Tips for a Kidney-Friendly Thanksgiving

Thanksgiving is right around the corner! And while many are grabbing their turkeys and pumpkin pies, you may be getting more anxious if you have chronic kidney disease. What about potassium? What’s safe to eat? What do I need to stay away from during my Thanksgiving meal?

Not to worry, my kidney warrior! Thanksgiving can be made into a kidney-friendly meal with some planning and swaps. What it takes is looking at your recipes to learn about the sodium, potassium, phosphorus, and protein that adds up on your plate.

Settle in and be sure you’ve had a good meal or snack because I’m about to get you drooling as we talk all about what you can eat at Thanksgiving. Let’s keep your kidneys healthy and happy!

Is Turkey Good for Kidney Disease?

Of course, we need to address the, um, turkey in the room. The main dish of Thanksgiving is traditionally turkey, but is turkey okay if you have kidney disease?

Turkey may be something you can fit into your kidney-friendly diet in some cases.

Turkey for Early stages of chronic kidney disease (stages 1-3a)

If you are in an early stage of chronic kidney disease, you may be able to have some turkey. In earlier stages, kidneys are still functioning at a rate that can better manage animal proteins. 

Turkey for Late stages of chronic kidney disease (stages 4 and 5 not on dialysis)

I do not recommend animal proteins for later stages of CKD. At this point, everything you are eating is an important part of your goals in preserving your kidney function. Your kidneys do not take a “holiday” from filtering and processing what you eat.

Turkey for Dialysis (end stage kidney disease or stage 5)

If you are on dialysis, the machine is assisting in cleaning out your blood since your kidneys cannot clear enough on its own. Many people on dialysis are encouraged to eat animal proteins since dialysis filters protein from the body as well, which needs to be replaced.

My best advice for any stage of kidney disease

It’s still important to consider that turkey has other components in it that may affect how your feel and how your lab results look. If you want to eat turkey for Thanksgiving or any other holiday or meal, ask your dietitian if and how much is best for you.

No matter what stage of kidney disease you are in, it is always best to ask your own dietitian for personalized diet advice. If you don’t have a dietitian, ask your primary doctor, nephrologist, endocrinologist, cardiologist -any doctor you have- for a referral to a dietitian! 

Nutrition information for Turkey

Turkey is a good source of protein as well as iron. It is important to know that your Thanksgiving turkey has more potassium than most people realize. However, many animal products contain more potassium than a banana!

Below is the detailed nutrition information for Turkey, both with skin and without skin. (Note the biggest difference here is the fat content.)

And deep-fried turkey? A serving of 100 grams (just over 3 ounces) of the trendy deep-fried version also still clocks in with 230 milligrams of potassium, 213 milligrams of phosphorus, and 270 milligrams of sodium to start.

Plant-Based Main Dishes to Replace Turkey

Tofurkey

A turkey replacement made from tofu, Tofurkey is marketed as a tofu-based turkey roast. This roast is one of the most well-known vegan alternatives to turkey during the holidays. But how does it compare nutritionally?

A serving of tofurkey is about 5 ounces and contains 34 grams of protein. If we compared to turkey in equal weights, it’s essentially equivalent in protein (21 grams for a 3-ounce serving). But what is important to note also is that it is very high in potassium- 870 milligrams per serving!

The roast is very high in sodium, but that’s to be expected with any processed food- especially one that is trying to replace animal meat. Per serving, this roast has 660 milligrams of sodium! It’s also high in potassium which may make it less of a good choice if you have to follow a low-potassium diet. Thankfully there are no phosphorus additives to be found!

One more note- the primary ingredient is gluten (this is common for meat replacements like seitan). If you have any gluten intolerance or if you have IgA nephropathy, you may need to avoid gluten.

Quorn Roast

Another turkey alternative is the roast from Quorn. This roast includes eggs and milk, making it vegetarian, not vegan. It’s a good time to point out that not everyone with kidney disease needs to follow a fully vegan diet.

Quorn’s roast is significantly lower in protein when compared to turkey, with 15 grams of protein per 4-ounce serving. It is also a lower-sodium option when compared to the Tofurkey roast, with 460 milligrams sodium per serving.

Note that the nutrition information of this roast does not include potassium data. However, the ingredients suggest that it would not be a very high source of potassium. But keep this lack of information in mind if you need to restrict your potassium levels.

Stuffed Squash

Winter squash may be a great turkey substitute if you do not have a potassium restriction. Butternut, acorn, kabocha, and other winter squash are high in potassium but pack a lot of other great nutrients, including fiber! 

Using a squash instead of tofu or turkey also a lower-protein option which may be great for someone with CKD that can have some extra potassium.

Check out this Roasted Stuffed Butternut Squash from the Minimalist Baker for a possible holiday recipe to try out as a turkey alternative.

Roasted Portobello Mushroom

Probably my favorite meat substitute is mushrooms! This is an easy swap for turkey that is lower in protein than the tofu-based subs mentioned. A portobello mushroom (also called portabella mushroom) has approximately 300 milligrams potassium per mushroom cap.

Compared to turkey, this is a higher potassium substitution when compared to turkey. But keep in mind that this is also a lower sodium and higher fiber option- both benefits!

To prepare for dinner, preheat the oven to 400 degrees Fahrenheit. Mix together ¼ cup avocado or olive oil, 1 tbsp low-sodium soy sauce or coconut aminos (be sure it’s still low in sodium!), 1 tsp liquid smoke, 1 tsp smoked paprika, and 1 minced or smashed garlic clove. 

Remove the stem and scrape out the gills on the bottom with a spoon. Wipe mushroom with a clean, damp towel. Place mushrooms in a shallow baking dish and pour marinade over the mushroom. Allow to marinate for 15-30 minutes, turning once or twice.

Place marinaded mushrooms on a baking sheet lined with parchment paper. Roast for 10 minutes, flip over and roast for another 10 minutes.

Potassium in Common Thanksgiving Foods

Many of the most common Thanksgiving dishes are very high in potassium. Here are some of the dishes you may need to limit or avoid.

High potassium dishes

High Potassium Holiday DishesServing SizePotassium content 
(in milligrams, from USDA food database)
Potatoes1 medium632 milligrams
Acorn Squash½ cup448 milligrams
Butternut Squash½ cup291 milligrams
Hubbard Squash½ cup367 milligrams
Pumpkin½ cup407 milligrams
Black-eyed peas½ cup239 milligrams
Parsnips½ cup285 milligrams
Creamed spinach½ cup409 milligrams
Sweet potato casserole½ cup256 milligrams
Pumpkin pie⅛ of 9” pie257 milligrams
Mustard Greens½ cup289 milligrams
Here’s a list of common holiday dishes that are higher in potassium.

Instead, you can swap for other dishes that are just as delicious but lower in potassium! Here are some ideas:

Lower potassium dishes

Lower Potassium Holiday DishesServing sizePotassium Content
(in milligrams from USDA food database)
Mashed Cauliflower½ cup241 milligrams
Glazed Carrots½ cup177 milligrams
Cabbage½ cup151 milligrams
Roasted Radishes½ cup175 milligrams
Roasted Turnips½ cup159 milligrams
Sauteed Green beans½ cup112 milligrams
Green bean casserole½ cup183 milligrams
Pecan pie⅛ of 9” pie113 milligrams
Cherry pie⅛ of 9” pie105 milligrams
Apple pie⅛ of 9” pie84 milligrams
Here’s a list of holiday dishes that are lower in potassium!

Tips to lower potassium at Thanksgiving

There are ways you can modify recipes to lower the potassium and make them more kidney-friendly!

Double-boil root vegetables

Did you know that double-boiling root vegetables have been shown to lower potassium levels by up to 75%

If you are going to mash or roast potatoes, try double-boiling them first! To do this, place cubed potatoes (about 1” cubes) into a pot of cold water. Bring to a boil and boil for 10 minutes. Turn off the heat, drain potatoes, and refill the pot with fresh, cold water. Bring to boil again for another 10 minutes or until completely cooked. Drain and proceed with your recipe!

Use more homemade ingredients

Some recipes call for ingredients that are high in sodium due to the pre-made ingredients. Take the classic green bean casserole. It calls for cream of mushroom soup. Check out the Kidney RD’s mushroom soup recipe as a swap for the typical mushroom soup ingredient in the casserole dish.

Low-sodium Thanksgiving Ideas for Healthy Kidneys

Here are some other suggestions to cut down on sodium for your holiday meal!

  • Try cutting the recommended salt amount in the recipe by one-third or half when making homemade gravy
  • For stuffing or dressing, choose the lowest-sodium bread and broth options in your grocery store
  • Rinse any canned vegetables with water before using

Phosphorus at Thanksgiving

While not everyone needs to worry about phosphorus, many people with kidney disease should pay attention to phosphorus in their foods. Phosphorus can be very harmful if not managed early on.

Read all labels

Be sure to check all food labels for any ingredients with added PHOSphates. You can find this information under the nutrition label in the ingredients list. Even if it’s at the very bottom of the ingredient list, any added phosphates can be damaging to the kidneys as they are absorbed by 100%.

Take your binders (and then some!)

If you are taking a phosphorus binder prescribed by your doctor, discuss what a higher safe dose could be to cover a larger meal. Binders work like sponges- they can only hold so much phosphorus before they’re full!

Be sure to discuss any phosphorus binder concerns with your nephrologist before making any changes. It’s important you speak with your kidney specialist about everything related to your kidney health!

Summary

Thanksgiving is a holiday that is all about being grateful for everything you have- your family, your friends, and your health! Be grateful for the health you have, even with chronic kidney disease.

Talk with your dietitian or healthcare provider about what you should pay the most attention to during the holidays. Looking at your labs and goals helps a lot when determining what to focus on.

If you have been directly advised to limit potassium intake, be sure to choose low-potassium foods or find ways to cut down the potassium of your favorites like mashed potatoes. 

By making healthy choices at your holiday meals, you’ll likely find yourself enjoying them even more as you feel good about yourself and your choices.

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6 thoughts on “Tips for a Kidney-Friendly Thanksgiving”

  1. This was a great article for me. I’m just starting to have to manage my diet as my potassium numbers soar. I was worried about the Thanksgiving “feast” being dangerous to my kidneys….so thank you so much.

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