What drinks should you stay away from if you have kidney disease? A Guide to Safe Hydration

October 15, 2025 •

4 min read

According to the National Kidney Foundation, 1 in 3 American adults is at risk for kidney disease. For those with compromised kidney function, proper hydration is crucial, but not all fluids are beneficial. This guide explores the critical question, what drinks should you stay away from if you have kidney disease? to help you make safer choices.

Quick Summary

People with kidney disease must limit or avoid certain beverages to protect their kidneys. This includes dark colas due to phosphoric acid, most fruit juices and smoothies high in potassium and sugar, and energy and sports drinks loaded with caffeine and electrolytes. A strict focus on low-phosphorus, low-potassium, and low-sugar options is essential for health.

Key Points

Avoid Dark Colas: Dark sodas contain phosphoric acid, a form of inorganic phosphorus that can build up to dangerous levels in people with kidney disease, causing bone and heart problems.
Limit High-Potassium Juices: Fruit juices like orange, prune, and tomato are high in potassium, which can lead to irregular heartbeats and muscle weakness when kidneys cannot filter it properly.
Skip Energy and Sports Drinks: These beverages are loaded with caffeine, sugar, and electrolytes like sodium and potassium, all of which put a significant strain on compromised kidneys.
Moderate Alcohol Intake: Excessive alcohol use causes dehydration and raises blood pressure, both of which are detrimental to kidney function and can worsen existing disease.
Monitor Milk Consumption: Dairy milk and some plant-based milks can be high in phosphorus and potassium. Check labels and consult a dietitian to determine appropriate intake.
Prioritize Water and Kidney-Friendly Alternatives: Plain or infused water, unsweetened herbal teas, and certain low-mineral plant-based milks are generally safer choices for hydration.

Understanding the 'Why': How Certain Drinks Harm Kidneys

Your kidneys are vital filters that remove waste and excess fluid from your blood. In kidney disease, this filtering function is compromised, causing waste products and minerals like potassium and phosphorus to build up in the blood. This can lead to serious health issues, including heart and bone problems. For this reason, controlling fluid and mineral intake is a cornerstone of managing the condition.

What you drink can have a significant impact. Some beverages contain ingredients that force your kidneys to work harder, accelerating damage. These include high levels of added sugar, artificial sweeteners, caffeine, and specific minerals. By understanding which beverages pose a risk, you can make informed decisions that support your health.

The Prime Offenders to Avoid

Many popular drinks are unsuitable for a renal diet due to their high mineral, sugar, and additive content. Knowing which ones to cut out is the first step toward better kidney health.

Dark Colas and Other Sodas

Dark-colored sodas are a significant concern. They are acidified with phosphoric acid to give them a tangy flavor and preserve them. This inorganic phosphorus is easily absorbed by the body, leading to dangerously high blood phosphorus levels (hyperphosphatemia) in people with compromised kidney function. High phosphorus levels can weaken bones and harden blood vessels, contributing to heart disease. Both regular and diet sodas should be avoided due to high sugar or artificial sweetener content, which is also hard on the kidneys.

Fruit Juices and Smoothies

While whole fruits are often encouraged in a healthy diet, their juice can be problematic. Many store-bought fruit juices, especially those from oranges, prunes, and tomatoes, are exceptionally high in potassium. When the kidneys can't remove excess potassium, it can cause an irregular heartbeat, muscle weakness, or heart attack. Smoothies are often concentrated versions of these high-potassium juices and fruits, making them equally risky. For kidney-friendly hydration, choosing low-potassium fruits like apples, berries, and grapes is safer, but whole fruit is generally better than juice.

Energy and Sports Drinks

These drinks promise performance but can be a nightmare for sensitive kidneys. Energy drinks are packed with high amounts of caffeine, sugar, and various additives that overstimulate the system and place a heavy burden on the kidneys. The high caffeine content can also cause dehydration, further straining kidney function. Sports drinks, while designed to replenish electrolytes after intense exercise, contain high levels of sodium and potassium that can be dangerous for someone with kidney disease. Their composition is typically unsuitable for those who aren't engaging in high-intensity, prolonged workouts.

Alcohol

Excessive alcohol consumption is harmful to everyone, but it poses particular risks for those with kidney disease. Alcohol dehydrates the body, forcing the kidneys to work harder. Chronic heavy drinking can increase blood pressure, a leading cause of kidney failure, and contribute to liver disease, which adds further stress to kidney performance. Some alcoholic beverages like beer, wine, and cider can also be high in potassium and other additives, which is another concern.

Dairy and High-Potassium Plant-Based Milks

Dairy milk can be high in both phosphorus and potassium, requiring moderation for many people with kidney disease. Whole, 2%, and skim milk all contain significant amounts of both minerals. Many fortified plant-based milks, such as certain oat and rice milks, can also have added phosphorus, so careful label reading is essential. Similarly, some plant-based options like coconut water are naturally very high in potassium and should be avoided.

Making Smarter Drink Choices

Navigating the world of beverages with kidney disease requires a proactive approach. Water is always the best option, but there are other flavorful and safer choices available to prevent boredom and support a healthy diet.

Infused Water: Add slices of lemon, cucumber, mint, or berries to plain water for a refreshing and kidney-friendly twist.
Herbal Teas: Many caffeine-free herbal teas, such as chamomile and ginger, are safe options. Always check with your doctor, as some herbal teas and supplements contain high potassium.
Low-Potassium Juices: If you must have juice, stick to small amounts of low-potassium options like apple or cranberry juice, and ensure they have no added sugar.
Kidney-Friendly Milks: Unsweetened almond milk is typically lower in phosphorus and potassium than dairy milk, but check the label for added phosphate.
Fluid Management on Dialysis: If you are on dialysis, a strict fluid restriction is often necessary. Your healthcare team will provide a specific daily allowance, which can be managed by tracking your intake and controlling thirst with things like hard candy or frozen grapes.

Comparison of Beverage Choices


Drink Category	Potassium	Phosphorus	Sugar/Additives	Verdict for Kidney Disease
Water	Minimal	Minimal	None	Excellent Choice
Dark Cola	Low	High (additive)	High/Artificial Sweeteners	Avoid Completely
Orange Juice	High	Low	Moderate	Avoid or Limit Strictly
Energy Drinks	High	High (additives)	Very High	Avoid Completely
Sports Drinks	High	Varies	High	Avoid for Most
Herbal Tea	Low	Low	None	Generally Safe (Check Ingredients)
Dairy Milk	Moderate	High	Moderate	Limit/Monitor Intake
Unsweetened Almond Milk	Low	Low (if no additives)	Low	Generally Safe

Conclusion: Your Beverage Blueprint for Kidney Health

Managing kidney disease is a lifelong commitment that requires careful attention to every aspect of your diet, especially your fluid intake. While water remains the gold standard for hydration, a clear understanding of the beverages to avoid is just as important. By steering clear of drinks high in potassium, phosphorus additives, and excessive sugar, you can significantly reduce the burden on your kidneys and help prevent further complications. Always consult with your doctor or a renal dietitian to create a personalized nutrition plan that is safe and effective for your specific condition.

For more detailed guidance on kidney-friendly diets, visit the National Kidney Foundation website for educational resources.

Frequently Asked Questions

Dark colas contain phosphoric acid as an additive, which the body absorbs very easily. This can lead to a rapid increase in blood phosphorus levels, which can be dangerous for individuals with impaired kidney function and contribute to heart and bone issues.

You should limit or avoid most fruit juices, especially high-potassium ones like orange, tomato, and prune juice. If you choose to have juice, opt for low-potassium, unsweetened versions like apple or cranberry juice, and only in small, controlled portions.

Yes, both energy and sports drinks should be avoided. They are typically high in caffeine, sugar, sodium, and potassium, placing a heavy burden on your kidneys and potentially causing dangerous electrolyte imbalances.

Excessive alcohol consumption can lead to dehydration and high blood pressure, both of which are harmful to the kidneys. It is best to avoid or strictly limit alcohol, and always consult your healthcare provider.

The safety of coffee depends on your potassium levels. If you need to follow a low-potassium diet, you may need to limit coffee. Unsweetened, caffeine-free herbal teas are often a better choice.

Fluid restrictions are common for people with more advanced kidney disease or those on dialysis. Your doctor or renal dietitian will determine the appropriate fluid allowance for your specific condition. It is important to adhere to this limit to prevent fluid overload.

Water is the best option. Other good choices include unsweetened, infused water with low-potassium fruits like lemon or cucumber, certain herbal teas, and unsweetened plant-based milks like almond milk (checking for added phosphorus).