Choose a meal from the sea—fish provides high quality protein, a nutrient encouraged in limited amounts in a pre-dialysis diet and increased in a dialysis diet.
Fresh fish is naturally low in sodium, fat and cholesterol—even the fatty fish are low fat compared to many red meat cuts. Potassium and phosphorus content varies with the fish variety–catfish, cod, sea bass and sole are among the lowest. Salmon contains higher amounts of potassium and phosphorus but can still be worked into a kidney diet by combining it with lower potassium sides and adjusting phosphorus binders if needed. It’s best to avoid fish canned with bones—some salmon, sardines—because phosphorus is very high. Tuna fish is probably the most popular canned fish. Choose the low sodium canned or rinse in water for at 3 minutes to reduce sodium by almost 80%.1
Omega-3
Salmon and other fatty fish like mackerel (avoid king mackerel) are high in omega-3 fatty acids, may protect against heart disease, stroke and possibly help decrease chronic inflammation when eaten at lease 2 times per week.2
Considerations
Mercury is a concern in some fish. The recommendation is to avoid king mackerel, orange roughy, shark, swordfish, marlin.3 Tilapia gets a bad reputation for hygiene reasons in farming, so avoid fish imported form China. The Monterey Bay Aquarium Seafood Watch has great information on seafood.
Recipes
Fish can be easy to prepare—try it grilled, baked, microwaved, fried or poached.
Some popular fish recipes on DaVita.com include:
- Cilantro-Lime Cod
- Crunchy Oven-Fried Catfish
- Honey Spice Rubbed Salmon
- Korean-style Fried Whitefish
- Mahi Fish on the Green
- Tuna Veggie Salad
References:
- https://chickenofthesea.com/blog/low-sodium-tuna/. Accessed July 9, 2026.
2. https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/omega-3/art-20045614. Accessed July 9, 2026.
3. https://www.fda.gov/food/consumers/advice-about-eating-fish. Accessed July 9, 2026.
