Navigating Summer Cookouts with CKD

Summer holidays often involve summer cookouts, and they can present a unique challenge for you if you have CKD.

As a review, CKD is divided into 5 stages. Your stage of CKD is determined using a blood test called an estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (uACR). For an accurate diagnosis, you need to complete these tests twice, about three months apart.”

Stage 1: eGFR 90 or higher and kidney damage; (e.g. uACR 30 or higher) for 3 months or more

Stage 2: eGFR 60-89 and kidney damage; (e.g. uACR 30 or higher) for 3 months or more

Stage 3a: Mild to moderate loss of kidney function; (eGFR 45-59 for 3 months or more)

Stage 3b:  Moderate to severe loss of kidney function; (eGFR 30-44 for 3 months or more)

Stage 4: Severe loss of kidney function; (eGFR 15-29 for 3 months or more)

Stage 5: Kidney failure; (eGFR less than 15 for 3 months or more) or you are on dialysis

Summer cookouts can present challenges related to CKD, especially when it comes to hydration, protein, sodium, phosphorus, and potassium. Here’s how you can navigate Summer Cookouts with CKD.

Dehydration is a risk for anyone during the hot summer months, but it’s especially dangerous for people with compromised kidney function.  If you become dehydrated and already have CKD, it can lead to a drop in blood pressure, increased risk of acute kidney injury, high electrolyte levels, uremia, and risk of kidney function decline.

If you’re attending an outdoor event, I recommend taking a large water bottle with you to ensure you have plenty to drink.  Also, stick with water over sugary beverages and alcohol. In very hot weather, drinking alcohol and sugary beverages can increase the risk of dehydration, especially for people with CKD. 

Read more about CKD and adequate hydration here.

Choosing the Right Proteins

Excessive protein intake is another danger during summer holiday get-togethers. One day of eating a little too much protein is probably not going to make a huge difference in your kidney health, but it should still be considered when you’re planning to go to a holiday party. Celebrating with friends and family can present some challenges when it comes to that, so having a plan in place ahead of time can be helpful.  

Common protein sources at summer cookouts include hamburgers, hot dogs, ribs, pulled pork, and chicken.  Baked beans are another protein source often served at a cookout.  

While it is still up for debate whether animal protein is truly more harmful to kidneys than plant protein, we know that animal protein tends to have a higher net acid load, resulting in a less alkaline environment in the body. Your kidneys function better in an alkaline environment, so keeping the net acid load down is desirable.  If you’re going to eat meat, your best bet is to choose a small piece of fish or chicken if it’s available. If not, you could choose a hamburger, a small rib, or a small amount of pulled pork. I recommend avoiding processed meats like hot dogs and brats. If beans are available, they can be a great option, but be mindful of the sodium content.  Baked beans especially can have a lot of sodium in them. 

Why not consider this? If it’s a covered dish or pot luck, bring a plant-based protein source like a black bean salad or low sodium baked beans.

Managing Sodium Intake

Sodium is another thing to watch out for at summer gatherings.

High sodium intake in people with CKD is associated with increased blood volume, increased blood pressure, faster CKD progression, increased cardiovascular events, increased proteinuria, and increased mortality.

During summer holiday gatherings, some of the highest sodium foods commonly served include:

• Processed meats like hot dogs, sausages, and deli meats
• Cheeses
• Potato chips
• Pickles
• Salad dressings, dips, and condiments
• Hamburger and hot dog buns
• Highly seasoned meats

To manage sodium intake during summer gatherings, it’s helpful to choose fresh fruits and vegetables, opt for homemade dishes with less salt, and be mindful of portion sizes of high-sodium foods. 

Read more about sodium and CKD here.

 Watching for Phosphorus Additives

Phosphorus is a mineral that helps build strong bones and teeth, supports muscle function, and plays a key role in how your body uses energy. It’s found naturally in many foods, especially protein-rich foods like meat, dairy, beans, and nuts.

In healthy people, the kidneys remove extra phosphorus from the blood. But if you have CKD, your kidneys can’t filter it out as well. When phosphorus builds up in your blood, it can pull calcium from your bones and deposit it in blood vessels and soft tissues. Over time, this can lead to weak bones, joint pain, itchy skin, and increased risk of heart disease. It can also speed up kidney disease progression.

That’s why managing phosphorus in your diet is so important when you have CKD.

The main phosphorus offenders at a holiday cookout are probably going to be things like beverages and flavored chips. Dark colas and many other bottled drinks contain phosphate additives, which unlike naturally occurring phosphorus are absorbed at 100%.  Flavored chips like Doritos and BBQ chips generally contain phosphate additives too.  This is another reason to drink water and to stay away from chips, which are also high in sodium. 

Read more about phosphorus and CKD here.

Managing Potassium Intake

Not everyone with CKD needs to follow a potassium restriction, but if you have been told by your doctor that you need to restrict your potassium intake, there are some things you should think about and plan for before you attend a summer holiday party. 

1. Watermelon if eaten in large quantities is a high potassium food, so if you eat it, keep your intake to a small wedge or a few cubes.
2. Meats are high in potassium, so if you’re eating animal protein, keep your portion to less than 3 oz.
3. Potato salad and potato chips are a source of potassium. Choose cole slaw or pasta salad instead.
4. Baked beans are high in potassium. Keep your portion small if you have them.

Read more about potassium and CKD here.

Practical Tips for Managing CKD at Summer Gatherings

1. Bring a CKD-friendly dish… Guarantee at least one safe option. Try a pasta salad with olive oil, fresh herbs, bell peppers, and green beans.

2. Watch portion sizes of high-potassium foods… If you want a bite of baked beans or watermelon, keep portions small.

3. Avoid dishes with phosphate additives…Check labels for ingredients with “phos-” such as phosphoric acid and potassium phosphate.

4. Skip the salt-heavy sides…Choose fresh corn (without salted butter), raw veggies, or coleslaw without too much dressing over chips and pickles.

5. Use herbs instead of BBQ sauces or marinades…Many sauces are high in sodium and potassium. Bring a small bottle of homemade herb vinaigrette to flavor meats or veggies.

6. Stay well-hydrated with low-risk options…Stick to water infused with lemon or cucumber, unsweetened iced tea, or club soda with a splash of cranberry or apple juice.

7. Limit alcohol and sugary drinks Both increase fluid loss and can worsen dehydration. If you choose to drink, do so in moderation and have a water between drinks.

8. Stay cool and shaded…Bring a hat, sunglasses, and sit in the shade. Dehydration can worsen kidney function quickly.

9. Set a timer to drink water regularly…Especially important in hot weather—even if you’re not thirsty.

10. Know your warning signs…Fatigue, dizziness, or dark urine may signal dehydration. Step away and rehydrate if you notice symptoms.

11. Let the host know your needs in advance…Most people are happy to accommodate if they understand you’re managing a medical condition.

12. Say “no thanks” with confidence…Prepare a polite line ahead of time like, “That looks great, but I’m following a special kidney diet—thanks for understanding.”

While having CKD can present unique challenges when it comes to summer parties, being prepared ahead of time with some basic information can help you have a great time without being worried about your kidneys. Hopefully navigating summer cookouts with CKD feels a little more doable to you with this information under your belt.

Now go celebrate!

References: Dietary Acid Load and Chronic Kidney Disease, InKidney Integrative Approach to Kidney Health, https://inkidney.com/dietary-acid-load-and-chronic-kidney-disease/