Can I eat pizza with CKD? (plus a FREE meal plan download!)

Yes! But in moderation…and with a little extra planning (which I’m about to go over!) to make sure we don’t go over on our sodium, protein, or phosphorus.

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What makes pizza a challenging food for the kidney diet?


Pizza is a sodium bomb. There’s no way to sugarcoat this. Just about every single ingredient that goes into making a pizza is a high sodium food. The crusts are usually high in sodium. The sauce is almost always high in sodium. The cheese is high in sodium. Many of the toppings are high in sodium (all the meats, some veggies including roasted red peppers, olives, pepperoncini, banana peppers, anchovies, etc). And then some pizza companies like to shake on some extra “seasoning” (a.k.a. salt) to add more flavor to the pizzas.

Phosphorus Additives

If you’ve taken our course or read this post on phosphorus additives, then you know that phosphorus additives are the primary driver of high phosphorus levels (and high phosphorus levels are bad for your cardiovascular health and can cause a lot of long term problems). Pizza components that very commonly include phosphate additives include: pizza crust, pepperoni, sausage, bacon, ham, chicken, beef, shrimp, ranch dressing, garlic (yes, the minced garlic!), certain cheeses (American, provolone)..the list can go on.


If you have Chronic Kidney Disease and need to watch your protein intake, then you should know that pizza is a high protein food. A single slice of veggie pizza can have all the protein you need for a meal….but not nearly enough calories, so you’ll definitely still be hungry when you finish that one slice.

If you are on dialysis and trying to eat more protein, then rest assured that pizza has plenty of protein. You mostly just need to watch out for the sodium and phosphates!

How to choose a kidney friendly pizza?

Avoid phosphate additives.

  1. Choose the right crust. Many pizza crusts contain phosphate additives, so be sure to check nutrition information to figure out which crust is best for kidney disease. For example, if you check the ingredient information from Domino’s Pizza, you can see that their Handmade Pan and Thin Crust both contain phosphate additives. You would want to choose from one of the other three pizza crusts to ensure the most kidney-friendly pizza.
  1. Choose the right toppings. If you have chronic kidney disease and are not on dialysis, you’ll want to avoid the higher protein toppings since the crust and cheese are already very high in protein. If you are on dialysis, you should still avoid most protein toppings because they tend to have phosphate additives. If you really want to add a meat topping, check the ingredients online. For example, the Domino’s pepperoni actually don’t contain any phosphorus additives! For non-meat toppings, most vegetable toppings will be phosphorus free.


As we already mentioned, pizza is loaded with sodium. I have yet to figure out a way to make pizza that is low in sodium and still actually tastes like pizza, so my personal strategy with including pizza into a low sodium meal plan is to use other meals in the day to balance out the high sodium pizza (more on that below). If you do want to try and cut down on some of the sodium in your pizza, here are some additional strategies to cut back (although it will still be high in sodium):

  1. Use less cheese. Many pizza places will let you specify that you want to use less cheese. Using less cheese will reduce the amount of sodium and protein in the pizza.
  2. Skip the meat toppings (which you are probably already doing because they are almost all loaded with phosphate additives, but it is worth repeating).
  3. Choose the right veggie toppings. If a veggie topping comes in a jar, then it is probably high in sodium. High sodium veggie toppings include olives, pepperoncini, and roasted red peppers.

Balance the rest of your day.

As we’ve already said, pizza is high in sodium, phosphates, and protein. Hopefully you’ve done your research at your pizza place of choice and you’ve selected a pizza that contains no added phosphates. In our meal plan, we included two medium slices of Domino’s Hand Tossed Pacific Veggie Pizza and it included 18g of protein and a whopping 920mg of sodium! Yikes!

But we can still make this work in the CKD Diet, and it doesn’t require you to eat bland food all day to make up for the high sodium pizza meal. We were able to include two pieces of pizza into a meal plan and end up with 2070 calories, 42g of protein, and only 1,625mg of sodium (so you can still salt your food if you want some extra flavor!).

Domino’s Hand Tossed Pacific Veggie Pizza, Medium, 2 slices

  • Calories: 440
  • Protein: 18g
  • Carbohydrate: 50g
  • Fat: 18g
  • Sodium: 920mg
  • Phosphorus
  • Fiber: 2g
  • Sugar: 1g
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