Kidney Nutrition Before Dialysis
A chronic kidney disease diagnosis usually comes with a long list of foods to avoid and very little help figuring out what to actually eat. Trusted Living Nutrition works with people in stages 1 through 5 who are not on dialysis, building an eating pattern around your own labs and your nephrologist's plan. All visits are telehealth, anywhere in California.
Who this is for
- Newly diagnosed. Your eGFR came back low and nobody has explained what it means for your meals.
- Stage 3 or 4. You want to slow progression and protect the function you still have.
- Managing CKD alongside diabetes or high blood pressure. The diets can seem to contradict each other, and you need one plan instead of three.
- Preparing for transplant. Weight, blood sugar and nutrition status affect candidacy.
- Told to avoid everything. You've cut out so much that eating has become stressful and your diet is narrower than it needs to be.
What working together looks like
Initial consultation (60 minutes). We go through your recent labs, your medications, your usual meals, and what your nephrologist has told you. You leave knowing which numbers actually matter for you and what to change first.
Follow-ups. We adjust as your labs move, since kidney nutrition is not one fixed diet. What's right at stage 3 with normal potassium is different from stage 4 with rising phosphorus.
Common topics we work on:
- How much protein is right for you, which depends on your stage, your other conditions and your nephrologist's target
- Potassium, adjusted to your actual lab values rather than a blanket avoid-list
- Phosphorus, with attention to additives in packaged foods rather than cutting whole foods
- Sodium and blood pressure, including cooking without relying on salt
- Eating for blood sugar and kidney function at the same time
- Building meals around more plant foods and fewer ultra-processed ones, which current guidance supports for kidney health
- Reading labels for hidden phosphate additives
- Supplements and over-the-counter products to be careful with
Why work with us
Maya Mangels, MS, RD. Maya works in a dialysis clinic, managing protein, potassium and phosphorus for patients whose kidney disease has already progressed, coordinating with their nephrologists. That's the perspective she brings to earlier-stage care: what these numbers look like further down the road, and which changes are worth making now.
For nephrologists and referring providers
Referring offices can send patient referrals to Maya@trustedlivingnutrition.com. We work from your treatment plan and lab targets, and send a visit summary back after each appointment.
Pricing
Initial consultation: $185 (60 minutes)
Follow-up sessions: $95
We don't accept insurance, but we provide superbills so you can request out-of-network reimbursement from your plan.
Frequently asked questions
Do I need to follow a renal diet if I'm not on dialysis?
Not the diet most people picture. Pre-dialysis nutrition looks quite different from dialysis nutrition, and many restrictions people expect don't apply until much later, if at all. The plan should follow your labs.
How much protein should I be eating?
There's no single right answer, and the major kidney guidelines currently differ on this. What's appropriate depends on your stage, whether you have diabetes, your body size and whether you're metabolically stable. Too little protein carries its own risks. We work from the target your nephrologist sets and build meals that actually reach it.
Do I have to avoid bananas, tomatoes and potatoes?
Only if your potassium is actually high. Many people with CKD have normal potassium and restrict these foods for years without needing to. We work from your lab values.
Can nutrition slow down kidney disease?
Diet is one of the levers, alongside blood pressure and blood sugar control and your medications. It isn't a cure and it isn't a replacement for nephrology care, but what you eat does affect how the numbers move.
What about fluid? Should I be limiting it?
Fluid limits are usually a dialysis issue, not a pre-dialysis one. Some people do need to watch intake, most don't. Your nephrologist sets this and we build around it.
Do you offer telehealth?
Every visit is telehealth. We see patients anywhere in California by secure video.
Ready to book?
This page is general information, not medical advice. Nutrition care for kidney disease should be coordinated with your nephrology team.