely. Just one egg could account for 20% of a total day’s worth of protein.
Phosphorus
Eggs can also be a source of organic phosphorus. Organic phosphorus is found in foods such as meats, dairy, nuts, seeds, and grains.
A whole egg contains 93 milligrams (mg) of organic phosphorus. Kidney patients generally need to stick to 800 to 1,200 milligrams of phosphorus.
This means a whole egg has about 12% of a person’s daily phosphorus goal.
The egg yolk has the majority of the phosphorus, with 66 milligrams of organic phosphorus.
Egg whites are very low in phosphorus. One egg white has just 5 milligrams of organic phosphorus.
Therefore, kidney patients can eat egg whites and even occasional whole eggs as part of a low phosphorus diet.
Great ValueTM Liquid Egg Whites are pure egg whites with no added ingredients. This is a good option for kidney patients that are encouraged to have egg whites as part of their diet.
Potassium
Eggs are not a high potassium food. A whole egg provides 66 milligrams of potassium.
The egg yolk has the lower amount of potassium with just 19 milligrams of potassium. The egg white has about 54 milligrams of potassium.
Therefore, kidney patients can enjoy whole eggs, egg yolks, and egg whites as part of a low potassium diet.
Potential Renal Acid Load
Potential Renal Acid Load, or PRAL for short, is a more complex consideration for kidney patients.
It comes from a calculation using the protein, phosphorus, potassium, magnesium, and calcium amounts in a food.
Eggs are rich in protein and phosphorus. However, they do not have as much potassium, magnesium, and calcium.
Therefore, whole eggs, egg whites, and egg yolks have an acid-producing positive PRAL value. Egg whites have the least acid-producing PRAL value at 0.36.
Kidney patients should include plenty of fruits and vegetables along with eggs to make them part of a kidney-friendly diet.
Fat
Egg yolks are a rich source of healthy monounsaturated fats (2). Egg yolks also have saturated fats.
One egg has 1.5 grams of saturated fat. This comes from the egg yolk.
The American Heart Association recommends a person stick to 5 to 6% of calories from saturated fat.
This means a 2,000 calorie diet should have no more than 13 grams of saturated fat daily.
Too much saturated fat can increase a person’s risk of cardiovascular disease and high low-density lipoprotein (LDL) cholesterol levels (3).
Kidney patients are already at higher risk of having high triglycerides and high LDL (4).
Therefore, it’s important for kidney patients to be mindful of the amount of saturated fat in their diet, including saturated fat from whole eggs and egg yolks.
Cholesterol
The question of if eggs increase cholesterol levels has been debated over the years.
Research still shows that the more eggs eaten, the higher the risk of cardiovascular disease according to a meta-analysis published in 2022 (5).
Kidney patients tend to have a higher risk of high cholesterol levels due to dyslipidemia and proteinuria (4).
A whole large egg has 207 milligrams of cholesterol, which is just over the 200 milligrams per day recommendation from The American Heart Association (6).
Carotenoids
Eggs contain lutein and zeaxanthin. These carotenoids promote good vision and eye health by reducing risk of macular degeneration and cataracts (7).
Choline
Choline is a nutrient found in eggs. It is primarily found in egg yolk. The white is virtually choline-free.
Choline is a precursor to Trimethylamine-N-Oxide (TMAO). High levels of TMAO are linked to poor cardiovascular outcomes, including heart plaque build-up.
Kidney patients are at much higher risk of having high TMAO levels due to the kidney’s decreased ability to remove TMAO in the urine (8).
Additionally, higher levels of TMAO can result in kidney function decline and kidney failure (9).
There is little evidence to connect choline in eggs to increasing TMAO levels.
In fact, one randomized control trial gave people with healthy kidney function a diet order of 4 eggs per day for a month. Another group had choline supplements with no eggs.
The results showed that the people who ate eggs did not have increased TMAO levels. However, the people that took choline supplements did have higher TMAO levels (10).
There is no research looking at egg consumption and TMAO levels in kidney patients at this time.
Vitamin D
Eggs are one of the few foods that are a good source of vitamin D. A large whole egg can provide 50 International Units (IU) of vitamin D (11).
The vitamin D is in egg yolk. So it is important to eat the whole egg or egg yolk to get the vitamin D.
Kidney patients are commonly vitamin D deficient, due in part to reduced kidney function. Ensuring adequate vitamin D can be an important part of protecting kidney health (12).
Therefore, including some eggs into a diet can help contribute some vitamin D to support not only kidney health, but vitamin D intake.
Nutrition Table for Eggs and Egg Whites
Below is a table to show the comparison of different nutritional components of whole eggs, egg yolks, and egg whites.
Egg, Grade A, Large, Whole (50 g) | Egg, Grade A, Large, Egg Yolk (17 g) | Egg, Grade A, Large, Egg White (33 g) | |
---|---|---|---|
Calories | 72 | 56 | 18 |
Total Fat (g) | 5 | 4.5 | <0.5 |
Saturated Fat (g) | 1.6 | 1.6 | 0 |
Protein (g) | 6.24 | 2.7 | 3.6 |
Calcium (mg) | 24.1 | 21.9 | 2.31 |
Iron (mg) | 0.84 | 0.5 | 0 |
Magnesium (mg) | 5.73 | 0.85 | 3.63 |
Phosphorus (mg) | 93 | 66 | 5 |
Potassium (mg) | 66 | 19 | 54 |
PRAL Score | 4.63 | 3.08 | 0.69 |
Vitamin D (IU) | 50 | 37 | 0 |
Cholesterol (mg) | 207 | 184 | 0 |
Choline (mg) | 169 | 139 | 0.36 |
How often can kidney patients eat eggs?
This is a great question, but one that won’t have an easy answer. If and how often a kidney patient can eat eggs will depend on a variety of concerns.
For example, someone with stage 3 CKD has very few dietary restrictions as compared to someone with stage 5 CKD or end-stage CKD on dialysis.
Egg whites tend to be the safest option for kidney patients. They are lower in phosphorus, cholesterol, and choline, but still provide some protein.
However, sticking to egg whites only means sacrificing the vitamin D and healthy fats that the egg yolk can provide.
Including whole eggs or egg yolks a couple of times per week may be allowable with individual nutrition parameters.
Starting with a food tracker like Cronometer* can show you how much eggs add up to your nutritional goals.
The best way to determine how often you can eat eggs is to speak with a registered dietitian (RD).
A RD can perform a complete nutritional assessment to determine your specific nutritional needs, including daily protein, potassium, and phosphorus needs.
Can dialysis patients eat eggs?
Eggs can be a great source of protein for those on dialysis.
As mentioned above, eggs provide protein. Dialysis patients require more protein than CKD patients not on dialysis.
Egg whites have been shown to improve albumin levels, while also decreasing phosphorus and cholesterol levels in dialysis patients (13).
Additionally, dialysis patients that ate egg whites as part of their diet improved iron and hemoglobin levels. This can reduce the need for IV iron and erythropoietin injections (14).
Therefore, a dialysis patient can enjoy eggs as a part of their balanced diet knowing that it can help them feel good.
Ways to Enjoy Eggs in a Renal Diet
There are many ways to incorporate eggs into a healthy renal diet. Here are some ideas to get you started.
Veggie Scramble or Omelet
Use a combination of whole eggs and egg whites, or just egg whites, to make a scramble or omelet.
The key is to incorporate plenty of vegetables to provide more nutrients and reduce the acidic PRAL score.
For example, a simple 2-egg omelet or scramble with 1 ounce of low-sodium cheddar cheese provides 20 grams of protein, 158 milligrams of potassium, and has a PRAL value of 14.6.
However, try using one whole egg and a ¼ cup egg whites, adding some diced peppers and onions and swapping the cheese for nutritional yeast.
This will provide 16 grams of protein, 405 milligrams of potassium and an improved PRAL of 2.7.
Add an apple to this meal to make drop the PRAL to -1.5 and give the meal 5 grams of fiber.
Poached Egg on Avocado Toast
Adding an egg to avocado toast is a great way to add more protein and help the meal feel more “complete.”
Be sure to use a bread with as low as sodium as you can find. Bread is a sneaky high-sodium food.
Deviled Eggs with EBTB Seasoning
Make deviled eggs using mayo or a yogurt of your choice. Sprinkle with salt-free Everything But The Bagel seasoning like this one from Dash.*
Don’t get carried away with these as they can be high in protein or fat. Try pairing one or two deviled eggs with some crunchy carrots, celery, and radish.
Add an apple for more fiber and to help fill you up.
Egg Substitutes
Here are some ideas for substitutes if you’re interested in using eggs but also want other options.
Flax Egg
You can quickly make an egg replacement using ground flaxseed. Flaxseed is a good source of omega-3s and provides 2 grams of fiber per tablespoon (15).
Combine 1 tablespoon of ground flaxseed with 2.5 tablespoons of water. Let the mixture sit for at least 5 minutes to thicken. Then add to your recipe and continue as you would.
Flax eggs are great to use in baking. Try it with your next banana bread recipe.
Chickpea Flour
Chickpea flour may not be a common pantry staple, but maybe it should be.
To make a large egg exchange, mix 3 tablespoons of chickpea flour and 3 tablespoons of water.
Try using this instead of eggs as a base for a veggie omelet.
Tofu
Tofu is a great substitute for many recipes featuring eggs.
For example, firm or extra-firm tofu can be crumbled and used as the base of a veggie scramble.
Silken tofu can be used in place of eggs for creamy dishes like custard and quiche. Try swapping out one egg for a quarter-cup of silken tofu in your next recipe.
You’ll get your protein from plants, plus a little extra calcium.
Store-bought Egg Replacements
There are many egg substitutes available in stores these days. Here are a couple that may work for you.
Ener-G Egg ReplacerTM uses potato and tapioca starch as its main ingredients to serve as a binder. Find it here on Amazon.*
Bob’s Red Mill® Egg Replacer is another good substitute. They also use potato and tapioca starch as the main ingredients. Find it here on Amazon.*
Many egg substitutes like Egg Beaters® have added phosphates listed in the ingredients. Be careful with these if you have high phosphorus levels or have been advised by your dietitian or doctor to avoid phosphate additives.
CKD Meal Plan with Eggs
If you’re interested in what a renal diet with eggs can look like for kidney patients, you’re in luck.
We have several sample meal plans, including a 7-day vegetarian meal plan with eggs. Click here to check out our done-for-you meal plans.
Summary
Eggs are a nutrient-packed and affordable vegetarian protein source. The majority of nutrients in the egg are found in the yolk including vitamin D, lutein, zeaxanthin, and monounsaturated fats.
However, the white of an egg provides some protein and potassium. Egg whites have been shown to support dialysis patients to improve albumin and anemia status.
In some cases, eggs may not be good for kidney patients. Those on a low protein diet or struggling with phosphorus control may need to limit eggs due to their protein content.
Additionally, eating eggs alone will produce more acid, which is difficult for kidney patients to manage. Adding more fruits and vegetables with eggs can make a meal more balanced for kidney patients.
If you are advised to avoid eggs, you can try flax eggs, chickpea flour egg substitute, or tofu for plant-based options. Some store-bought options are available such as egg substitutes or liquid egg whites.
Working with a registered dietitian will provide the most clarity and guidance on how much and how often you can enjoy eggs in your renal diet.
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.