Constipation and kidney disease is common for those living with Chronic Kidney Disease (CKD). Studies have shown a higher prevalence of constipation among those with CKD, reported to be present in 29.0% of patients on peritoneal dialysis and 63.0% of patients on hemodialysis.
Common causes of constipation in CKD patients are low dietary fibre intake, water restriction, low physical activity levels, and medication side effects. The severity of constipation may vary depending on the stage of CKD and the individual patient.
Importance of fibre
Poor dietary habits, including inadequate intake of fibre-rich foods, can lead to constipation. Increasing fibre in the diet is important to manage constipation and kidney disease:
- Promote regular bowel movements
- Maintain gastrointestinal health
- Alleviate constipation symptoms
- Support a healthy gut microbiota for better digestive health
- Help maintain intestinal transit time (often increased in advanced kidney failure)
- Contribute to preventing the progression of CKD by improving overall health
How to increase fibre for constipation and kidney disease
Increasing fibre intake gradually through dietary modifications can be a simple and effective strategy to manage constipation and promote gastrointestinal health in CKD patients.
Strategies to increase fibre include to help manage constipation and kidney disease:
- Superfoods: incorporating superfoods such as whole grains, fruits and vegetables into the diet are great sources of fibre and other nutrients.
- Meal Planning: consider planning meals ahead of time to ensure they contain adequate fibre. For example, include fibre-rich snacks like raw vegetables, fruits, and nuts.
- Cooking Methods: use methods of cooking that better retain fibre content, such as steaming or baking compared to boiling, which can result in nutrient loss.
- Variety of Sources: include a diverse range of fibre-rich foods such as fruits, vegetables, whole grains, nuts, and seeds into meals and snacks.
High fibre foods
High fibre foods such as the few listed below, provide not only fibre but also a range of essential nutrients for the body.
These include the following:
| Fruits | Fibre | Protein | Potassium |
| ½ cup raspberries | 4.0 g | 0.75 g | 93 mg |
| ½ cup blackberries | 4.0 g | 1 g | 117 mg |
| 1 pear, raw with skin | 4.0 g | 0.676 g | 198 mg |
| Vegetables | Fibre | Protein | Potassium |
| 1 cup frozen peas, cooked | 4.4 g | 8 g | 350 mg |
| ½ cup broccoli, cooked | 2.6 g | 1.3 g | 144 mg |
| Grains | Fibre | Protein | Potassium |
| ½ cup quinoa | 2.6 g | 4 g | 629 mg |
Remember to read nutrition and ingredient labels and consider what’s essential for managing constipation with CKD. While increasing fibre intake, be mindful of potassium and phosphorus levels in high-fibre foods. Start slowing increasing fibre and add on. Remember to speak with your healthcare team before making any nutrition changes. For additional information, consult with a registered dietitian today!
This article was written by Neha Dewan, Nutrition Student Volunteer.
This article was reviewed by Emily Campbell, RD CDE MScFN.
Great post on constipation and CKD. I appreciate the list of fiber rich fruits, vegetables and grains. I also appreciate the cooking method. I guess the boiling method is a no go.
Boiling is no problem it can just reduce fibre and nutrient amounts compared to others. Glad the post was helpful.
With CKD, Is it okay to add a little ground flaxseed to foods like salads, etc. to help increase fibre content for constipation? I eat prebiotic multigrain bread, pumpernickel bread, whole wheat bread – the breads recommended for CKD in one of the articles and I have at least one salad every day and I still don’t get enough fibre to deal with constipation. However, because I need to lose weight I do not eat more than one to two slices of bread in a day.
Flax seeds can be consumed with CKD. But everyone’s needs are different. Having a dietitian can help you determine how much and how often to have things. I have a blog post on some top fibre sources here: https://kidneynutrition.ca/2022/09/02/top-fibre-sources-for-ckd/