Kidney patients - everyday eating recipe book

Everyday EatingTasty recipes and helpful hints for kidney patients by kidney patients

The following renal dietitians contributed

to producing this book:

Rachel Wolfenden BSc, PGDip, RD

Veronica Heard BSc, PGDip, MSc, RD

Elizabeth Jeffreys BSc, RD

Linda Tarm BSc, PGDip, RD

Nicole Ward BSc, RD

Angela Doherty BSc, PGDip, MSc, RD

“Most of all I attribute my relative good healthand fitness to eating well (despite the limitations)and never missing meals. It just makes dialysisharder if you are empty inside.”

New Cross Dialysis patient

“Your body gets used to the diet and I’m muchbetter for it.”

Forest Hill Dialysis patient

“I try to vary my diet with meat, fish andvegetables.”

Peritoneal Dialysis patient

IntroductionPeople who have kidney disease usually need to followa restricted diet to help control their blood chemicaland fluid levels. This can make it feel difficult to find tastyeveryday meals and recipes for you and your family. Thisbook helps to get the balance right between enjoying yourfood and making the necessary changes to your diet.

This user-friendly recipe book was written followingrequests from our kidney patients for more practical advice(including easy recipes and meal ideas) about the food theycould eat. A competition was held asking patients to sendin their own favourite recipes, meal ideas and tips for fluidcontrol. Where necessary the recipes were adapted byrenal (kidney) dietitians, to ensure they are suitable in termsof salt, potassium, phosphate and fluid content.

The book contains recipes to suit African, Caribbean andAsian tastes as well as some British favourites. The widerange of recipes gives you the opportunity to try a familiardish and perhaps something new.

Most of the recipes are quick and easy to prepare withingredients that are readily available and not too expensive.Suitable serving suggestions are given for most of therecipes. There is a practical information section whichincludes snack and meal ideas, hints and tips for eating outand ideas on how to create tasty dishes without salt.

Patients tell us that the hardest part of their renal dietis the limited amount of fluid they can have each day.We have included a section of patients’ own practical hintsand tips on how they manage their fluid intake. Some oftheir tips may work for you!

We hope you find this book, which has been written ‘forpatients by patients’, a useful guide and that you enjoy bothcreating and eating these tasty dishes.

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AcknowledgementsWe would like to thank Guy’s and St Thomas’ Charity andthe Kidney Disease Modernisation Initiative which enabledthe production of this recipe book.

We are grateful to all of the patients and staff who havecontributed to this book. Where their permission wasgiven, patients have been acknowledged individually for therecipes and practical information they provided.

We would also like to thank Guy’s Kidney PatientsAssociation for helping to fund and distribute this book.

Finally, thank you to Elliot Franks for the photography.

Note for using this bookAll of the recipes in this book, cooked using the statedquantities of ingredients, cooking methods and serving sizesare suitable for low salt, phosphate and potassium diets.

However, everyone’s diet is individual and you will haveyour own specific dietary requirements. If you have anyqueries, please ask your dietitian.

Photographs are for illustrative purposes and should not beused as portion size guides.

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ContentsRecipesLight bites and salads Page

Tuna Mayonnaise Pasta Salad 6

Salmon Salad 7

Jamaican Beef Patties 8

Meat Pasties 9

Salad a la McQueen 10

Chicken Tikka 11

Chicken dishes

Chicken and Pesto Pasta 12

Chicken with Orange and Ginger 13

Jamaican Chicken Soup 14

Chicken and Groundnut Stew 15

Meat dishes

Mince with Basil 16

Steak with Peppercorn Sauce 17

Chilli Con Carne 18

Jamaican Curried Goat 19

Pork Chops with Herb Crust 20

Easy Beef Burgers 21

Fish dishes

Coconut Fish Dream 22

Ivory Coast Fish Soup 23

Lemon Baked Fish 24

Vegetarian dishes

Quick Chickpea Curry 25

Vegetarian Shepherd’s Pie 26

Cheese and Onion Flan 27

Tofu Stir-fry with Sesame Noodles 28

Side dishes Page

Jollof Rice 29

Couscous 30

Potato Wedges 31

Champ – Irish Potato Side Dish 32

Desserts and puddings

Lemon Drizzle Cake 33

Spiced Baked Apple 34

Fruit Flan 35

Easy Trifle 36

Ginger and Pineapple Meringues 37

Practical informationLight meal ideas 38

Snacks and biscuits 39

Cakes and desserts 40

Eating less salt 41

What type of drinks can I include? 42

Managing on a limited fluid intake 43

Helpful hints when eating outor ordering in 44

Further information 45

05

06 Light bites and salads

This is a great quick colourful recipe thatcan easily be halved for a snack meal.

Serves 1 as a main meal

Ingredients90g/3oz pasta shells1 x 200g/8oz can of tuna in spring-water2 spring onions, chopped2 tablespoons reduced fatmayonnaise2 tablespoons canned sweetcornin water1 medium tomato, dicedHandful parsley or coriander,choppedBlack or white pepper

MethodCook the pasta following the instructions onthe packet. Drain and put into a large bowl.

Drain the tuna and add to the pastatogether with the spring onions, parsleyand sweetcorn.

Add the mayonnaise and stir untileverything is coated.

Season with pepper.

Garnish with the tomato and some extraparsley and serve.

Tuna Mayonnaise Pasta SaladRoy Anderson

Light bites and salads 07

This is a tasty salad dish that can easily bedoubled for more people. The salmoncould be swapped for tuna in spring waterif you prefer.

Serves 1, but easily doubled

IngredientsSmall tin of salmon, bones removed4 lettuce leaves e.g. little gem orround lettuce1 spring onion1/4 bag /1 handful of watercress2 slices of beetroot3 rings of red pepper3 new potatoes1 small or 3 cherry tomatoes1 tablespoon of coleslaw

MethodHalve the potatoes and boil in plenty ofwater until soft. Drain.

Cut the salad ingredients into small piecesand toss together.

Arrange the salad and potatoes on a plate.

Place the coleslaw and salmon in themiddle of the plate and serve.

Salmon SaladPembury Dialysis Unit patient


Serves 6Suitable for freezing

Ingredients200g/8oz lean minced beef1 small onion, finely chopped1 clove garlic, crushed1/2 teaspoon dried thyme1 fresh chilli,minced or 1 teaspoonchilli powder1 tablespoon curry powderBreadcrumbs made from 2 slices ofbread or 4 tablespoons of boughtbreadcrumbs1 packet (500g/1lb) short crust pastry

MethodPreheat the oven to 200°C /400°F/Gas Mark 6.

Fry the mince, garlic and onion in a non-stick frying pan, over a gentle heat, untilthe meat is brown throughout. Add thebreadcrumbs and seasoning and cookcovered, over a low heat for 15 minutes.Drain through a colander or sieve toremove any excess liquid.

Roll out the pastry and using a saucercut 6 circles.

Divide the meat between the circles ofpastry. Dampen the edges of the pastry,fold in half and press the edges togetherto seal. Place on a baking tray and brushwith milk.

Bake for 25-30 minutes in the centre ofoven, or until golden brown.

Jamaican Beef Patties

Patties and PastiesThese can be frozen and reheated to make a quick snack. Pastry is high in fatso keep this recipe for an occasional treat if you are watching your weight.



Ingredients1 packet (500g/1lb) short crust pastry200g/8oz minced beef (low fat ifpossible)1 medium or 2 small (100g) potatoes1 medium carrot1 small onionWhite or black pepperDried herbs (optional)

MethodPreheat the oven to 200°C /400°F/Gas Mark 6.

Brown the meat in a non-stick saucepan.Add water to half cover the meat andsimmer for 15 minutes. Drain the meatto remove excess liquid.

Boil the potato, carrot and onion for 10minutes, drain well and cut into small pieces.Stir into the mince.Taste the meat andseason as required with pepper and herbs.

Roll out the pastry and using a saucer cut6 circles.

Divide the meat between the rounds ofpastry. Dampen the edges of the pastry, foldin half and press the edges together to seal.Place on a baking tray and brush with milk.

Bake for 25-30 minutes in the centre of oven.

Meat PastiesHome Haemodialysis patient


This is a quick and easy recipe by Cyrilla,a renal patient.The garlic, onion andlemon juice provide plenty of flavourwithout the need for salt.

Serves 2, but is easily doubled

Ingredients4 skinless chicken thighs2 handfuls of bean sprouts1 medium carrot1 clove garlic, crushed1/2 small onion1 tablespoon olive oil1 teaspoon lemon or lime juice200g tin black eyed beans in water,rinsed and drainedWhite or black pepper

MethodPut the chicken thighs in a small pan andcover with water. Bring to the boil andsimmer for 10-15 minutes. Drain andwhen cool, remove the meat from thebones and cut into small pieces.

Peel the carrot and cut into matchsticksize strips. Finely slice the onion.

In a large bowl, mix together the beansprouts, carrot, onion, garlic and beans.Add the lemon juice and olive oil andmix to coat the vegetables.

Add the chicken and mix again.

Season with black pepper.

Serve with toasted pitta bread.

Salad a la McQueenCyrilla McQueen


This is a quick, fragrant recipe and anyleftovers make a great sandwich filling.Using only a small amount of yoghurtmeans this recipe is ideal for a renal diet.

Serves 2 as a main meal or 4 as asnack meal

Ingredients3 tablespoons of low fat naturalyoghurt1 tablespoon curry paste1 teaspoon lemon juice2 small boneless chicken breasts,skin removed

MethodStir the curry paste into the yoghurt.Place the chicken in a shallow dish and addthe lemon juice and curried yoghurt.

Leave for 1 hour, or overnight in the fridgeif you have time, to allow the flavours toinfuse.

Cook the coated chicken under a preheatedgrill for about 20 minutes or until the juicesrun clear when pierced with a knife.

Serve in a tortilla wrap with some shreddedlettuce for a snack meal or serve withboiled rice and side salad for a main meal.

Chicken Tikka

12 Chicken dishes

This is a quick and easy pasta recipe thatcan be enjoyed hot as a main meal or coldas a snack.

Serves 2

Ingredients2 small skinless chicken breasts or200g/8oz strips of chicken breast4 tablespoons low fat crème fraicheor low fat cream1/2 small head of broccoli, cut intosmall florets2 tablespoons green pesto150g/6oz dried pasta twirls

MethodCut the chicken into 1 cm thick strips. Stir-fryin a non-stick pan for 2-3 minutes until thechicken begins to brown. Add the pesto andcrème fraiche and cover. Cook on a lowheat for 5-10 minutes more until the chickenis cooked through.

Meanwhile, cook the pasta according to thedirections on the packet, adding the broccolifor the last 5 minutes of cooking.

Drain the pasta and broccoli well and mixwith the cooked chicken and pesto. Serve.

Chicken and Pesto Pasta

Chicken dishes 13

This is a quick and easy dinner dish, whichcan be prepared in advance and refrigerateduntil you are ready to cook.

Serves 4

Ingredients4 skinless chicken breasts or legs1 tablespoon mustard1 tablespoon honey3 tablespoons orange juiceGrated rind of 1 orange2 teaspoons ground ginger powder

MethodPreheat oven to 190°C/375°F/Gas Mark 5.

Make 3 cuts /scores across each chickenpiece and place in a roasting tin orcasserole dish.

Mix the mustard, honey, orange juice,orange zest and ground ginger togetherand spoon over the chicken.

Cook in the pre-heated oven for 25-30minutes, or until thoroughly cooked.

Serve with boiled new potatoes, rice orcrusty bread and a boiled vegetable ofyour choice.

Chicken withOrange and Ginger

14 Chicken dishes

Jamaican Chicken SoupThis is a nutritious traditional one-pot Caribbeandish with great flavours.The amounts of some ofthe ingredients and the method have been adaptedfrom the traditional recipe to make it suitablefor a renal diet.


Ingredients900g/2lb of skinless chicken piecese.g. thighs, drumsticks200g/8oz piece of pumpkin, skin andseeds removed, cut into chunks1 clove garlic (optional)250g of taro/dasheen or potato,peeled and cut into chunks2 medium carrots, peeled and sliced300g /10oz piece yellow yam, peeled andcut into chunks6 spring onions, peeled and sliced1 sprig of fresh thyme1 whole scotch bonnet chilli pepper or1 tsp chilli powder1 reduced-salt chicken stock cube

For the dumplings200g/8oz plain flour1/2 cup cold water

MethodFirst make the dumplings. Place the flour into alarge mixing bowl and add the water 3 teaspoonsat a time. Add just enough water to bring thedough together with a firm consistency. Tear off‘golf-ball-size’ pieces, roll them in the palm of yourhand until smooth and then flatten to discs.

To make the soup, wash the chicken pieces andplace in a large cooking pot.

Chop the pumpkin, crush the garlic, if using, andadd to the pot.

Cover with water and bring to the boil.

Cover, reduce the heat and cook for 20-30minutes, until the pumpkin is soft.

Meanwhile, place the taro/dasheen/potato, carrotsand yam into a large pan of cold water. Bring tothe boil and cook for 15 minutes. Drain anddiscard the water.

Add the cooked vegetables, spring onions, thyme,chilli pepper, stock cube and the dumplings to thechicken and cook for a further 30 minutes.

Remove the scotch bonnet pepper and discardbefore serving.

Chicken dishes 15

This is a traditional West African dish withgreat flavours.The amounts of some of theingredients and the cooking method havebeen adapted from the traditional recipe tomake it suitable for a renal diet.

Serves 4

Ingredients2 cups (about 20 pods or 200g/8oz)fresh okra, sliced1 whole chicken, cut into piecesand skinned1 inch (3cm) piece of ginger, peeled1/2 onion1 tablespoon vegetable oil1 medium onion finely chopped2 medium tomatoes, chopped (160g)2 tablespoons peanut butter2 hot chillies, finely chopped,or 1 teaspoon cayenne pepper1 medium size eggplant (aubergine),peeled and cubed

MethodSoak the okra and eggplant for 1-2 hoursin a large bowl of water. Drain.

Boil the chicken pieces with ginger and theonion half, in 2 cups of water.

In a separate large pot, heat the oil over alow heat and fry the chopped onion untilsoft. Add the tomatoes.

Remove the partially-cooked chickenpieces and add, together with about half ofthe broth, into the large pot.

Add the peanut butter, salt, chillies andcayenne pepper. Cook for 5 minutes beforestirring in the drained eggplant and okra.

Continue cooking until the chicken andvegetables are tender.

Add more broth as needed to maintain athick, stew consistency.

Serve with rice bread, or dumplings madefrom wheat or corn flour.

Chicken and Groundnut Stew

16 Meat dishes

This is a quick and easy mince recipe whichrelies on garlic and herbs for flavour.This isa good recipe for making extra portions andfreezing for a later date. For variety, try turkey,pork or soya mince in place of the beef.


Ingredients500g/1lb minced beef (low fat ifpossible)1 clove garlic clove, crushedI chilli, finely chopped (optional)1 medium onion, chopped10g/1/2oz (1 handful) fresh basil,chopped1 tablespoon reduced-salt soy sauce1 tablespoon vegetable oil

MethodHeat the oil gently and fry the garlicand chilli.Add the mince and stir fry on a high heat.Add the rest of ingredients, cover and cookgently for 15-20 minutes or until the minceis browned through.Serve with rice or pasta and salad or aboiled vegetable of your choice.

Mince with BasilCyrilla McQueen

Meat dishes 17

This classic combination of flavours makes anexcellent dinner dish that is quick to prepare.

Serves 2

Ingredients2 x 125g/4oz beef steaks100g/4oz half fat crème fraiche ordouble cream2 teaspoons vegetable oilFreshly ground black pepper2 teaspoons peppercorns, crushed

MethodHeat the vegetable oil in a large non-stickfrying pan.

Lightly season the steaks with freshly groundblack pepper and cook over a medium-highheat for 2-5 minutes on each side, dependingon how well done you like them.

Remove the steaks from the pan, and leaveto rest on warmed plates.

Add the peppercorns to the frying panwith the crème fraîche or double creamand stir in any meat juices that havecollected in the pan.

Cook gently for 2 minutes until the saucethickens and reduces slightly.

Spoon 1-2 tablespoons of sauce over eachthe steak.

Serve immediately with boiled potatoes anda salad or boiled vegetables of your choice.

Steak with Peppercorn Sauce

18 Meat dishes

This recipe is an old favourite.The amountsof some of the ingredients in this recipehave been adapted from the traditionalrecipe to make it suitable for a renal diet.This is a good recipe for making extraportions to freeze for a later date.


Ingredients200g/8oz canned red kidney beans inwater, rinsed and drained1 medium onion chopped1 clove garlic, crushed1 tablespoon vegetable oil500g/1lb minced beef, low fat if possible1/2 teaspoon chilli powder, or more totaste200g/8oz tinned tomatoes1/2 teaspoon paprika1/2 tablespoon vinegar1/2 tablespoon sugar (optional)

MethodHeat the oil over a low heat and fry onionand garlic for about 5 minutes.

Add the minced beef and fry until lightlybrowned.

Add all of the other ingredients, except thekidney beans and mix together. Simmer gentlyon the hob for about 30 minutes adding alittle extra water if necessary to stop it sticking.

Add kidney beans and cook for a further10 minutes.

Serve, using a slotted spoon, with rice orcrusty bread.

Chilli Con CarneSheila Finigan

“If you can batch cook and freezeportions that cuts down on the labourif you find cooking a chore.”

Home dialysis patient

Meat dishes 19

This traditional Jamaican dish, suggested bya member of the kidney team at Guy’s, is fullof flavour and ideal for a cold winter’s day.


Ingredients600g/1lb boneless goat,mutton or lamb2 tablespoons vegetable oil

Marinade1 small Scotch Bonnet/Chilli Pepper,seeds removed but left whole6 spring onions, chopped2 cloves garlic, crushed1 teaspoon All Spice (JamaicanPimiento)1 reduced salt stock cube, crumbled1 thumb-sized piece fresh ginger,gratedor 1 teaspoon ground ginger powder1-2 sprigs fresh thymeFreshly ground black pepper1 tablespoon vegetable oil

MethodWash the meat, remove the fat and cutinto 3cm (1inch) cubes. Put into a largeplastic or glass bowl.

Add all of the marinade ingredients to themeat and mix gently to coat the meat.Cover and leave overnight in the fridge tomarinate.

Heat the remaining oil in a large, heavy potand add the marinated meat. Reduce theheat to low and cook covered for 2-3 hoursuntil the meat is tender, adding a littleboiling water, if required, to stop it sticking.

Serve, using a slotted spoon, with plain rice.

Jamaican Curried Goat

20 Meat dishes

Baking is a healthy way of cooking as itdoes not use extra fat.The chops can beprepared in advance and kept in therefrigerator until you are ready to cook.

Serves 2

Ingredients2 x pork chops (fat trimmed off)1 teaspoon mustard2 teaspoon oil2 spring onions or 1 shallot, finelychopped1 clove garlic, crushed2 tablespoons of fresh or boughtbreadcrumbs1 pinch mixed dried herbs or ahandful of fresh herbs (e.g. parsley)chopped

MethodPreheat the oven to 200°C/400°F/Gas Mark 6.

Spread the mustard over one side of eachpork chop and place in a shallow bakingdish or roasting tin.

To make the herb crust, mix together theoil, onions, garlic, dried herbs andbreadcrumbs.

Press the herb crust mixture on to the topof each pork chop/loin and cover the dishwith tin foil.

Bake for 25 minutes, removing the foil forthe last 5 minutes.

Serve with boiled potatoes or rice, and aboiled vegetable of your choice.

Pork Chopswith Herb Crust

Meat dishes 21

Making your own burgers is cheap andeasy. It also means that you can keep thesalt and fat content to a minimum.Theycan be grilled or barbecued and are easyto make in advance.


Ingredients500g/1 lb minced beef or pork (lowfat if possible)1 medium onion, grated or finelychoppedA pinch of dried mixed herbsBlack pepper to season

MethodPreheat the barbecue or grill to hot.

Place all the ingredients in a large bowl andmix together with a fork.

With clean wet hands, divide the mixtureinto 8 small or 4 large portions. Shape themeat into flattish rounds of an equal depthto ensure even and thorough cooking.

Grill or cook on the barbecue for 5 -10minutes on each side – the burgers shouldbe brown in the middle as well as on theoutside.

Serve in a burger bun or pitta bread with ateaspoon of tomato sauce, mustard ormayonnaise and shredded lettuce.

Easy Beef Burgers

22 Fish dishes

This is a wonderfully fragrant dish but quitehigh in fat so keep it for an occasional treatrather than a regular dish.The quantity ofcoconut in this recipe has been adaptedfrom the traditional recipe to make itsuitable for a renal diet.

Serves 4

Ingredients450g/1lb skinless cod fillet cut intolarge chunks1 tablespoon vegetable oil3 teaspoons low salt margarine or butter1 teaspoon cumin seeds1 medium onion, grated or finely chopped2 small fresh tomatoes (100g/2oz), diced2-3 fresh green chillies (to taste), chopped1/2 teaspoon ground turmeric1/2 teaspoon red chilli powder1/4 teaspoon garam masala300ml/1/2 pint reduced fat coconut milkHandful fresh coriander,chopped (optional)

MethodHeat the oil and margarine/butter over alow heat in a large saucepan. Add thecumin seeds and onion and fry gentlyuntil softened.

Add the tomatoes, green chillies, groundtumeric and chilli powder. Stir well.

When the sauce is shiny, and the oil hasseparated, add a sprinkle of garam masalaand stir in the coconut milk.

Add the cod, cover and cook for 12-15minutes.

Sprinkle with a handful of coriander togarnish.

Serve using a slotted spoon, with rice anda green salad.

Coconut Fish DreamSusana Costeira

Fish dishes 23

This tasty traditional Ivory Coast recipe hasbeen modified slightly to ensure it issuitable for a renal diet.

Serves 4

Ingredients2 medium fresh white fish fillets e.g.halibut, tilapia, snapper, cod2 small-medium aubergines, diced1 small onion, finely chopped5 cloves garlic, crushed1 tablespoon tomato puree1 hot chilli pepper1 reduced salt stock cube

MethodPlace the aubergine into a large pan ofcold water. Bring to the boil and cook for10 minutes. Drain and discard the water.

Put all the ingredients except for the stockcube in a large pot. Cover with water andsimmer for 45 minutes.

Add the stock cube and continue tosimmer, uncovered, until the soup hasreduced and is thick.

Serve, using a slotted spoon, with plainboiled rice.

Ivory Coast Fish SoupMr Martin Dagrou Gbolou

24 Fish dishes

Baking is a healthy way to cook fish, as ituses only a small amount of fat.You willfind the lemon and herbs go well with thefish without the need for salt.

Serves 4

Ingredients4 x 100g/4oz portions white,boneless fish fillets e.g. cod, haddock,snapper, coleyJuice of one lemon/ 2 tablespoons oflemon juiceGrated rind of one lemon (optional)1 tablespoon reduced salt butter ormargarine1 pinch dried rosemary or dillBlack pepper

MethodPreheat the oven to 180°C/350°F/Gas Mark 4.

Place the fish in a single layer in a shallowbaking dish.

Mix together the butter or margarine,lemon juice, grated lemon rind, rosemary,and pepper and dot over fish fillets.

Cover with foil and bake for 25 minutes oruntil fish flakes easily when tested with a fork.

Serve with boiled or mashed potatoes orrice and a boiled vegetable of your choice.

Lemon Baked Fish

Vegetarian 25

Using tinned chickpeas means this dish isquick and easy to prepare. You can vary theamount of curry powder to suit your taste.


Ingredients2 teaspoons oil2 cloves garlic, crushed3cm/1 inch piece of fresh ginger,peeled and finely chopped or 1teaspoon of ground ginger powder1 tablespoon curry paste1 small (200g/8oz) tin choppedtomatoes, juice drained and discarded100 ml (about 6 tablespoons) water1 onion, peeled and chopped1 x 400g/15oz tin chickpeas in water,drainedHandful of fresh coriander leaves,chopped (optional)

MethodGently fry the garlic, ginger, onion andcurry paste in the oil for 2-3 minutes.

Add the tomatoes and water and cook fora further minute.

Add the chickpeas and most of thecoriander, if using.

Cook gently for 10 minutes until reduced.

Sprinkle with the remaining coriander.

Serve, using a slotted spoon, with chapatti,rice, cous cous or naan bread and a garnishof sliced cucumber sticks and spring onion.

Quick Chickpea Curry

26 Vegetarian

This is a quick and easy dish. Christine’s tipof swapping a mashed potato topping forcouscous not only saves time but makes thistomato-based dish suitable for a renal diet.


Ingredients400g/16oz can of chickpeas in water,rinsed and drained2 tea-cups of mixed frozen vegetables,boiled in water300g/12oz tin lentils in water, rinsedand drained400g/16oz canned chopped tomatoes,juice drained and discardedA pinch of dried mixed herbs1 teaspoon paprika250g/12oz couscous60g/2oz hard cheese, gratedFreshly ground black pepper

MethodPlace the mixed frozen vegetables in alarge pan of cold water and bring to theboil. Cook for 5 minutes, drain and discardthe water.

Meanwhile, place all of the otheringredients, except the couscous andcheese, into a pan and heat through. Addthe cooked vegetables.

Place into an ovenproof dish.

Cook the couscous following theinstructions on the packet and sprinkleover the dish.

Sprinkle the cheese over the couscous andgrill until golden brown.

Serve with crusty bread.

Vegetarian Shepherd’s PieChristine Allen

Vegetarian 27

You can save time when making this classicdish by using ready made pastry althoughthis increases the salt and fat content. Theflan can be frozen in individual slices for aquick meal at a later date.


Ingredients75g/3oz wholemeal flour25g/1oz low fat spreadPinch salt15g/1/2oz white vegetable fat3 tablespoons cold water1 medium onion, thinly sliced75g/3oz reduced fat cheddar cheese,grated1 egg150ml/1/4 pint skimmed milkPinch dried mixed herbsBlack pepper

You will also need a 18cm/7” flan tin.

MethodPreheat the oven to 180ºC/350ºF/Gas Mark 4.

Rub the low fat spread and whitevegetable fat into the flour to form finebreadcrumbs.

Add enough cold water to form a firm dough.Roll out thinly and place in the flan tin.

Prick the base and arrange the onion onthe base of the flan case.

Beat together egg, milk, cheese and herbsand season with black pepper. Pour overthe onion.

Bake for 45 minutes.

Serve hot or cold with a side salad andboiled potatoes or crusty bread.

Cheese and Onion Flan

28 Vegetarian

This tasty recipe is a good mix of tofu,vegetables and noodles and is easy to make. Fora non-vegetarian meal, replace the tofu with 1large skinless chicken breast, cut into thin strips.

Serves 2

Ingredients

250g/8oz plain tofu (drained)

1 tablespoon olive oil

1 clove garlic, crushed

3cm fresh root ginger, peeled and finelychopped1/2 small head broccoli, cut into smallflorets

1 carrot, cut into thin matchstick strips

3 spring onions, trimmed and cut intostrips

125g/4oz medium egg noodles

1 tablespoon reduced salt soy sauce

1 tablespoon honey

1 teaspoon sesame oil

Freshly ground black pepper

MethodCut the tofu into 2cm cubes and place in a bowlwith the olive oil, ginger and garlic.Toss to mixand set to one side.

Cook the noodles as per instructions on thepack and drain.

Rinse the noodles in cold water, drain and tossin sesame oil to keep the noodles separated.

Boil the broccoli and carrots in plenty ofunsalted water for 5 minutes, drain and rinsewith cold water.

Heat a large non-stick wok or frying pan, addthe marinated tofu and stir-fry for 2-3 minutes.

Add the carrots, broccoli and 1 tablespoon ofwater. Cover with a lid and steam-fry for 4-5minutes until the tofu is cooked, adding thespring onions for the last minute.

In a bowl, mix together the soy sauce and honey.

Add the noodles to the pan with the soymixture.Toss well until everything is piping hot.

Season with black pepper.

Serve immediately.

Tofu Stir-fry with Sesame Noodles

Side dishes 29

This is a basic version of the traditionalrice dish cooked in many West Africancountries and makes an excellent side dishto meat or fish.

Serves 2

Ingredients100g/4oz long grain rice, white orbrown1 medium tomato, peeled andchopped1 chilli pepper,minced2 teaspoons of vegetable oil1/2 reduced salt stock cube1 clove garlic minced (optional)1 medium onion chopped (optional)

MethodBring the rice to the boil for 5 minutes.Drain and rinse with cold water to removethe excess starch.

Bring the rice to boil again in 200ml/1/3 pintof cold water with the stock cube. Add thetomato, hot chilli (garlic and onion, if using)and the vegetable oil.

Cook for 30-40 minutes or until the wateris absorbed.

Serve with grilled, white fish and a mixedside salad.

Jollof RiceElizabeth Adeolokun

30 Side dishes

Couscous is quick and easy to prepare and can be flavoured with herbs and spices in place of salt.Serve with meat, fish or chicken in place of potatoes, pasta or rice. Here are two ideas to try.

Mint CouscousServes 4

Ingredients225g/8oz couscous600ml/1 pint water3 tablespoons of fresh mint chopped2 teaspoons of olive oil

MethodBring the water to the boil in a sauce pan.

Remove the pan from the heat and add thecouscous. Stir briefly and cover with the pan lid.

Leave to stand for 5 minutes then fluff up witha fork.

Drizzle with the oil and add the finely choppedmint.

Season with black pepper as required.

Serve with grilled meat or fish.

Lemon andCoriander CouscousServes 4

Ingredients250g/8oz couscous600ml/1 pint water3 tablespoons of fresh coriander,choppedGrated rind and juice of 1 lemon2 teaspoons of olive oil

MethodBring the water to the boil in a sauce pan.

Remove the pan from the heat and add thecouscous. Stir briefly and cover with the pan lid.

Leave to stand for 5 minutes then fluff up witha fork.

Drizzle with the oil and add the finely choppedcoriander, lemon rind and juice. Season withblack pepper.

Couscous

Side dishes 31

These tasty homemade wedges are lowerin potassium and fat than ready-made orbought chips.

Serves 4

Ingredients4 medium sized potatoes (total 800g)1/2 teaspoon chilli powder (optional)1 teaspoon dried oregano2 teaspoons paprika1 tablespoon vegetable oilBlack pepper

MethodPreheat the oven to 220ºC/425ºF/Gas mark 7.

Peel the potatoes and cut into thin wedges.Place them in a large pan of cold waterand bring to the boil.

Boil for 15 minutes and drain.

Brush the oil over a baking sheet.In a large bowl mix the oregano, paprikaand chilli powder (if using) together. Addthe potatoes and toss to coat.

Spread the wedges in a single layer ontothe baking tray.

Cook for 20-30 minutes or until browned.

Potato Wedges

32 Side dishes

This traditional Irish version of mashedpotato relies on onion for flavour in placeof salt. You could also try adding a handfulof chopped fresh parsley or chives, insteadof the spring onions.

Serves 4

Ingredients600g/1lb 4oz potatoes, peeled andcut into small piecesFreshly ground black pepper1-2 tablespoons milk2 finely chopped spring onions

MethodBoil the potatoes in a large pan of wateruntil soft.

Drain the potatoes and mash with the milk,black pepper and spring onions.

Champ –Irish Potato Side Dish

Desserts and puddings 33

A slice of this can be enjoyed as a snack orteatime treat. Individual slices can be frozento enjoy at a later date.

Serves 8-10Suitable for freezing

Ingredients225g/8oz self raising flour, sieved225g/8oz low salt butter/margarine225g/8oz caster sugar4 medium eggsJuice and rind of 1/2 lemon

For the icing110g/4oz icing sugarJuice and rind of 1 lemon

You will also need a deep 18cm /7”round cake tin, lined with non-stickpaper

MethodPreheat the oven to 180ºC/350ºF/Gas Mark 4.

Cream the butter and sugar until lightand fluffy.

Add eggs one at a time, beating well inbetween.

Add flour and stir in gently.

Add lemon rind and juice.

Pour the mixture into the cake tin.

Bake for approximately 70 minutes untilgolden and the cake springs back whentouched.

Remove from the tin, peel off the paperand leave to cool.

Mix the icing sugar with lemon juice andpour icing over the cake allowing it to rundown the sides. Sprinkle with lemon zest.

Lemon Drizzle CakePeritoneal Dialysis patient

34 Desserts and puddings

This recipe makes a quick healthy dessertand is a good way of using up old apples.

Serves 1

Ingredients1 apple, preferably Bramley1 teaspoon sugar or sweetener1/2 teaspoon of cinnamon and/or afew cloves

MethodCore the centre of the apple and put on amicrowavable plate.

Mix the sugar with the cinnamon and/orcloves and spoon into the centre of theapple.

Cook in the microwave on half power for2-3 minutes or until soft.

Serve with a spoonful of low fat cream.

Spiced Baked ApplePaulette Woods


This quick and easy dessert can easily bevaried by using tinned peaches ormandarins (as used in the photo above) inplace of the fruit cocktail.

Serves 4

Ingredients1 small sponge flan case400g/16oz tin of fruit cocktail1 packet of red quick jel

MethodDrain the juice from the can of fruit anddiscard.

Place flan case on a flat plate and arrangethe fruit in it.

Make up the quick jel following theinstructions on the packet.

Allow to cool for a few minutes and pourover the fruit.

Leave to set.

Serve with a spoonful or two of cream.

Fruit FlanHome Haemodialysis patient

36 Desserts and puddings

Easy TrifleA quick version of a classic dish.Try swapping themandarins for canned raspberries for a moreluxurious dessert.

Serves 4

Ingredients1 small plain sponge swiss roll1 x 75g/3oz sachet custard powder1 x 400g/16oz canned mandarins segments injuice, drained2-3 tablespoons of sherry (optional)150ml/1/4 pint double cream4 squares of chocolate, grated

MethodTo make the custard, empty thesachet into a measuring jug andpour on boiling water up to the300ml / 1/4 pint mark.

Whisk briefly with a fork untilsmooth and creamy and leave tostand while you prepare the restof the trifle.

Cut the swiss roll into slices anduse to cover the base of 1 largeor 4 individual serving dishes.

Sprinkle the sherry, if using, overthe swiss roll.

Spread all but 6 of themandarin segments evenly overthe swiss roll.

Pour or spoon the custard overthe fruit.

Whip the double cream andspread over the custard.

Decorate with a little gratedchocolate and the reservedmandarins.


The ginger gives a wonderful spicy contrastto the sweet pineapple in this non-cookdessert.

Serves 4

Ingredients4 meringue nests200 ml/8oz half fat crème fraiche orwhipping cream60g/2oz stem ginger in syrup,chopped200g/8oz can pineapple chunks injuice, drained

MethodArrange the meringue nests on individualserving plates or dishes.

Stir the chopped ginger into the crèmefraiche.

Fill the meringue nests with the ginger-crèmefraiche and top with pineapple chunks.

Serve.

Pineapple andGinger Meringues

38

It can be difficult to think of light meal ideas that are suitable for a renal diet.Vary the types of breads,fillings and flavourings given below to make sandwiches more interesting.

Light meal ideas

BreadsSliced bread – fresh or toasted, e.g.– Wholemeal– Granary– White– CrustyPaniniWraps, chapattisBagels, rollsPitta breadCroissantsCream crackers, water biscuitsCrisp breads, rice cakesScotch pancakesCrumpetsEnglish muffins

Toppings for toast etcEggs**SpaghettiHoumousSardines**Cream cheese – plain, garlic, chives, black pepperCottage cheeseTraditional cheese**

Other tasty ideas…Fish fingersFish cakesIndividual pizza or pizza slicePancakesBoiled egg**Tuna pasta saladSalmon or tuna saladCheese & onion flan*Cous cous saladReady bought chicken pieces/legsRice salad containing meat or fishCold meat

Sandwich filling ideasCold meat e.g. chicken, turkey, beef, pork, hamSteakBeef burger*TunaCream cheese* – plain, garlic, chives, black pepperCottage cheese – plain, chives or pineappleSalmon spreadChicken tikkaEgg & cressEgg mayonnaise*HoumousCoronation chicken

FlavouringsTry adding a small amount to give flavour andmoisture to your sandwich.

Stuffing e.g. with chicken or turkeyHorseradish e.g. with beefApple sauce e.g. with porkMustard e.g. with hamPickle e.g. with cold meat

Notes*Choose reduced fat/use sparingly if you are on alow fat diet or are overweight.

** Your dietitian may advise you to limit theamount of these foods you have each week.

Snacks and desserts are not always needed but if your appetite is poor, they improve your dailyfood intake.

If you need to lose weight or keep your weight stable a portion of fresh or tinned fruit makes agood, low fat snack. If necessary, your dietitian will discuss with you about any types of fruit youshould avoid or about how many portions you should have a day.

If you require snacks low in sugar choose the savoury snacks, breads and plain biscuits. If you haveany questions speak to your dietitian.

Snacks and biscuits

“Have light meals in between main meals,

because as the older you get your

appetite is not like it was years ago.”

Forest Hill Dialysis patient

Biscuits

Shortcake

Shortbread

Rich tea

Digestives

Ginger nut

Chocolate chip cookies

Sweetened rice cakes

Viennese whirl

Iced gems

Nice

Malted milk

Savoury snacks

Breadsticks

Low salt crackers

Cream crackers

Water biscuits

Crispbreads

Plain popcorn

Unsalted crisps (small bag)

Low salt rice cakes

Melba toast

Breads

Scotch pancakes

Croissants

Crumpets

Waffles

English muffins

Pitta (mini, white, wholemeal)

Sliced bread/toast

Part baked bread

Ciabatta

Naan

Wraps

Bagels

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Cakes and desserts

40

Cakes

Madeira (plain or cherry)

Angel layer cake

Victoria/jam sponge

French fancies

Fairy cakes

Swiss roll (not chocolate)

Lemon cake

Doughnuts

Iced finger

Flapjack

Plain/cherry scones (homemade if possible)

Sweets

Marshmallows, jellied fruits / jelly babies

Turkish delight, wine gums

Boiled sweets, pastilles

Mints /peppermint creams

Desserts /puddings

Chocolate eclair

Apple turnover or apple strudel

Apple tart / tart tatin

Lemon meringue pie

Brandy snap biscuits / baskets

Apple / pear / berry crumbles

Fresh, stewed or canned fruit

Trifle

Baked apple

Treacle tart

Meringue nest with fruit

Fruit flan

Serve with:

Cream (whipped, single, double), Crème fraiche

or ice cream.

Remember to eat all snacks and desserts

sparingly. Choose reduced fat and sugar

options if you are on a low fat or low sugar

diet or are watching your weight.

Speak to your dietitian if you have any

questions about choosing suitable desserts.

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A low salt diet helps to prevent fluid retentionand control your thirst.

Here are some practical ways of reducing your saltintake and other ideas of ways to flavour your food.

Stock cubes,Maggi cubes,pre-mixed seasoningsStock cubes and pre-mixed seasonings are highin salt.They can be used to add flavour but usehalf the amount stated in recipes and don’t addany other salt.

SaucesTomato ketchup, brown sauce, salad dressingsand soy, fish and Worcester sauces all contain alot of salt. Buy reduced salt varieties and usethem sparingly. Try using half the amount statedin recipes.

Hints for flavouringInstead of salt use herbs and spices to flavouryour food. Fresh or dried herbs can be used.Both are widely available in local shops andsupermarkets. Dried herbs are best added at thestart of cooking and fresh herbs at the end. If youneed to add flavour at the table, try black orwhite pepper, vinegar or lemon juice.

The following table gives some ideas for whichflavourings to use with different foods.

Eating less salt

Food Flavouring

Fish Lemon, lime, parsley, allspice, bay leaf, red cayenne pepper,tartare sauce, dill

Roast meat Pork: cloves, apples, sageLamb: marjoram, rosemary, mintChicken: tarragon, dill, honey, lemonBeef: mustard, horseradish

Grilled Meat Balsamic vinegar, crushed peppercorns

Stews Basil, bay leaf, dill, garlic, bouquet garni, marjoram, oregano,sage, thyme, red cayenne pepper, paprika, ginger

Rice Bay leaf, nutmeg, coriander, cardamom, peppercorns,turmeric

Potatoes Parsley, bay leaf, nutmeg, chives, chopped spring onion, dill,garlic, mint

Eggs Chilli, chives, black pepper, paprika, chervil, tarragon

All dishes Freshly ground black and white pepper

“My use of herbs and spices means younever need salt and I haven’t used itfor many years.”

New Cross dialysis patient

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This table gives a general guide of the types of drinks that you can have. If necessary yourdietitian will modify it to meet your individual needs.

If you are on dialysis you will need to restrict the total amount of fluid you take in each day.Your health care team will help you work out your daily fluid allowance.

*Choose ‘diet’ or ‘no added sugar’ types if you have diabetes or are watching your weight.

What type of drinks can I include?

Drinks Allowed?

TeaIncluding herb and fruit teas Yes

Coffee One small cup per day. Avoid milky coffees

WaterIncluding flavoured and sparkling Yes

Fruit squash* or cordial* Yes

Fizzy drinks* Yese.g. lemonade, orangeade, ginger beer but avoid Cola, Dandelion and Burdock

Milk Limit to 200-300 ml (1/3 to 1/2 pint) per daye.g. in tea, on cereal

Alcohol Choose white wine and spirits more oftenthan beer and lager

Fruit or vegetable juice No

Milky drinkse.g. milk shakes, nourishment,stout punch, hot chocolate, latte No

Malted drinks e.g. Horlicks, Ovaltine No

“I find fluid controlfar more difficultthan diet.”

Haemodialysis patient

43

“The bottom line of my fluidintake is to cut down in saltintake because salt makesyou thirsty every time”

Elizabeth Adeoloken

“Distraction helps sokeeping your mind occupiedis essential”

“Freezing a small amount offruit squash mixed with thewater for ice cubes relievesthe boredom”

New Cross Dialysis patient

“When taking tablets, use acup of water or less, or trywithout”

Cyrilla McQueen

“If you are going on a longjourney take a small bottle ofyour frozen water and onlysip when you really need it”

Cyrilla McQueen

“Measure how much thecups/glasses you useregularly hold”

Christine Allen

“If I think I am going over mylimit I have an ice cube instead”

Astley Cooper Dialysis patient

“I don’t cook with salt – I usegarlic and pepper instead”

“Flavour ice cubes with limeor try making them withsparkling water”

Bostock Dialysis Patient

“Use a small glass – this willstop you pouring out morethan you need”

“Be aware of hidden fluidin foods”

“Stay cool, especially inwarm weather”

“Battle dry mouth – drymouth can be uncomfortable.Try using mouthwash orbrush your teeth”

Susana Costeria

“I control my fluid by havingonly half a cup of drink at atime and always leave a bitin the cup”

Home-Haemodialysis patient

“Try to reduce the amountyou drink during the 24hours before a party or mealout where you may want todrink more than usual”

Camberwell dialysis patient

“Serve/ask for sauces to beserved separately”

“Frozen segments of orangeto quench my thirst”

Elizah

Managingon a limitedfluid intake

Patients tell us that the hardest part oftheir renal diet is the limited amountof fluid they can have each day.We asked patients for their hints andtips on how they manage on a limitedfluid intake.This is what they said...

44

Helpful hintswhen eating outor ordering inHow often do you eat out or have atake-away? If it is only occasionally (i.e.once a week), it is unlikely to make muchdifference. However, if you eat out moreoften, you will need to be careful aboutwhat you choose.

If you know you will be eating out orhaving a take-away, be careful before orafter the meal to allow for any foods anddrinks you would not normally have

Ask for sauces or dressings to be servedseparately so you can control the amountyou have

Ask for food to be cooked or servedwithout salt

If you are unsure what ingredients a dishcontains, ask

You can also ask that high potassiumingredients e.g. mushrooms, are left out ofa dish

Rice, pasta, couscous and noodles are goodto have in place of starchy foods likepotatoes, yam or plantain

African-CaribbeanTry to avoid dishes containing salted fish ormeats as they are unlikely to have beenpre-soaked

Ask for soups and stews to be served witha slotted spoon to drain the liquid away

Ask for food to be cooked or served withless seasoning

Choose plain boiled rice, ground rice,couscous or bread with a dish rather thanextra starchy vegetables such as yam,plantain, green banana or cassava

Chinese,Thai and IndianThe saltiest part of the dish is the sauce sochoose dishes that do not have a sauce orleave most of the sauce on the plate

Avoid adding pickles, chutneys or soy sauceto your meal

Ginger, garlic and lemon grass add flavourwithout the need for salt

Choose plain rice or noodles instead ofpilau rice which is cooked in a salty stock

Avoid soups and limit salty snacks such aspoppadoms or prawn crackers

Fast foodChoose a plain burger without cheese orrelish

Choose chicken or lamb kebab with saladand pitta bread

Choose plain cooked chicken rather thanone that is heavily seasoned

Avoid milk shakes

Fish in batter or breadcrumbs can be eatenbut have only a small portion of chips

Avoid or use very small amounts ofketchup or dips.Vinegar is fine

ItalianAvoid dishes which contain large amountsof cheese e.g. Four-cheese pizza, macaronicheese

Choose pizzas with lower salt toppingssuch as chicken, vegetables, pineapple,mozzarella cheese or beef

Avoid dishes or pizzas that contain saltyingredients e.g. olives, anchovies, curedmeats (ham and bacon) or blue cheese

Use black pepper, herbs, chillies or vinegarto add extra flavour in place of Parmesan

Remember, if you are watching yourweight or are on a low fat diet, manytake-away foods are high in fat. Yourdietitian can give you more advice onhealthier take-away choices if necessary.

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The following websites have beenwritten or reviewed by medicalexperts and found to be the mostuseful and reliable. However, the useof websites is not intended to replaceconsultation with your own doctor,dietitian or health care team.

www.edren.org

This website from the Royal Infirmary ofEdinburgh Renal Unit gives a very usefulreview of ‘what’s in food’ and sections fordiet at different stages of treatment. It hasinformation sheets available to downloadand print.

Link through to the diet section by searching‘diet’ in the ‘Search this site’ link, and then clickon ‘diet in chronic renal failure and CKD’.

www.cambridge-transplant.org.uk

This website from Addenbrooke’s TransplantUnit, Cambridge gives dietary advice forpatients who have had a kidney transplant.

Click on the ‘kidney’ button at the top ofthe home page, and then scroll down tothe section called ‘Going home’ to findinformation on diet.

www.kidneypatientguide.org.uk

This website has information for ‘kidneypatients and those who care for them’.It includes a brief diet section with a veryuseful ‘cartoon’ explaining fluid control as wellas cookbooks and menu ideas. This websitealso has an excellent online discussionforum for patients and their carers.

www.kidney.org.uk

This website is from the National KidneyFederation – the UK charity for kidneypatients by kidney patients. It has somedietary information and a useful onlinediscussion board called Talkline.

If you don't have access to the internetat home, try your local library or visitthe Knowledge & Information Centreon the ground floor of the North Wingat St Thomas' Hospital.

You can use the websitewww.judgehealth.org.uk to judgethe quality of other health informationwebsites you find.

If you have any questions regarding yourdiet please contact your renal dietitian.

Further information

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Notes

Design and print by CDP Print Management London, Unit 1,Tomo Industrial Estate, Packet Boat Lane, Cowley, Uxbridge, UB8 2JP. Tel: 01895 462462. Fax: 01895 420911.

Notes

Guy's and StThomas' NHS FoundationTrust

St Thomas' Hospital,Westminster Bridge Road, London SE1 7EH

Guy’s Hospital, Great Maze Pond, London SE1 9RT

Swtichboard: 020 7188 7188 www.guysandstthomas.nhs.uk

© May 2008. Guy's and St Thomas' NHS Foundation Trust. All rights reserved. Renal/PPG 2288. For review May 2010.

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