Fish

There are many varieties of fish. While all fish provide excellent high-quality protein for your diet, some fish provide higher amounts of omega-3 fatty acids. Our bodies do not produce omega-3 fatty acids, so we have to get them from our diet. 

Fish is a good source of protein without being high in saturated fat– Just a 3 oz portion of fish (the size of a deck of cards) provides an average of 20 grams of protein.

Other reasons why fish is considered a superfood include:

• Fish is loaded with vitamins such as D and B2 (riboflavin). 
• Fish is a great source of minerals, calcium, phosphorus, iron, zinc, iodine, magnesium, and potassium. 
• Fatty fish, such as salmon, are some of the best sources of omega-3 fatty acids. These omega 3-fatty acids are packed with benefits for your heart, brain, eyes, inflammation, and your overall health. 

The amount of potassium and phosphorus in fish varies depending upon the type of fish (see the chart below). The amount of potassium and phosphorus you can have each day will depend on your stage of kidney disease and/or the type of dialysis you receive.  

Chronic kidney disease (CKD) and transplant

Most people with kidney disease or transplants do not have to limit fish.  

When you reach the later stages of kidney disease your doctor may want you to limit the amount of protein you eat.  Eating fish can still be a great option but you might need to eat smaller portions.  Talk to your doctor or to a kidney dietitian to find out your individual needs.  

With a transplant, you will want to avoid raw or undercooked fish as it can pose an increased risk of foodborne illness (also known as food poisoning). Transplant patients are at higher risk since they take immunosuppressive medications or “anti-rejection medications” to protect the new transplanted kidney. 

Hemodialysis (3 times a week) and daily home or nocturnal hemodialysis/peritoneal dialysis

People on dialysis have increased protein needs. Include fish two times per week as a great lean protein option and a way to help boost intake of omega-3 fatty acids. The potassium and phosphorus content of fish varies (see the chart below). Choose fresh fish when possible because it is lower in sodium. Canned fish can be high in sodium.  Always talk to your kidney dietitian to find out how you can include fish in your diet. 

Kidney stones

Eating fish will not have an effect on forming kidney stones.

Some concerns

Larger fish like tuna and sharks may have high mercury concentrations. See list of seafood, mercury levels and maximum serving recommendations per week at https://www.verified.org/articles/guides/mercury-poisoning-from-fish.

*Good source of omega-3 fatty acids
Additional nutrition information can be found at the United States Department of Agriculture (USDA) website https://fdc.nal.usda.gov/fdc-app.html#/

Baked salmon in foil

Servings – about 8 - 3oz servings

Ingredients

• ½ cup olive oil
• 2 ½ tablespoons lemon juice, or more to taste 
• 5 cloves garlic, minced or pressed through a garlic press
• 1 tablespoon brown sugar
• 1 teaspoon dried oregano
• 1 teaspoon dried thyme
• freshly ground black pepper to taste
• aluminum foil
• 1 teaspoon olive oil
• 1 (2 pound) salmon fillet 
• ¼ cup chopped fresh parsley
• 1 lemon, sliced

Directions

1. Preheat the oven to 375°F (190°C).
2. Combine 1/2 cup olive oil, lemon juice, garlic, brown sugar, oregano, thyme, and pepper in a bowl. 
3. Place a large piece of aluminum foil on a baking sheet and brush with olive oil. Place salmon in the middle of the foil, skin-side down. Drizzle with olive oil mixture. Fold up the edges of the foil over the salmon to create a packet, making sure to seal the edges. 
4. Bake in the preheated oven until the fish flakes easily with a fork, 20 to 25 minutes, until the internal temperature is 145°F. If your salmon fillet is very thick, it can take longer. Garnish with fresh parsley and lemon slices.

Nutrition facts per serving

Recipe adapted from https://www.allrecipes.com/recipe/263217/baked-salmon-in-foil/

Download the National Kidney Foundation’s Fact Sheet: Fish

Toll-free helpline: 855.NKF.CARES or email nkfcares@kidney.org

*This content is provided for informational use only and is not intended as medical advice or as a substitute for the medical advice of a healthcare professional.