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If you or someone you care about is living with IgA nephropathy (IgAN), you may be wondering how much your daily habits, like salt intake, can affect your kidney health. Sodium doesn’t cause IgA nephropathy, but eating too much salt can put extra strain on the kidneys and worsen related symptoms, like high blood pressure and swelling.
Keeping track of and managing your sodium intake is a strategy that can help your condition and possibly prevent it from getting worse. We’ll discuss practical ways you can limit your sodium intake while still enjoying the meals you love. Since sodium needs vary based on your current kidney function, medications, and overall health, it’s important to work closely with your nephrologist and a registered dietitian to determine the right approach for you.
IgA nephropathy is a form of kidney disease, also called renal disease, in which antibodies build up and cause inflammation in the kidneys. This harms the glomeruli, or tiny clusters of blood vessels that filter waste and extra fluid from your blood through urine. When the glomeruli are damaged, they can begin to leak blood and protein into the urine, leading to signs such as blood in the urine and higher-than-normal protein levels, called proteinuria.
Treatment for IgA nephropathy is personalized. The goals are to lower protein in the urine and protect kidney function. Most people start with blood pressure control using ACE inhibitors or angiotensin-receptor blockers and a low-sodium eating plan. Many adults with protein in the urine also benefit from sodium-glucose cotransporter-2 (SGLT2) inhibitors (a type of diabetes/heart-kidney medicine) even if they don’t have diabetes. If your risk is higher, your doctor may add a special steroid capsule made for IgA nephropathy called budesonide (Tarpeyo). They may also prescribe a newer kidney-protecting medicine called sparsentan (Filspari) that lowers urine protein — not just a standard blood pressure pill. Your kidney team will help decide what fits your labs, symptoms, and stage of disease.
Sodium is a mineral we need to get from food or drinks on a daily basis. It has many functions, including maintaining fluid balance in our bodies, supporting blood pressure, and assisting nerves and muscles in working well. We get most of our sodium from salt, which can come from table salt or many foods that we eat.
Getting more sodium than your body needs can be harmful, especially if you have a medical condition like IgA nephropathy. That’s because too much can lead to raised blood pressure and increased swelling. It can also lead to heart disease and stroke in some people.
On average, Americans have about 3,300 milligrams per day. This is way above the general recommendation of less than 2,300 milligrams per day. For some people, such as those with IgA nephropathy or those who are salt sensitive, their goal may be closer to 1,500 to 2,300 milligrams per day.
The health of your kidneys, sodium levels, and hydration are all connected. When you have IgAN or other medical conditions that impact your kidneys, these organs can’t function as well. As a result, they may not be able to filter out extra sodium. This can lead to higher blood pressure, hypertension, and swelling.
High blood pressure increases the risk of health problems such as stroke, heart attack, vision damage, and kidney failure. This creates a harmful cycle because kidney disease can contribute to high blood pressure, and elevated blood pressure places extra strain on the kidneys. Over time, this can also damage the blood vessels throughout the body, increasing the risk of kidney failure and kidney damage. The good news is that you can reduce your risk of hypertension by decreasing your sodium intake.
If you’re a salt fan, don’t worry. You can be healthy while not giving up salt completely. It’s about making small changes to reduce your total intake. Your body still needs some sodium, so the goal is to just be mindful of and moderate how much you have on a daily basis. Here are some tips to help:
Highly processed foods such as deli meats, packaged snacks, breads, soups, and wraps are common sources of excess salt. Limiting them or avoiding them is an easy way to reduce your total sodium intake. Keeping low-sodium snacks, like fresh fruit or unsalted nuts, on hand can prevent the temptation of grabbing the highly processed ones.
Checking the food label can guide you toward lower-sodium options. First off, it’s important to note how many servings are in a package. For example, if a bag has four servings, that means the sodium total per bag should be multiplied by four. When reading the label, salt- or sodium-free means less than 5 milligrams per serving, very low sodium is less than 35 milligrams per serving, and low sodium is 140 milligrams or less per serving. No added salt is also a great option because it simply means salt wasn’t added to the food.
Going out to eat at a restaurant or for fast food makes it challenging to limit sodium because a lot is often added to enhance the flavor or extend the shelf life. When you cook at home, you can control how much salt goes in by swapping some herbs or spices. It can also help when you plan ahead or do meal prep because you’ll be less likely to go for the convenient and high-sodium grab-and-go options.
In addition to limiting your sodium intake for IgA nephropathy, there are other lifestyle changes and nutrition plans that can help support the condition. Focusing on nourishing foods in the right portions, consulting your dietitian on what nutrients to consume, and maintaining a healthy weight can protect the kidneys.
Following a plant-based diet rich in minimally processed foods, like whole grains, beans, fruits, and vegetables, is often recommended for overall health and a strong immune system. Some examples of good kidney diet plans include the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. A diet low in saturated fat, which is found in fatty cuts of meat or full-fat dairy, is a good idea at certain stages of kidney disease.
One note: Many fruits, vegetables, and salt substitutes are high in potassium. Some people with kidney disease need to limit potassium, especially if blood tests run high or certain medicines raise it. Ask your kidney team for your personal potassium target and which foods to choose more often or limit.
When it comes to protein recommendations per day, it depends on your condition and age. Your nephrology expert may suggest you increase lean protein like fish, eggs, nuts, and tofu if you’re on dialysis. A lower protein diet may also be recommended for nephrotic IgA, or chronic kidney disease (CKD). Plant-based proteins may cause less strain on the kidneys.
Hydration matters for kidney health, but the right amount is different for everyone with IgA nephropathy. Creatinine is a waste product your kidneys filter; being dehydrated can make creatinine go up, while drinking too much can cause swelling and raise blood pressure. Follow the fluid target your kidney team gives you. If you have not been given a limit, ask for one.
Simple tips: Sip fluids throughout the day, choose water most of the time, and flavor it with fruit slices or mint if you like. Alcohol can dehydrate you, so it’s best to limit or avoid it.
A registered dietitian or kidney nutrition professional can help create an eating plan that fits your kidney health and lifestyle. Your healthcare team can also use your specific medical history and lab results to guide recommendations for salt intake and diet in general. In some cases, like with dialysis, they may suggest supplements or recommend limiting certain nutrients, like phosphorus or potassium. Working with a kidney specialist ensures that changes are safe and tailored to your needs.
On myIgANteam, people share their experiences with IgA nephropathy, get advice, and find support from others who understand.
How do you decrease your daily sodium intake? Let others know in the comments below.
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