What Nuts Are Bad for Kidney Disease? Know the Risks and Better Choices

Nuts are often considered a healthy snack—rich in plant protein, fiber, and heart-healthy fats. But if you’re living with kidney disease, not all nuts are safe.

Some nuts are naturally high in potassium and phosphorus, two minerals your kidneys may struggle to manage when their function declines. Over time, too much of these minerals can raise your risk for heart problems, bone disease, and other serious complications.

This guide will cover why certain nuts can be risky for kidney health, which nuts are best to avoid or limit, safer alternatives for people with kidney disease, and how to enjoy nuts in moderation—if approved by your care team.

Why Do Nuts Matter for Kidney Disease?

When your kidneys don’t work properly, they can’t filter out potassium and phosphorus as efficiently. This leads to a buildup that can harm your body in several ways:

• High potassium (hyperkalemia) can cause muscle cramps, fatigue, or even irregular heartbeats

• High phosphorus (hyperphosphatemia) may lead to itchy skin, weak bones, and calcium deposits in your blood vessels

Because many nuts are naturally high in both minerals, your kidney dietitian may suggest avoiding or limiting them.

These symptoms often occur alongside other warning signs like creatinine level changes or protein in urine, especially in patients with declining kidney function.

Because many nuts are naturally high in both minerals, your kidney dietitian may suggest avoiding or limiting them.

Which Nuts Are High in Potassium and Phosphorus?

Here's a look at how much potassium and phosphorus are found in common nuts (per 1-ounce/28g serving):

As you can see, even a small serving can contribute a significant amount of these minerals—especially if you’re snacking frequently or combining multiple sources.

If you have high glucose in urine or are managing diabetes alongside CKD, these mineral imbalances can be even more dangerous.

What Nuts Are Bad for Kidney Disease?

Based on their high phosphorus and potassium content, these nuts are generally less kidney-friendly:

• Pistachios – Highest in potassium on the list

• Cashews – High in both potassium and phosphorus

• Almonds – Very common, but mineral-dense

• Brazil nuts – Rich in phosphorus and selenium (too much can be toxic)

These may need to be avoided or eaten very rarely—especially in later stages of CKD or if you’re on dialysis.

Nuts with preservatives may also increase your phosphorus load, especially when phosphate additives are involved.

Can You Eat Nuts If You Have Kidney Disease?

In some cases, yes. Many people with kidney disease can safely eat small portions of select nuts—especially if they’re working closely with a kidney dietitian.

Tips to enjoy nuts more safely:

• Limit serving size to 1 tablespoon (or fewer)

• Avoid pre-packaged or seasoned nuts with added phosphorus preservatives

• Choose dry-roasted or raw, unsalted varieties

• Use phosphorus binders if prescribed before eating high-phosphorus foods

Symptoms such as frequent urination or changes in urine color may indicate early issues when incorporating mineral-rich foods like nuts.

Portion control is essential. Even lower-mineral nuts can cause problems if eaten in large amounts.

What Are Safer Nut and Seed Options?

Some nuts and seeds have lower levels of phosphorus and potassium and may be safer in small servings:

• Macadamia nuts – Lower in potassium and phosphorus

• Pecans – Moderate levels, often allowed occasionally

• Chia seeds – High in fiber and omega-3s, with balanced minerals

• Flaxseeds – Good source of anti-inflammatory fats

• Pumpkin seeds – Still high in phosphorus but okay for some people in tiny portions

Always check with your doctor or dietitian before making changes to your diet. You may also benefit from monitoring changes with an at-home kidney function test.

Healthy Snack Alternatives to Nuts

If your care team suggests avoiding nuts altogether, you still have great snack options that won’t overwhelm your kidneys:

• Fresh fruit like apples, berries, or grapes

• Veggie sticks (carrots, cucumbers) with hummus

• Air-popped popcorn (no salt or butter)

• Rice cakes with low-sodium toppings

• Plain Greek yogurt (in moderation)

• Applesauce or homemade fruit smoothies (potassium-controlled)

For those managing proteinuria, nutrient-dense but kidney-safe snacks can help reduce pressure on your kidneys.

A 24-hour urine collection test may also help you and your doctor identify mineral intake patterns related to your snack choices.

Final Takeaway

Nuts can be a nutritious part of many diets, but if you’re managing kidney disease, you need to be selective. Nuts like pistachios, cashews, almonds, and Brazil nuts are higher in potassium and phosphorus and may not be safe for regular consumption.

The good news? With help from your kidney care team, you can still enjoy safe snacks that fit your needs. Whether it’s a sprinkle of macadamia nuts or a handful of blueberries, there are plenty of kidney-friendly options to choose from.

Support Your Kidney Health with Ribbon Checkup

Want to see how your food choices affect your kidney health? Ribbon Checkup offers at-home testing to help you track important kidney markers—so you can take control with confidence.

Explore Ribbon Checkup’s kidney health tools

References

References

Clegg, D. J., Headley, S. A., & Germain, M. J. (2020). Impact of Dietary Potassium Restrictions in CKD on Clinical Outcomes: Benefits of a Plant-Based Diet. Kidney Medicine, 2(4), 476–487. https://doi.org/10.1016/j.xkme.2020.04.007 

Kalantar-Zadeh, K., & Moore, L. W. (2020). Precision Nutrition and Personalized Diet Plan for Kidney Health and Kidney Disease Management. Journal of Renal Nutrition, 30(5), 365–367. https://doi.org/10.1053/j.jrn.2020.07.005 

Kubala, J. (2019, November 18). The 20 Best Foods for People with Kidney Disease. Retrieved June 23, 2025, from Healthline website: https://www.healthline.com/nutrition/best-foods-for-kidneys 

Staying Healthy Newsletter - In the news: Nuts Linked to Kidney Health Polyphenols Help Gut. (2022). Retrieved June 23, 2025, from Sciencebasedhealth.com website: https://www.sciencebasedhealth.com/ContentPage.aspx?WebpageId=845 

Superfoods: Nuts and Seeds. (2025, May 23). Retrieved June 23, 2025, from National Kidney Foundation website: https://www.kidney.org/kidney-topics/nuts-and-seeds 

Wang, K., Qian, D., Hu, Y., Cheng, Y., Ge, S., & Yao, Y. (2022). Nut Consumption and Effects on Chronic Kidney Disease and Mortality in the United States. American Journal of Nephrology, 53(6), 503–512. https://doi.org/10.1159/000524382