Tomatoes and Your Kidneys…Should You Even Think About Including Them In Your Kidney Diet?

Tomatoes are EVERYwhere and are featured in several of the most popular foods (pizza anyone?). From sauces, to juices, to salads, toppings and everything in between, tomatoes are a hallmark of Italian cuisine and have become a staple of most Americans’ diets.

But, as with every food, when you have chronic kidney issues, you need to start re-assessing and going back to the drawing board. Meaning, evaluation of what this food, no matter how “healthy” you think it is, and what it contains and in what amounts. Is this food rich in potassium? Phosphorus? Protein? Could it throw off my levels? Even in things like sauces and juices, which are by their very nature more concentrated, these questions become crucial. Everything that goes into your body is eventually processed by the kidneys, so you need to be an active participant in ensuring that only the best gets through, and limit as much of the toxic junk as possible. So, what’s the healthy kidney verdict on tomatoes? Let’s explore!

What’s In A Tomato?

Although widely regarded as a vegetable, tomatoes are actually fruits technically. They are one of the richest sources of lycopene, which contains tons of benefits for heart health, anti-aging, even preventing certain types of cancer like prostate cancer and skin cancer. However, these benefits may be overshadowed (for kidney sufferers at least) by the tomato’s high potassium, phosphorus and sodium content, which make it less suitable for a healthy kidney diet.


Is there any way I can incorporate tomatoes into my diet?

Per your physician’s guidance, and your latest lab work, you MAY be able to consume a small serving of tomatoes infrequently. This, of course, depends on your phosphorus and potassium levels, if that is something you are struggling with in your own unique case of kidney disease and if your nephrologist approves of it. This will most likely be possible in the earlier stages of CKD like stage 1 or 2. Even then, though, every case is different and if you want to do the utmost to keep your diet as kidney healthy as possible, you should steer clear.


Are All Tomatoes Created Equally?

Not really. Tomatoes are not really the best choice for a zesty addition to your soup, salad, sub, or any other recipe you previously enjoyed that featured tomatoes if you suffer from kidney issues. But, as we said earlier, if you are cleared to incorporate some every once in awhile, you should weigh your options, because different tomatoes feature different potential pitfalls and some are much worse than others.

Unfortunately, potassium and phosphorus isn’t always featured on the back of every food product’s nutritional facts label, sodium typically is but we’ve compiled a list for you to reference depending on the kind of tomato you’re thinking about. Fresh tomatoes are usually the best choice, but if you’re going for a canned option we’ve listed the phosphorus, potassium and sodium content for those as well.


  • Fresh Tomatoes (1 cup serving)
    Sodium: less than 35mg
    Potassium: 427mg
    Phosphorus: 43mg


  • Canned Diced Tomatoes (½ cup serving size)
    Sodium: 250mg
    Potassium: 226mg
    Phosphorus: 23mg


  • Canned Whole Tomatoes (8oz serving size)
    Sodium: 290mg
    Potassium: 426mg
    Phosphorus: 43mg


  • Canned Petite Cut Tomatoes (1/2 cup serving size)
    Sodium: 250mg
    Potassium: 226mg
    Phosphorus: 23mg


  • No Salt Added Canned Diced Tomatoes (1/2 cup)
    Sodium: 50mg
    Potassium: 226mg
    Phosphorus: 23mg


  • No Salt Added Canned Whole Tomatoes (1 cup)
    Sodium: 24mg
    Potassium: 451mg
    Phosphorus: 46mg


  • Canned Stewed Tomatoes (1 cup serving)
    Sodium: 563mg
    Potassium: 528mg
    Phosphorus: 51mg


  • Canned Tomato Paste (2tbsp serving)
    Sodium: 20mg
    Potassium: 310mg
    Phosphorus: 27mg


  • Tomato Sauce, Canned (1 cup serving)
    Sodium: 1284mg
    Potassium: 811mg
    Phosphorus: 64mg


  • Tomato Juice, Bottled (1 cup serving)
    Sodium: 654mg
    Potassium: 556mg
    Phosphorus: 44mg


  • Juice, No Salt Added (1 cup serving)
    Sodium: 25mg
    Potassium: 556mg
    Phosphorus: 44mg


  • Sun-Dried Tomatoes (1 cup serving)
    Sodium: 134 mg
    Potassium: 1851 mg


Is There Anything I Can Use As A Substitute?

Kidney-friendly tomato substitutes are an option, and can be a very tasty one! Depending on what recipe you’re trying to cook, roasted red peppers may be a much safer alternative with lower potassium and phosphorus content and a very similar texture. Try this recipe for a killer-tasting, healthy kidney “nomato” tomato sauce.


  • 8 fresh or frozen red peppers
  • Whole 3 tablespoons olive oil
  • 2 whole onions
  • Chopped 4 cloves garlic
  • Chopped 5 fresh basil leaves
  • Chopped 2 tablespoons balsamic vinegar
  • ½ cup water
  • 1-2 tsp of Mrs. Dash Italian Medley Seasoning blend DIRECTIONS:
  1. Roast whole red peppers and peel skins off. If you are using frozen peppers, save the juice and add to the recipe.
  2. Heat oil in pan. Sauté onions and garlic.
  3. Puree whole red pepper in blender and add to the pan.
  4. Add remaining ingredients and simmer for 1/2 hour, stirring occasionally.
  5. This sauce can be added to pasta, veggie lasagna, veggie meats/tofu/seitan, any kidney-safe dishes that you would use a traditional tomato sauce for. You can also freeze the tomato sauce in small portions and use later. 

What Else Can I Substitute?
For substituting tomatoes in other dishes like salsas, on sandwiches, in salads, bruschetta and ceviche, try opting for red peppers instead as they are much kidney-friendlier. The added bonus to incorporating red peppers is a nice crunchy texture that pairs well with numerous ingredients in a plethora of dishes. Experiment with different peppers, carrots, celery and cucumber along with many other kidney-friendly vegetables and fruits. Also, for Italian dishes, feel free to use oregano and basil along with the aforementioned Mrs. Dash Italian seasoning as these can provide much of the robust flavor you associate with Italian cuisine and tomatoes.

Substitutes for Tomatoes in Sandwiches, Pitas, and Wraps

  • Sliced cucumbers – Sliced cucumbers can be a great alternative for tomatoes in sandwiches and wraps. A dash of hot sauce, if desired, can be added. The cucumbers are always low in calories but contain various important vitamins and minerals, as well as a high water content. They provide a crunchy texture and have many potential health benefits, including weight loss, balanced hydration, digestive normality, and reduced blood sugar levels.


  • Grilled mushrooms – If you have kidney disease, you probably know that vitamin D is extremely important since it helps regulate kidney function, and mushrooms are an excellent source. Especially grilled mushrooms. You can easily incorporate some grilled mushrooms into your burgers, salads, sandwiches, and many more. The reason we suggest people with kidney disease to grill the mushrooms is because frying or boiling may destroy their nutritional value. Mushrooms usually contain no fat and are a valuable source of fiber.


Other Substitutes

Tamarind – Tomatoes in short resemble these three tastes: sweet, tart, and tangy. They’ve naturally had this delicious tartness and it complements a variety of cuisines. Tamarind is a tropical fruit with numerous health benefits and is one of the ingredients that come closest to mimicking the fresh sweet-tanginess of tomatoes. Adding a hint of tamarind to soups, curries, or stir fries can seriously add some flavor into your renal diet. Furthermore, a glass of tamarind juice will keep you full for longer and prevent you from overeating or bingeing on unhealthy snacks. It has also been linked with assisting weight loss and suppressing hunger.

Alternatives for Tomato Soup
French onion, chicken, leek & potato etc.

French Onion Soup – French onion soup may not look or taste like tomato soup but they’re a wonderful alternative and are surprisingly healthy. The onions in it provide a powerful anti-inflammatory substance called Quercetin. Quercetin has antioxidant and anti-inflammatory effects which might help reduce inflammation, kill cancer cells, control blood sugar, and help prevent heart disease. For a vegan or vegetarian option, a vegetable broth will do the job although you will need to take the time to cook the onions thoroughly.

For more info on tomatoes and all other dietary components of a healthy kidney diet, be sure to check out our diet guide in the shop and our videos on YouTube. We even have one about tomatoes with even more information! Do you have a favorite ‘nomato’ tomato recipe or swap you’d like to share with us? Feel free to comment and while you’re there be sure to like, subscribe and share as well!