KIDNEY STONE DIET®

with Jill Harris, LPN, CHC

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Goal 3 of 6 · Sodium

How Much Sodium Should You Eat with Kidney Stones?

Jill Harris, LPN, CHC

By
Kidney stone prevention nurse since 1998
Updated

Jill’s answer

1,500 mg

of sodium a day

The Kidney Stone Diet® goal is 1,500 mg of sodium a day, and 1,500 to 2,000 mg is where I want you to be around: low salt doesn’t mean no salt. Skipping the salt shaker isn’t enough, so start by reading the nutrition label on the foods you eat most.

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Why Sodium Matters for Kidney Stones

Too much sodium raises the calcium in your urine and lowers how much urine you make. Both raise your stone risk.

Your kidneys work to get rid of extra sodium, and sodium and calcium are filtered through the same pathways. It’s like both minerals are trying to exit through the same revolving door: if one rushes out, the other follows. So when you eat a lot of salt, calcium that belongs in your bones ends up in your urine. When there’s too much calcium in urine, other minerals like oxalate and phosphate can bind to it and form stones. Over time, this can weaken your bones, too. My mentor Dr. Coe has always said, “Where you see a stone clinic, a bone clinic is close by.”

High sodium also means you make less urine, so the calcium and oxalate in it become more concentrated and stick together more easily. Higher urine calcium raises stone risk even when hydration is good.

This is why so many patients are shocked by their urine results while “eating healthy.”

Jill Harris, LPN, CHC

How Much Sodium Should You Aim For?

Your goal is 1,500 mg of sodium a day, not less. The American Heart Association recommends the same number. Less is not always better, and patients tend to go lower than they need to.

Please check with your doctor before going down to 1,500 mg, since some of you may already have low blood pressure or take medications that make 1,500 mg a day the wrong target.

For perspective

1 teaspoon of salt has 2,300 mg of sodium. Hard to believe, isn’t it?

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Lower It Step by Step

Don’t try to get there overnight. Every day on my calls, people tell me they don’t use much salt, and their urine collection shows they’re eating around 8,000 mg a day. I don’t ask someone eating 8,000 mg to go straight to 1,500. That’s too drastic, and it won’t last. Instead, we set a goal of 5,000 mg a day. When they hit that regularly, we drop a little lower, and keep going until we reach 1,500.

Food will taste bland at first. In my experience, it takes about two weeks of real effort to start noticing how incredibly salty foods are and to enjoy lower-sodium food. Within a short time, most people crave less salt, feel less bloated and pee more (a bonus for stone formers). Even my most salt-addicted patients are happy they changed.

You are not expected to meet your goal every day. We don’t form kidney stones overnight, so one high-salt day isn’t the problem. What we do each day, month over month, year after year, is what matters. When you overdo it, get right back to work.

Where the Salt Is Hiding

“I never use the salt shaker!” is the most common thing I hear. That’s a good start, but salt is added to almost all processed, packaged and canned foods. These are estimates per serving (brands vary, so read your labels):

Estimated sodium per serving 20 foods
  • Pickles (1 medium): 800 to 1,200 mg
  • Soy sauce (1 tablespoon): 900 to 1,000 mg (reduced sodium: 500 to 600 mg)
  • Miso paste (1 tablespoon): 600 to 900 mg
  • Bone broth (1 cup): 600 to 900 mg
  • Teriyaki sauce (2 tablespoons): 600 to 800 mg
  • Canned soup (1 cup): 700 to 1,000+ mg
  • Deli turkey or chicken (2 ounces): 500 to 700 mg
  • Rotisserie chicken (3 ounces): 400 to 600 mg
  • Canned beans, not rinsed (½ cup): 400 to 500 mg
  • Veggie burgers (1 patty): 400 to 600 mg
  • “Healthy” frozen dinners (1 entrée): 400 to 800 mg
  • Cottage cheese (½ cup): 350 to 450 mg
  • Seasoning blends (1 teaspoon): 300 to 500 mg
  • Restaurant rice (1 cup): 300 to 600 mg
  • Olives (5 large): 250 to 450 mg
  • Bottled salad dressing (2 tablespoons): 250 to 400 mg
  • Protein bars (1 bar): 200 to 400 mg
  • Cheese, sliced or shredded (1 ounce): 150 to 250 mg
  • Crackers (5 to 8): 150 to 300 mg
  • Bread and wraps (1 slice or wrap): 150 to 300 mg
Other foods that fool almost everyone

Bagels, breakfast cereal, BBQ and other bottled sauces, condiments, bacon, hot dogs, marinated meats, canned vegetables, instant oatmeal packets, flavored rice or pasta mixes, baking mixes, pizza, burritos and tacos (Chipotle is so high in sodium), canned tuna or salmon (unless labeled “no salt added”), sardines, plant-based meats, protein powders, vegetable and tomato juice, soda, club soda and mineral water with added sodium, and restaurant and fast food meals.

How to Read a Sodium Label

“Turn it around, Buster Brown,” and read the nutrition label on everything. If a food has a label, read it. If it doesn’t, assume it’s higher than you think.

The label gives sodium per serving, so respect serving sizes. If chips have 390 mg per serving and the bag holds 2 servings, eating the whole bag is 780 mg, half your day. A tablespoon of ketchup adds 154 mg to your already salty cheeseburger.

Know what the front of the package means:

  • Low sodium140 mg or less per serving.
  • Very low sodium35 mg or less per serving.
  • Sodium-freeLess than 5 mg per serving.
  • Reduced (or less) sodiumAt least 25 percent less than the usual version.
  • Light in sodiumReduced by at least 50 percent.

Compare brands, too

When I buy canned beans, I look for a lower-sodium can next to the regular one, and if my usual brand doesn’t have one, I choose a brand that does. One “low sodium” label doesn’t mean the next can with the same claim is as low.

Do You Have to Count the Sodium in Fruits, Vegetables and Milk?

Not if it stresses you out. Fruits and veggies grow in soil that contains sodium, so they have a bit. If you’re happy counting it, keep going. If it’s overwhelming, don’t. Why give up over the tiny bit of sodium in a plum? The same goes for dairy milk: focus on getting your calcium rather than worrying about that small amount of salt.

What about cheese?

This only applies to fresh produce and regular dairy milk, and to under 200 mg of naturally occurring sodium in a product. It does NOT apply to cheese, which is too high for tiny portions and easy to overeat.

Everyday Ways to Eat Less Sodium

In your kitchen 5 tips
  • Use salt where it matters most to you. I use just a “bip” of sea salt on eggs and avocados, and since I follow a low-sodium diet, a bip does me just fine.
  • Buy fresh. Non-processed meats, fruits and veggies are typically lower in sodium than anything in a package, jar or can.
  • Treat condiments as food. They’re not free. Squirt less ketchup and add a slice of tomato.
  • Cook with herbs, spices and citrus. My kitchen always has fresh herbs, and lemon and lime are in many of my meals.
  • Cook simple meals. Fast, easy meals you enjoy. I don’t have hours to spend in the kitchen either.
Cheese, eating out and portions 3 tips
  • Watch the cheese. Patients often tell me, “I eat plenty of cheese, so I’m good” on calcium. Then I must break their heart: cheese is very salty and could be the reason for their high urine sodium. Choose lower-sodium cheeses like ricotta and Swiss. You can still have cheddar sometimes. In an omelet, I use Swiss for most of the cheese and sprinkle a little cheddar on top so I see some orange!
  • Eat out less. Restaurant meals are a quick way to blow your sodium. Can you go from eating out four times a week to twice?
  • Portion, not perfection. Have three slices of pizza instead of four, or a smaller portion of a salty snack. If you can’t control the portion, keep it out of the house. I can’t have Cheez-Its in mine.

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What’s included

  • A new meal plan every week $24/mo value
  • My 8-part video prevention course $249 value
  • Group coaching with me $24/mo value
  • 20% off private consults Member discount
  • Four cookbooks $116 value

Sodium in All Access: the weekly meal plans make your days simpler to plan, my video course walks you through the sodium goal step by step, and on the group calls you can bring me your sodium questions and work on your goal with people doing the same.

The Kidney Stone Diet is far more than just a diet; this plan is life-altering! … The group calls are such support; this is more like family than a zoom meeting to stay accountable. Jill is far more than a nurse; she is a life coach.

Kim J. | Kidney Stone Prevention Course

Podcast Episodes on Sodium

13 episodes of the Kidney Stone Diet Podcast, each with a full transcript. Pick the question closest to yours.

Newest

Is bread safe to eat with kidney stones?

Listen or read
Why sodium matters, and how much 5 episodes
Packaged food, bread, soup and dressings 5 episodes
Salt types, electrolytes and salt caves 3 episodes
All podcast episodes

Go Deeper

Frequently Asked Questions

How much sodium should I eat a day with kidney stones?

The Kidney Stone Diet® goal is 1,500 mg a day, and not lower. Check with your doctor first if you have low blood pressure or take medications that affect it.

I don’t use a salt shaker. Am I fine?

Probably not. Salt is added to almost all processed, packaged, canned and restaurant food, so read the nutrition labels on the foods you eat most.

What foods are hidden sources of sodium?

Salt is added to almost all processed, packaged and canned foods. Brands vary, so read your labels. See where the salt is hiding.

What does “low sodium” mean on a label?

140 mg of sodium or less per serving. Check the serving size, and compare brands, because two cans with the same claim can be quite different.

Do I need to count the sodium in fruits and vegetables?

Only if it doesn’t stress you out. Naturally occurring sodium in fresh produce and regular dairy milk is small, but that doesn’t apply to cheese.

Can I still eat cheese?

Yes, in smaller portions. Choose lower-sodium cheeses like ricotta and Swiss, and treat cheddar as a sprinkle.

How long before low-sodium food tastes normal?

About two weeks of real effort. After that, most people start noticing how salty foods are and enjoy lower-sodium food.

Is Himalayan or Celtic sea salt better for kidney stones?

Although health gurus will tell you otherwise, salt is salt, no matter what the type!

Does softened water add sodium?

If your softened water contains unusually high sodium, it might make a difference. Check with the company you get it from.

What if my blood sodium gets too low?

Talk to your doctor, as it could be many things. Did you lower your sodium too much? Are you peeing more than 4 liters a day?

Want to know what to eat every week? All Access is a new Kidney Stone Diet® meal plan every week, my video course (a $249 value) and group calls with me, all for $48/mo, or try a week for $24. Cancel anytime.

Join All Access →
$48/mo, cancel anytime

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On this page

  1. Why sodium matters
  2. How much to aim for
  3. Lower it step by step
  4. Where salt hides
  5. Reading the label
  6. Fruits, veggies and milk
  7. Everyday ways to eat less
  8. All Access with Jill
  9. Podcast episodes
  10. Questions
  11. Free weekly email

Six evidence-based goals

Kidney Stone Diet Goals

Too much sodium raises the calcium in your urine and lowers how much urine you make, so this goal helps the others. Here are all six, and the test that shows which ones matter most for you.

Goal 1

Increase Fluids

Goal 2

Reduce Sugar

You are here

Goal 3

Reduce Sodium

Goal 4

Increase Dietary Calcium

Goal 5

Eat Moderate Protein

Goal 6

Lower High-Oxalate Foods

Know your numbers

The 24-Hour Urine Test

Want help with all six? In All Access, a new meal plan every week puts the goals on your plate, and my video course teaches each one step by step.

Jill Harris

About Jill Harris, LPN, CHC

Jill Harris is a Licensed Practical Nurse (LPN) who specializes in kidney stone prevention, with more than 26 years of experience and years of work with University of Chicago nephrologist Dr. Fred Coe. Her goal is to teach you what you need to know and, more importantly, how to put that knowledge to work so you can stop forming stones. More about Jill