How to Reduce Sodium in an IgA Nephropathy (IgAN) Diet

If you are living with the kidney disease IgA nephropathy (IgAN), you may be more sensitive to sodium, the mineral in salt. It can cause your blood pressure to rise more quickly, says Lakshmi Kannan, MD, a board-certified nephrologist based in Charlottesville, Virginia, which can put extra stress on already inflamed kidneys.

You also may experience proteinuria (extra protein leaking into the urine), medication issues, and other kidney problems if you have too much sodium.

There are ways, however, to cut or limit sodium from your IgAN diet and still maximize flavor in your meals.

1. Cut Back on Salt Gradually

The adjustment to a low-sodium diet can feel more difficult than it needs to be if you cut out salt “cold turkey.” Instead, try to scale back slowly to retrain your taste buds, says Jen Hernandez, RDN, a board-certified renal dietitian based in Florida, as our taste preferences naturally adapt over time.

Here are a few ways to cut back on salt gradually.

Avoid adding salt at the table, Dr. Kannan says. Keep the salt shaker in the cupboard instead of on the table to remove the temptation to add salt to your plate out of habit.
Reduce the amount of salt you add during cooking little by little, rather than cutting it out all at once.
When following a recipe, use half the salt it calls for and adjust from there.

“Once you’re adjusted to a low-sodium diet, you’ll be much more satisfied with little to no salt and can tell quickly if a food has a lot of sodium in it,” Hernandez says.

2. Swap Salt for Herbs, Spices, and Citrus

When you’re used to cooking with salt, food can taste a bit flat or dull without it. But herbs, spices, and acidic ingredients can add flavor without raising the amount of salt in your meal, and these ingredients add depth and brightness to food, Hernandez says. As your palate adjusts, you may prefer these flavors to salt.

Experiment with different combinations to see what you enjoy most and can tolerate. Try keeping these swaps on hand:

Fresh or dried herbs, such as basil, thyme, rosemary, cilantro, or parsley
Pure pantry spices, such as garlic powder, onion powder, smoked paprika, cumin, or black pepper
A splash of acid, such as lemon or lime juice, balsamic vinegar, or apple cider vinegar

“Add a lemon wedge to your plate when serving and squeeze over your food to brighten the flavor,” Hernandez says.

3. Cook More Meals at Home to Control Sodium

“Cooking at home gives you more control over salt and helps reduce reliance on convenience foods,” Hernandez says.

Whether it’s fast food or fine dining, eating out often means filling your plate with more sodium than you’d use at home. Restaurant meals, takeout, and packaged or prepared foods account for about 70 percent of the sodium in a typical diet, Kannan says.

One fast-food hamburger with condiments, for example, contains around 640 milligrams (mg) of sodium.

If you have IgAN, nephrologists often recommend a sodium intake of about 1,500 to 2,000 mg per day, depending on your blood pressure, kidney function, or medications, Kannan says.

That means a hamburger alone can account for about one-third of your daily sodium goal.

A little planning can make home-cooking feel more manageable. Hernandez suggests spending 20 to 30 minutes once a week taking stock of what’s already in your kitchen and jotting down a grocery list.

If you’re short on ideas, meal-planning apps and AI-based resources can help you organize your week and streamline shopping, Hernandez says. And if you find yourself missing your favorite takeout, try re-creating it at home using herbs, spices, and citrus for flavor while cutting back on salt.

4. Dine Out With a Plan

You might feel like you have to avoid restaurant meals altogether. But giving up eating out is neither realistic for most people nor necessary, Hernandez says. Find a middle ground by limiting dining out to once or twice a week, she says.

A good strategy is to review restaurant menus ahead of time and to choose items labeled “heart-healthy” or lower-sodium options when available. The U.S. Food and Drug Administration (FDA) requires chain restaurants with more than 20 locations, for instance, to provide this nutritional information upon request.

When you order, ask for sauces or dressings on the side so you can control how much you use, Hernandez says.

5. Choose Wisely at the Grocery Store

Whenever you shop for food, Kannan recommends choosing fresh vegetables and meats instead of packaged or processed options.

If you buy canned goods, look for labels that say “no salt added” or “low sodium.” If those options aren’t available, rinsing canned beans or vegetables under cold water can remove extra sodium content, Kannan says.

Be mindful of the American Heart Association’s “salty six,” a list of common foods that tend to be high in sodium, Hernandez says. These include:

Breads and rolls
Pizza
Sandwiches
Cold cuts and cured meats
Soup
Burritos and tacos

The changes can be somewhat simple. Swapping a standard slice of bread, which can contain about 350 mg of sodium, for a lower-sodium version with around 80 mg can save you roughly 500 mg of sodium on a sandwich, Hernandez says.

6. Get in the Habit of Reading Nutrition Labels

Nutrition labels are one of the most useful tools you have when following an IgAN diet. Hernandez says to look for foods where the milligrams of sodium are lower than the number of calories per serving.

Kannan recommends aiming for 140 mg of sodium or less per serving, which the FDA considers “low sodium.”

Anything at 460 mg of sodium or more per serving is considered “high sodium,” the FDA says. Watch out for foods marked “instant,” “ready-to-eat,” or “seasoned,” as these are often red flags for extra sodium content.

And sodium isn’t always labeled simply as “sodium” on food packages. Hernandez and Kannan say that the following terms also indicate the presence of sodium:

Sodium chloride
Sodium bicarbonate (baking soda)
Sodium phosphate or disodium phosphate
Monosodium glutamate (MSG)
Brine or curing salts
Baking powder
Soy sauce
Vague terms such as “flavoring” or “seasoning blends”

7. Be Careful With Salt Substitutes

You may encounter salt substitutes, which are not always a safe choice for people with IgAN.

Most salt substitutes replace sodium with potassium chloride, which can raise potassium levels in the blood, Hernandez says.

When your kidneys aren’t working properly, they may not get rid of excess potassium effectively, which can cause serious heart rhythm problems, she says.

Kannan recommends avoiding salt substitutes if:

Before adding any salt substitute to your diet, talk to your nephrologist or a dietitian to create a safe eating plan. Whether it’s appropriate depends on your kidney function, the medications you’re taking, and if your potassium levels are monitored regularly, Hernandez says.

The Takeaway

Reducing sodium is an important part of managing IgAN because too much salt can raise blood pressure, increase proteinuria risk, and put extra stress on the kidneys.

Gradually cutting back on salt, using herbs and spices for flavor, and cooking more meals at home can make it easier to lower sodium without feeling like you’re giving up foods you enjoy.

Pay attention to nutrition labels, common high-sodium foods, and hidden sources of sodium to help you stay within daily sodium-intake goals. Be cautious with salt substitutes, as they can be risky for people with reduced kidney function.

Work closely with your nephrologist or a dietitian to create a safe, realistic, and manageable kidney-friendly eating plan.