Is your milk kidney friendly?

by KNI

Table of Contents

    Is milk good for kidney patients? Or is milk bad for kidneys? If so, then which milk is good for kidney patients?

    If you have kidney disease, you may ask yourself these questions. Rest assured, you are not alone! Milk and kidney disease is one of the most frequently inquired topics. The answer, unfortunately, is not so simple.

    And with more and more milk alternative options hitting the shelves, it's getting harder to know which way to turn. So let's dive into the world of milk and milk alternatives to find out which type of kidney friendly milk is best for you.

    meadow with brown cow resting in background, pitcher pouring milk into glass cup

    This post was last updated on June 2023. Please keep in mind that the ingredient list for products may change over time.

    What's the deal with dairy?

    As children, many of us were encouraged to drink milk to grow strong and keep our bones healthy. The USDA recommends 2-3 servings of dairy per day depending on age, weight, and sex for a healthy diet. (1)

    Cow's milk provides essential nutrients, including protein, calcium, vitamin D, and many other vitamins and minerals.

    So if milk is such a healthy food, then why is it so controversial?

     

    Can kidney patients drink milk?

    Limiting dairy products like milk to just 4-8 ounces per day is recommended for people with kidney disease. Much less than the USDA suggests, right?

    It's not because milk is inherently bad for kidneys. The main reason dairy is limited for people with kidney disease is that it is very rich in minerals, including phosphorus and potassium.

    When kidneys are not functioning well, they become less efficient at removing extra phosphorus and potassium from the body, especially as kidney disease progresses. (2)

    Calcium, kidney stones, and PKD

    Calcium is another mineral found in milk. Some people with kidney disease need to limit calcium-rich foods, while others benefit from having more.

    If you suffer from kidney stones, specifically calcium oxalate stones, getting enough calcium can prevent the formation of kidney stones. (3)

    The same is true for those with polycystic kidney disease (PKD). Adequate calcium intake can prevent crystals from forming in the kidneys, which help to prevent disease progression. (4)

    That's because when we eat calcium along with a high oxalate food, the calcium from food can bind to oxalate in the stomach or intestines before entering the kidneys, where it could crystallize and create kidney stones.

    If you have PKD or are prone to kidney stones, it may be helpful to seek the support of an experienced Renal Dietitian who can help you balance calcium, oxalates, and other nutrients of concern.

    Does fat content in milk matter?

    People often ask if the fat content in milk matters when it comes to potassium and phosphorus. Check out the table below that highlights the nutrients in different types of cow's milk.

    Although higher fat content milk has slightly fewer minerals, the difference is not significant. That's because all types of milk are high in potassium and phosphorus and are a good source of calcium.

    Milk (1 cup)CaloriesProtein (g)Fat (g)Carbohydrate (g)Potassium (mg)Phosphorus (mg)Calcium (mg)
    Skim8480.112411263325
    Low Fat 1%1068212.7391253310
    Reduced Fat 2%1228412390252309
    Whole1528811.5374251306
    1% Lactaid11082.513410240300
    Per the USDA Food Central Database
    Picture of Silk Unsweetened almond milk half gallon bottle

    Plant-based milk: A kidney friendly milk option?

    To some individuals avoiding cow's milk is no big deal. But for the avid cereal-eater and milk drinkers (me!!), cutting back on milk is one of the hardest things about following the renal diet.

    Luckily, there are endless options of plant-based milk alternatives available at the grocery store today! But not all are created equal, and knowing which type of milk is best for you can be a wild ride.

    Before we walk through all of the plant-based milk choices available, let's talk about the importance of label reading.

    Label Reading: the #1 rule for plant-based dairy products

    Plant-based milk and dairy products do not have the same nutritional profile as cow's milk, but are often enriched with vitamins and minerals to make them a more comparable substitute.

    When fortifying plant-based milk, food manufacturers commonly add potassium and phosphorus- two minerals to look out for if you have kidney disease.

    "PHOS" in plant-based milks

    Phosphorus (or what we lovingly call PHOS) is naturally found in almost all milk alternatives. For example, almond milk, rice milk, and soy-milk contain about 20 mg, 50 mg, and 80-150 mg of phosphorus per cup, respectively. Not too shabby compared to the 250 mg found in cow's milk!

    However, the big concern is that phosphorus is often added to alternative milk. Phosphorus that is added to food is also known as inorganic phosphorus or phosphorus additives. The problem with inorganic phosphorus is that it's much easier for our bodies to absorb than phosphorus naturally occurring in food, like milk. (5)

    Ingredients list from a food label with Trisodium phosphate circled in red

    Phosphorus is not typically found in the "nutrition facts" part of the food label. The best way to know if phosphorus has been added to food is to check the ingredients list.

    There are numerous common phosphorus additives in alternative milk. A few examples include:

    • Tricalcium phosphate
    • Dipotassium phosphate
    • Magnesium phosphate

    The easiest way to know if phosphorus is added is to check for "P-H-O-S" embedded in the ingredients. Click here to learn more about checking the ingredients list for phos! It's so crucial to kidney care that we've dedicated content just to this topic!

    Potassium in alternative milks

    The potassium content of plant-based milk varies. While some plant-based milk options naturally contain more potassium, others have very little. Fortunately, potassium is now listed on the Nutrition Facts label, so there is no question about how much potassium is packed into an 8-ounce glass of your favorite milk!

    You might also notice the increased use of potassium additives in plant-based milk. Potassium additives may go by the names:

    • Potassium citrate
    • Dipotassium phosphate

    Studies show that foods with potassium additives contain more potassium than the same food without potassium added. (6)

    It's important to remember that not everyone with kidney disease needs to limit potassium. However, if you do, check the label for the amount of potassium in the nutrition facts label and the ingredient list for any potassium additives.

    For your personalized nutrition plan, book your free Zoom call with a KNI dietitian today!

    Kidney friendly plant-based milk alternatives to consider

    The variety of different types of plant-based milk alternatives has grown immensely over the years. There are lots of reasons why consumers have been leaning into plant-based dairy options.

    For some, it may be due to health reasons such as milk allergy or intolerance. For others, it may be due to concerns about the hormones or saturated fat found in milk. In addition, many people are choosing to eat a more plant-based diet for environmental reasons or because they do not consume any animal products at all.

    No matter the reason, consumer demand for plant-based milk options is growing. Data from the plant-based food association show that the demand will likely continue to grow as new options become available. (7)

    Let's review the most popular choices on the market today and the considerations for a kidney-friendly diet!

    1) Rice milk:

    Rice milk is one of the original plant-based milk options available on the market. A key benefit is that rice is not a top allergen and does not contain lactose. Therefore, it's an excellent option for people with an allergy to milk, soy, or lactose intolerance.

    Because rice milk is naturally low in potassium, phosphorus, and protein, it becomes an excellent choice for people with kidney disease. Remember always to check the ingredient list to avoid those pesky PHOS additives!

    Our top choice for rice milk: Rice Dream™ Original Rice Dream.

    2) Soy milk

    Another one of the original milk alternatives, soy milk, is naturally higher in potassium and phosphorus than many other plant-based dairy options. The amount of potassium in soy milk varies by brand but averages about 400 mg per 8-ounce serving, while phosphorus can range anywhere from 80 mg- 250 mg.

    Soy milk is one of the highest protein plant milk. It contains about the same amount of protein as cow's milk per serving, making it an excellent plant-based milk option for individuals on dialysis and those with CKD and Diabetes because of higher protein needs. (8)

    Plain soy milk is also low in oxalates, at only 4 mg oxalates per cup. This makes soy milk kidney-friendly, even for those with PKD.

    However, if potassium and phosphorus are a concern, choosing a lower potassium and phosphorus plant-based milk may be best.

    Our top choice for soy milk is 365 Organic Unsweetened Soy Milk because there are no phosphorus additives and potassium is <300 mg per serving, making it a good kidney-friendly milk. However, note that it is fortified with calcium. Be sure to discuss with your KNI dietitian if you need guidance on calcium management.

    3) Almond milk

    Our patients often ask about almond milk and kidney disease. Is almond milk good for kidney patients?

    Good news if you are a fan! Almond milk is an excellent option for people with CKD because it is naturally lower in potassium and phosphorus. Potassium in almond milk is only 75 mg per cup, while phosphorus in almond milk is 73 mg per cup. To ensure that you choose the best almond milk, we recommend checking the label for those pesky phosphorus additives.

    It's also very low in protein, making it perfect for those following a low- or very low-protein diet.

    If you are limiting calcium in your diet, be aware that some brands of almond milk are fortified with up to 500 mg per serving! That's half of the recommended 1000 mg per day!

    One final note: almonds are HIGH in oxalates. If you have PKD or are at risk of kidney stones, you may want to avoid almond milk.

    Other than that, almond milk is good for kidney patients. Our top choice for almond milk is Almond Breeze Unsweetened Original Almond Milk. Prefer a little sweetness without any added sugar? Almond Breeze Unsweetened Vanilla is a great option. If you want a product that does not contain calcium, try Elmhurst Unsweetened Milked Almonds.

    4) Coconut milk

    Coconut milk can get a bit confusing because it comes in two different forms:

    • Canned coconut milk: Fresh coconut mixed with a just a little water is full of fat and deliciously creamy! Canned coconut milk is typically used for cooking and because it's full of fresh coconut it contains about 300 mg of potassium per 1 cup serving. Fortunately, with canned coconut milk a little goes a long way to get that creamy coconut flavor.
    • Coconut milk beverage: Has more water added to ensure a thinner consistency more akin to milk. It is typically much lower in potassium but always check the label to be sure.

    Coconut milk is keto friendly because it is naturally high in fat and low in sugar. It is also very low in oxalates, making it a perfect choice for those with PKD and/or are at risk of kidney stones.

    If you're looking for a kidney-friendly alternative to milk, coconut milk beverage is the way to go. Many options are available, but finding the right one can be tricky because many products contain phosphorus additives.

    Two of our favorites include Simple Truth Unsweetened Coconut milk and 365 Organic Unsweetened Coconut Original Coconut milk beverage.

    5) Oat milk

    Oat milk is one of the dairy-free newcomers on the block but is increasing in popularity. One of the things that people love about it is the creaminess and that it is allergy-free.

    Oat milk is higher in carbohydrates (usually around 20  grams) and protein (approximately 4 grams) compared to many other milk alternatives. Many of the oat milk products available are also packed with sugar.

    The potassium in oat milk varies depending on the brand. If potassium is a concern for you, always check the label or discuss with your KNI dietitian for more help.

    Also, remember to check the label for phosphorus additives because they are used widely in most oat milk options!

    If you are hoping to get a source of calcium from oat milk, we have not yet found a brand that does not have calcium added without phosphorus.

    Two of our favorite oat milk brands are Elmhurst Milked Oats and Trader Joe's Non-Dairy Oat Beverage.

    6) Cashew milk

    Cashew milk is another plant-based milk made from nuts, though not nearly as popular as almond milk. Nevertheless, it is a deliciously creamy option that works well as a topper for cereal or in your morning cup of coffee.

    Only a few brands of cashew milk are available right now; however, you can find many that have blended cashew milk with other types of milk.

    Cashews are chock full of heart-healthy monounsaturated fats and minerals like iron, magnesium, zinc, and copper. Unfortunately, much of this can get lost in the process of making cashew milk.

    If you are watching your oxalate intake, please note that cashews are naturally high in oxalates.

    Most cashew milk products contain 150 mg of potassium or less, making it a good choice when limiting potassium. Always check the label for phosphorus additives. When we researched, we found at least one brand using added phosphate.

    Our favorite cashew brands so far are Elmhurst Milked Cashews or Forager Unsweetened Cashew Milk. We're forecasting that as cashew milk gains more fans, more and more products will be hitting the shelves!

    Glass mason jars filled with different nuts and seeds and three large glass bottles of plant-based milk

    Other Non-Dairy Milks

    The plant-based milk options listed above are the most popular choices, but several other types of milk are available. So come journey with us as we explore them all!

    Hemp Milk:

    Hemp milk is made from hemp seeds which are a great source of the two essential fatty acids, omega-3 and omega-6. Hemp seeds also contain minerals and small amounts of amino acids.

    Hemp milk can be an excellent option for those who have an allergy to nuts or soy. However, there are limited options available on the market. The two major brands available at most stores contain phosphate additives.

    If you are interested in trying hemp milk, we recommend consulting with your renal dietitian.

    Flax Milk:

    Flax milk is made from; you guessed it- flax seeds! Like hemp seeds, flax seeds are also a great source of Omega-3 fatty acids and fiber.

    Another benefit of flax milk is that it is nut-free, so it's great for people with allergies. Flax milk is naturally low in protein for those following a low protein or very low protein diet.

    However, if you need more protein, you can find flax milk with added pea protein. Flax milk is naturally low in potassium and oxalates, but sadly, the primary brand of flax milk available at most grocery stores contains phos additives.

    There are only two brands of flax milk at this time, so the optimal brand for folks with CKD is Malibu Mylk. Unfortunately, Malibu Mylk is currently hard to find at most stores and is quite expensive.

    We love the omega-three profile and that it contains fiber and prebiotics, so we are hopeful that access to Malibu Mylk becomes easier over time!

    Pea Milk

    Pea milk is one of the new kids on the block of plant-based milk alternatives. Derived from the humble yellow dried pea, it has many significant advantages over some of the other options on the market.

    • Like soy milk, pea milk has the same amount of protein as cows milk, making it one of the highest protein plant milk available
    • Pea milk is allergen-friendly
    • Peas take less water to grow than nuts like almonds, cashews, and coconuts, making it a more sustainable choice.

    While we love the nutritional profile of pea milk and the fact that it is a more sustainable option, pea milk is not the most kidney-friendly milk at this time.

    That's because the only two brands available on the market use phosphorus additives in their full current product line.

    As pea protein gains popularity, we hope that more phos-free options may become available in the future.

    Macadamia Milk

    There are not many options available for macadamia nut milk, with only one major player available on the market.

    Macadamia nuts are full of fat, making this milk extraordinarily creamy, delicious, and perfect for those following a ketogenic diet. In addition, it's relatively low in potassium and protein, making it an excellent choice for those with late-stage CKD who are not on dialysis.

    Unfortunately, all of the macadamia nut milk products available at this time contain calcium phosphate to add a source of calcium. Talk with your Renal Dietitian before adding macadamia milk.

    Walnut Milk

    Walnut milk is another nut milk with just two options available.

    One of the benefits of walnut milk over other nut milk is that walnuts are an excellent source of alpha-linolenic acid (ALA), an essential Omega-3 fatty acid.

    Walnut milk is very high in fat yet low in protein and typically contains less than 100 mg of potassium per serving- a perfect choice for folks with CKD who are limiting protein intake.

    Our top choice for walnut milk is Elmhurst Unsweetened Milked Walnuts.

    Hazelnut Milk

    Hazelnuts are not reserved exclusively for Nutella and holiday treats; you can find Hazelnut milk in the plant-based milk aisle too!

    Hazelnuts offer a distinct flavor that can be a lovely addition to baked goods or a nice way to jazz up your morning coffee or bowl of oatmeal.

    Hazelnut milk has just over 100 mg of potassium and is also low in carbohydrates and protein.

    Elmhurst Milked Hazelnuts is the hazelnut milk option that get our stamp of approval because it doesn't contain phosphorus additives.

     

    Make your own!

    Most of the products we've mentioned are store-bought and ready-to-drink. However, making homemade plant-based milk is quite simple and inexpensive. In addition, making homemade plant milk allows you to eliminate any additives and sweeten it to your taste. We hope to post our own recipe for alternative milk soon, but until then, this is one of our favorite recipes for Oat Milk from OhSheGlows.com.

    Get the support you need from a Renal Dietitian

    Don't forget that your friendly Renal Dietitian is here to help you navigate the grocery aisle to help you achieve your best health!

    All dialysis units have a dietitian on staff who can guide you through local products and help you find the right fit for you. If you are a patient with earlier-stage kidney disease, don't hesitate to ask your doctor for a referral to visit with a registered dietitian who specializes in kidney disease, or join our free class all about CKD nutrition for kidney health.

    Picture of 10 different types of plant-based milk options in a tetra pack

    *Data is current as of 9/24/2023

    Author: Lauren Antle, Texas A&M University Dietetic Intern

    Reviewed by: Jessianna Saville, MS, RDN, CSR, LD, CLT

    September 2023 edit: KNI

    30 thoughts on “Is your milk kidney friendly?”

    1. mercedes morel-rodriguez

      Hi, I just started dialysis around a month ago. I am very new at this. Your website is very interesting and helpful. Thank you so much!!!

    2. Rice dream Original Non-Fortified is the best (lowest Phos. & Pot.) for CKD and ESRD patients. It has been a staple on cereal and for cooking for me for years, making it easier for me to meet my highly restrictive dietary goals.
      Make sure you get the Non-Fortified version; it is a little hard to find. I usually order it on-line by the case (it is very shelf stable).

    3. Thanks for sharing your insight here! I agree with the Rice Dream Non-fortified milk sub. It is hard to find but the lowest in phos and potassium. I am always disappointed with the number of milk subs with added phosphates these days. Looking forward to updating this post in the next couple months as there have been lots of new products and product changes since I originally posted 2 years back.

    4. I can’t see the table you mention, but due to the ‘wateryness’ Of rice milk we really like cashew milk as an option. It is very low in potassium, and doesn’t have added phosphates, but I’m not sure how much is naturally occurring.

      Do you recommend silk unsweetened cashew milk for stage 4 CKD?

    5. Agree! So many great products on the market now! Just always have to watch for those darn phos additives

    6. Ok. So I have no gallbladder, diabetic sugar glucose runs 150 approx. And stage upper 3 kidney disease. What’s my best choice in non dary milks?

    7. Helene Kay Yeager

      I am struggling to find out phosphorus content in various non-dairy yogurts. I do read labels but just because something has “phos” listed way down the label does this mean it’s bad?

    8. Hi Helen – any time you see phos on the label means you should try and avoid. Oui Dairy Free by yoplait or Lava yogurt are good choices.

    9. This is why,as a kidney patient. I do not buy or consume processed foods. Plant based milks are ridiculously easy and cheap to make and contain no harmful chemicals! Takes about 2 minutes costs about 35 cents a quart to make my own oat milk!

    10. That is amazing Cheryl that you are making your own oat milk, this is definitely a great way to avoid any additives!

    11. I just found out on October 2020 that I have CKD stage 2, high cholesterol, High BP, and pre-diabetic. I did a lot of research by DaVita and change the way I ate. We can prevent CKD by increasing by following strict diet to those are still in early Stage. I love meat and other junk food and it’s not easy to give up the food you love! But thinking forward what you’ll be facing later on in life if you don’t take care your health now. I am doing this diet to avoid dialysis and kidney transplant in the future. I know it’s boring to eat the food you don’t like but I feel healthier. These are my daily recipes: I eat Oatmeal with apple sauce (no salt and sugar added) every morning and 1 cup of smoothie. I blended 1 cup of cranberry juice cocktail or Oat Milk with frozen blueberries, cherries, strawberries, pineapple, kale, spinach, arugula and 1 red bell pepper. Then for lunch I eat, 1-slice of white bread with 100% mixed berries jam, almond butter spread (no added sugar and salt ), 2 boiled eggs not eating egg yolks and another 1 cup of smoothies I blended. Then, for dinner I made salmon fish sautéed with garlic, onions and seasoned with parsley powder, black pepper, oregano powder, rosemary and dill powder. Then for my vegetables I sautéed garlic, onions, mushrooms and cabbage seasoned with thyme powder, black pepper, oregano powder and parsley powder. I also eat 1 apple a day to keep the doctor away. I eat them over white rice because eating white rice it’s healthier than brown rice for CKD patient. Make sure to use 100% Olive Oil for cooking. Also, I walk 30 minutes a day too to keep my body healthy.

    12. Hi Rhea,
      That is so great that you are taking charge of your kidney health by researching and changing your diet and keeping physically active! It looks like you are eating lots of fresh fruit and vegetables which is wonderful. We like to include brown rice and white rice, but we know that there may be differenced in opinion on whole grains.
      Thank you so much for sharing your experience with the KidneyRD community! We’d love it if you can share what you find useful on our website with others.

    13. Pingback: Tropical Coconut Oatmeal - Kidney RD

    14. All of these are great stories, however, I thought oat meal was bad for kidney disease?

    15. Hi Jose,
      Oatmeal gets a bad reputation because it is whole grain and contains potassium and phosphorus. Old renal diet information recommended limiting whole grains, but we know now that the phosphorus in oatmeal is poorly absorbed and the potassium in oatmeal is only about 150 mg per 1/2 cup serving so not a huge source. The fiber from oatmeal can help with regularity which increases potassium removal and helps to keep your digestive and cardiovascular systems healthy.

    16. Dr. Barnali Sen

      I am dr. barnali, 37 yrs old, my creatinine is 1.5 mg/dl, potassium is very low (2.57), high triglyceride, weight 50 kg. how can i improve my physical condition & maintain my food chart?
      Thanks.

    17. I’m on dialysis and was wondering is the brand so delicious okay for dialysis patients? I’ve heard silk is okay so just wondering thanks…

    18. Hi Jessi, that’s a great question! It really depends on each individual product because some products from So Delicious contain Phosphorus additives while others don’t. This is true of the Silk brand as well, so checking the ingredients list on all of your labels for any additives is the best way to avoid them.

    19. Hi Diane,
      You are correct, arsenic has been found in rice products including rice milk. Although the type of rice and where it is grown affects the arsenic level. You don’t need to completely exclude rice from your diet, but it is a good idea to be mindful of how often you are consuming rice products and try not to overdo it to limit exposure.
      If you are consuming more than one serving of rice products, you might consider alternating rice milk with other types of plant milk.

    20. Pingback: The BEST golden milk recipe: A must-try hot drink for kidney health! - Kidney RD

    21. Pingback: Plant Milks Ranked From Best to Worst: See How Your Favorite Fared - CONNECT HERE

    22. Pingback: Plant Milks Ranked From Finest To Worst: See How Your Favourite Fared -

    23. Pingback: Plant Milks Ranked From Best to Worst: See How Your Favorite Fared - CNET - NewsReap

    24. Pingback: Plant Milks Ranked From Greatest to Worst: See How Your Favourite Fared – My blog

    Comments are closed.

    Nutrition Guide Kidney Function

    Grab our Mini Nutrition Guide

    Our Mini Nutrition Guide to Preserve Kidney Function shows you the top 8 opportunities to start improving and preserving your kidneys today!

    Join the KNI Care newsletter to get this free resource!

    Scroll to Top