What Can Diabetics With Kidney Disease Drink?: Safe Hydration Guide

November 14, 2025 •

4 min read

Did you know that diabetes is the most common cause of kidney failure in the United States? For individuals managing both conditions, choosing the right beverages is crucial for health, and this guide provides clarity on what can diabetics with kidney disease drink safely.

Quick Summary

This article outlines the best and worst beverage choices for individuals with both diabetes and kidney disease, focusing on low-sugar and low-potassium options to protect kidney function and manage blood sugar levels effectively.

Key Points

Prioritize Water: Plain water is the best and safest choice for hydration, with no added sugars or minerals.
Choose Low-Mineral Alternatives: Unsweetened herbal teas, low-potassium juices like apple or grape, and plant-based milks (almond, coconut) are good options in moderation.
Avoid Sugary and Dark-Colored Drinks: Regular sodas, energy drinks, and dark-colored colas are high in sugar, phosphorus, and other additives harmful to kidneys.
Limit High-Potassium Beverages: Avoid juices and drinks high in potassium, such as orange juice and coconut water, as they can be dangerous for those with compromised kidney function.
Manage Fluid Intake Carefully: Fluid limits may be necessary for advanced kidney disease or dialysis patients, so always consult a healthcare provider for personalized advice.
Read Labels Carefully: Always check nutrition labels for hidden sugars, sodium, potassium, and phosphorus in packaged beverages.

The Importance of Proper Hydration for Diabetics with Kidney Disease

Maintaining proper hydration is a delicate balancing act for people with diabetes and kidney disease. For those in the early stages, drinking enough fluid, primarily water, is essential for helping the kidneys filter waste products like sodium and urea from the blood. Staying hydrated helps prevent dehydration, which can put additional stress on the kidneys. However, for individuals in the later stages of chronic kidney disease (CKD) or those on dialysis, fluid intake often needs to be carefully monitored and restricted. A doctor or renal dietitian can provide a personalized fluid plan based on kidney function and urine output.

Kidney-Friendly and Diabetes-Safe Beverages

When selecting a drink, the best options are typically those with no added sugar and low levels of potassium and phosphorus, which can accumulate in the blood as kidney function declines.

Best Choices

Water: Plain water is the best drink for everyone, especially for those with diabetes and kidney disease. It has no calories, sugar, or additives and helps flush toxins from the body.
Infused Water: For added flavor, infuse plain water with low-potassium fruits like berries, apples, or cucumbers, and herbs like mint or basil. Avoid high-potassium citrus like oranges.
Herbal Teas: Unsweetened herbal teas like chamomile, ginger, peppermint, and hibiscus are excellent, caffeine-free choices. Ensure they are free from added sugar and high-potassium or phosphorus additives.
Unsweetened Green or Black Tea: Unsweetened, moderated amounts of green or black tea are generally safe. Some studies suggest green tea may offer kidney-protective benefits due to its antioxidant properties. Drink it plain or with a small amount of unsweetened almond milk, but be mindful of the caffeine and potassium content.
Clear Diet Sodas: Clear, diet carbonated beverages that are free of phosphoric acid (a phosphorus additive common in dark colas) can be consumed in moderation as a refreshing, sugar-free alternative.
Vegetable Juice (Homemade): Homemade vegetable juices from low-potassium vegetables like celery or cucumber can be a nutritious option. Making them yourself ensures no added sodium or sugar. Store-bought vegetable juices can be high in sodium.
Low-fat Dairy and Alternatives: Unsweetened almond, coconut, or unenriched rice milk alternatives are often lower in phosphorus and potassium than cow's milk. Low-fat cow's milk can also be an option in moderation, but the carbohydrate and mineral content must be accounted for.

Comparison of Kidney-Friendly Drinks


Beverage	Key Benefits	Important Considerations
Plain Water	Zero calories, sugar, potassium, and phosphorus. Essential for hydration and filtering waste.	None, unless on fluid restriction.
Herbal Tea	Sugar-free, caffeine-free, and full of antioxidants. Adds variety without stress on kidneys.	Avoid varieties with high-potassium or phosphorus additives.
Unsweetened Apple Juice	Low in potassium compared to orange juice. Can be used for low blood sugar episodes.	Must be 100% juice, unsweetened, and used in limited portions.
Unsweetened Almond Milk	Typically lower in phosphorus and potassium than dairy milk.	Check labels for added sugars and fortified minerals.
Sparkling Water	A fizzy, sugar-free alternative to soda.	Choose brands with no added sodium or other additives.

Drinks to Avoid or Limit

Several common drinks are harmful for individuals with diabetes and kidney disease and should be avoided or significantly limited.

Dark-Colored Sodas and Colas: These beverages contain high levels of phosphoric acid, an additive form of phosphorus that is easily absorbed and can weaken bones over time, contributing to bone disease.
Sugary Drinks: Regular sodas, sweetened fruit juices, sports drinks, and energy drinks are loaded with sugar, causing blood sugar spikes and putting added stress on the kidneys.
High-Potassium Juices: Fruit juices like orange juice, prune juice, and some tropical fruit juices are high in potassium and should be avoided, especially in later stages of CKD.
Alcoholic Beverages: Excessive alcohol consumption can raise blood pressure and dehydrate the body, straining the kidneys. Alcohol can also interact with diabetes medications and impact blood sugar levels.
Sweet Tea and Lemonade: These drinks are high in added sugar, posing risks for blood sugar control and kidney health.
Coconut Water: While often promoted as healthy, coconut water is very high in potassium and is not suitable for a renal diet.

How to Manage Fluid Intake

For those in the early stages of kidney disease, drinking plenty of water is usually recommended. However, as kidney function declines, your doctor or renal dietitian may recommend limiting fluid intake to prevent fluid overload, which can lead to complications like swelling and high blood pressure.

Tips for managing fluid intake:

Measure fluids: Keep track of all fluids consumed, including drinks, soups, and foods with high water content.
Control thirst: Limit high-sodium foods, which increase thirst. Chewing ice or frozen low-potassium fruits can help manage thirst within fluid restrictions.
Listen to your body: Pay attention to swelling, sudden weight gain, or shortness of breath, which can indicate fluid retention.

Conclusion

Navigating beverage choices with both diabetes and kidney disease requires careful consideration of sugar, potassium, and phosphorus content. Prioritizing plain water and unsweetened, low-mineral teas and infused waters is the safest and most effective strategy for hydration. Always discuss your fluid intake and beverage choices with your healthcare team to ensure they align with your specific health needs and stage of kidney disease. For more information on managing chronic kidney disease, you can visit the National Kidney Foundation website.

Frequently Asked Questions

Clear diet sodas, free of phosphoric acid, may be an option in moderation. However, dark-colored sodas, even diet ones, often contain phosphorus additives that can be harmful to kidneys. Many diet sodas also contain artificial sweeteners that can impact metabolic health over time.

Orange juice is not recommended for individuals with diabetic kidney disease due to its high potassium content. Lower-potassium alternatives include apple, grape, or cranberry juice, consumed in very small, controlled portions.

Coffee is generally safe in moderation, but should be consumed black and unsweetened. Excessive caffeine can increase blood pressure, which is a risk factor for kidney disease. Limit intake to a few cups and consider decaf to manage caffeine levels.

Excessive alcohol should be avoided as it can raise blood pressure, dehydrate the body, and interact with medications. Some individuals may be able to have very light, occasional drinks, but only with a doctor's approval.

For a flavor boost without the sugar and potassium of fruit juice, try infusing plain water with low-potassium fruits like berries or cucumbers. Unsweetened herbal teas are another excellent alternative.

To manage thirst, limit your sodium intake, chew ice chips, or eat frozen low-potassium fruit pieces. Avoid salty foods, which increase thirst.

No, coconut water is very high in potassium and is not a safe beverage for individuals managing kidney disease, especially if advised to limit potassium intake.