Kidney-Friendly & Low Sodium McDonald's Options [Free PDF]

Is it really possible to have a low sodium McDonald's meal? What about kidney-friendly?

I’m a realist.  I know life happens. 

You’re out running errands and realize it’s past lunchtime and you are STARVING!  Perhaps you’ve had a long day and the thought of cooking dinner is just too much!  Or, your family has a craving for fast food and you’d like to enjoy it with them.  

McDonald’s seems like it would be a convenient and logical choice, doesn’t it? But, isn’t McDonald’s an absolute “NO!” when watching your sodium intake?  And surely those needing to follow a kidney-friendly diet (a diet low in sodium, phosphorus and potassium) can NEVER eat at McDonald’s, right? 

I believe in giving people the tools and information to make the best choices for the situation.  And I’m pleased to let you know that there ARE kidney-friendly and low sodium McDonald’s options.   You just need to know what to look for!  And The Everyday Kidney Cook can help with that!

This article will highlight how you can eat low sodium and, if needed, kidney-friendly at McDonald’s.  Finally, you’ll be able to download a chart listing the specific foods that are the best and worst (“sodium sabotagers”) when it comes to being kidney-friendly or sodium-friendly.

Note: If you're on a mobile device, the download option is likely at the bottom of the page after this article. If you're on a laptop or desktop computer, the download option is likely on a side bar on the right!

Sodium in Fast Food

Fast food is notoriously high in salt (sodium).  There are a few reasons for this:

1. It makes food taste good.

Most people are used to eating a lot of salt, and therefore salty fast food tastes better to them. 

In fact, according to the American Heart Association, the typical American consumes ~ 3500 mg of sodium/day.  This is well above the American Heart Association’s recommendation for a sodium limit of 1500 to 2300 mg daily.  The National Kidney Foundation suggests that a limit of 1500 mg is most appropriate for those with high blood pressure or kidney disease.

2. Salt can enhance the texture and color of food

This makes it more appealing to customers.

3. Salt acts as a preservative

Preservatives prevent food spoilage and the growth of disease-causing bacteria.

Additional Kidney-Friendly Concerns: Potassium & Phosphorus

In addition to sodium, many people with kidney disease need to watch potassium and/or phosphorus in their diets as well.  If you need to follow a kidney-friendly diet and you don’t know how to make the best choices, fast food restaurants like McDonald’s can be a disaster!

We already talked about sodium.  Let’s discuss the phosphorus and potassium in typical fast food.

Phosphorus in Fast Food

Phosphorus in fast food is present in two forms:

• Organic phosphorus is the phosphorus found naturally in certain foods. Animal sources of phosphorus include dairy, meat, poultry and seafood. Plant sources include grains, nuts, seeds, and beans.  Two common fast food items that are high in organic phosphorus are cheese and milkshakes.

• Inorganic phosphorus is phosphorus in food by the way of phosphate additives. Phosphates are added to many different fast food items as a preservative and to improve texture.  Fast food items that commonly contain phosphate additives include processed cheese, french fries and some breaded products (to name a few).

According to the newest research, our bodies absorb almost all (~ 90-100%) of the phosphorus that is in the form of an additive.  In contrast, we only absorb ~ 20-40% of the organic phosphorus (natural phosphorus) from plant sources and 30-80% from animal sources.  

Therefore, eating fast food high in phosphate additives can have a profound effect on your phosphorus levels when you have kidney disease.  Our downloadable chart takes into account both phosphate additives and foods naturally high in phosphorus when designating whether or not a food is kidney-friendly.

Potassium in Fast Food

Potassium in fast food also comes in two forms:

• Potassium occurring naturally in food such as the potatoes used to make french fries and the dairy in milkshakes.
• Potassium additives.  These are present in fast food for some of the same reasons that phosphate and sometimes sodium are added to fast food:  They extend the shelf-life and improve flavor and texture.
  
  In addition, in response to pressure to reduce the sodium content of processed and fast foods, some manufacturers have started adding potassium chloride to food in place of some of the sodium chloride (salt) to mimic the salty taste, which can be a problem for those needing to follow a low potassium diet.  (Pretty, sneaky, right?).  The total potassium content of foods via both natural and added sources are taken into account in our chart as well.

Let’s take a walk through the McDonald’s menu and discuss some tips on how to choose foods that are lower in sodium and also those that are kidney-friendly (lower in sodium, phosphorus and potassium). 

Tips for Choosing Kidney-Friendly & Low Sodium McDonald’s

Use the following key as a guide to determine whether a menu item is sodium or kidney-friendly:

Kidney-Friendly & Low Sodium McDonald's Breakfast

Good sodium-friendly and kidney-friendly choices include an Egg McMuffin®️ with only a fried egg (no cheese or canadian bacon), an english muffin w/ butter, scrambled eggs and Fruit & Maple Oatmeal.  If eating kidney-friendly, the Fruit & Maple Oatmeal should be the main entrée.  Otherwise, it is too high in potassium.

Limit/avoid menu items containing processed meats such as bacon, sausage and canadian bacon.  Limit/avoid hashbrowns and quick breads such as pancakes and biscuits used in breakfast sandwiches.   

Kidney-Friendly & Low Sodium McDonald's Burgers

A hamburger (no cheese) is a good sodium- and kidney-friendly choice.  Unfortunately, other burgers containing cheese and/or bacon are high in sodium and contain phosphate additives and are therefore not sodium- or kidney-friendly.

Kidney-Friendly & Low Sodium McDonald's Chicken & Fish Sandwiches

Filet-O-Fish®️ with either cheese OR tartar sauce removed is sodium-and kidney-friendly.  McChicken®️ sandwiches are sodium-friendly, but not kidney-friendly due to containing phosphate additives.  All other chicken sandwiches are not sodium- or kidney-friendly

Kidney-Friendly & Low Sodium McDonald's Fries

A small or kid-sized fries is sodium-friendly.  Choose kid-sized fries for kidney-friendly, as they do contain phosphate additives (the portion-control of the kid-sized fries limits the amount of added phosphate consumed).   BONUS: Making a special request for fries without salt reduces sodium further and usually means you'll get them fresh!

Kidney-Friendly & Low Sodium McDonald's Chicken McNuggets®️

4- or 6-piece McNuggets®️ are sodium-friendly.  For kidney-friendly, choose the 4-piece McNuggets®️ rather than 6 or more pieces to limit added phosphates and sodium.

Kidney-Friendly & Low Sodium McDonald's Sauces

The sodium in sauces can really add up!  Honey, honey mustard and sweet ‘n sour are the lowest in sodium.  Barbeque and spicy buffalo contain the highest amounts of sodium.

Using Ketchup when eating a Kidney-Friendly & Low Sodium McDonald's Meal

McDonald's ketchup contains 90 mg sodium/packet; therefore, more than 1 packet could tip the sodium content of your meal into the excessive category!  (I know, I love ketchup, too!). You might be able work 2 packs into your meal plan if you're careful with the sodium intake otherwise.

Kidney-Friendly & Low Sodium McDonald's Happy Meals®️

Happy Meals®️ are a good choice.  The smaller portions mean smaller amounts of sodium and phosphorus!  For kidney friendly, choose the hamburger meal or the 4-piece McNuggets®️ meal rather than the 6-piece meal.

Kidney-Friendly & Low Sodium McDonald's McCafé®️ coffee drink options & smoothies

Most contain acceptable amounts of sodium except those with caramel flavoring.  Unfortunately, most McCafé®️ drink options and smoothies are very high in potassium and/or phosphorus and are not a good choice for those needing a kidney-friendly diet.

The basic hot coffee (both Americano or Premium Roast are kidney-friendly), are kidney-friendly. Just be careful with adding too much cream, which is high in phosphorus!

Kidney-Friendly & Low Sodium McDonald's Sweet Treats

The baked apple pie, one chocolate chip cookie and the ice cream cone are kidney- and sodium-friendly.  Shakes, sundaes & McFlurries®️ are sodium-friendly (except the large chocolate shake), but they are very high in potassium and phosphorus and are therefore not kidney-friendly.

Kidney-Friendly & Low Sodium McDonald's Soft Drinks

Soft drinks contain acceptable amounts of sodium.  However, if you need to limit phosphorus, avoid Coke®️ and Dr. Pepper®️ due to phosphate additives. 

Kidney-Friendly & Low Sodium McDonald’s Chart

If the above tips and guidelines have your head spinning, no worries!  We’ve scoured the nutrition content of the entire McDonald’s menu on their website and devised a comprehensive downloadable chart to give you the scoop on the entire McDonald’s menu! 

(Note:  every effort is made to keep the chart up-to-date.  However, McDonald’s does make changes to its menu frequently, so it’s possible the chart may include items that are no longer available, or new items may not have been added yet if you catch it between updates).  Let’s break down the components of the chart.

Sodium

Our chart tells you exactly what foods in each category are considered safe for a sodium-controlled diet.  We list the sodium content of each of these foods as well!

Kidney-Friendly

Another column specifies which of those lower sodium options are also kidney-friendly, meaning they are also low enough in potassium and phosphorus to fit into a kidney-friendly diet.

Comments

If a food isn’t kidney-friendly, we tell you exactly why in the comment column.  Here, we also list a few other important notes regarding the menu item.

Sodium Sabotogers

Finally, we specify which foods in each category are “sodium sabotagers”.  These are foods that are particularly high in sodium and would be very difficult to fit into a low sodium and kidney-friendly diet.

Parting Thoughts on Ensuring a Kidney-Friendly or Low Sodium McDonald’s Visit

It’s true that you aren’t going to be able to haphazardly order off the menu without any pre-planning and expect your McDonald’s meal to be low sodium or kidney-friendly.  However, by following our tips noted above, or better yet, by using our downloadable chart as a guide, it IS very possible to have a kidney-friendly or low sodium McDonald’s meal!  Enjoy!