Kidney Friendly Mac and Cheese: Phosphorus, Potassium and Sodium by Ingredient

There is no single kidney friendly mac and cheese, because the right amounts of phosphorus, potassium, sodium and protein differ from person to person with chronic kidney disease. NIDDK notes that nutritional needs change as the disease advances and advises working with a health care professional to find the right amount of potassium for you and to set your sodium limit. [1] What can be compared is the ingredients. In USDA FoodData Central reference data, per 100 grams, cooked pasta without added salt lists 58 mg of phosphorus and 44 mg of potassium, cheddar lists 455 mg of phosphorus and pasteurized process American cheese 641 mg, and whole milk lists 84 mg of phosphorus and 132 mg of potassium. [2] In USDA label data for 752 boxed, cup and pouch mac and cheese mixes sold in the United States, 679 list an ingredient with “phos” in its name, and none report phosphorus on the Nutrition Facts label. [2] The recipe example on this page, Mac in a Flash from the American Kidney Fund’s Kidney Kitchen, lists 122 mg of phosphorus, 79 mg of potassium and 94 mg of sodium per serving, one of four servings. [3]

This page is general education, not a kidney diet plan, and it does not rate any food as suited to your kidneys. If you have kidney disease, use the eating plan from your health care team. Ask your provider before using salt substitutes or lower-sodium products made with potassium chloride; potassium in salt substitutes could make potassium levels too high in people with kidney disease or who take certain medications. [4] Mac and cheese is made with cheese, which contains milk, and most store mac and cheese lists wheat [2]; milk and wheat are both major food allergens. [5]

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Phosphorus, potassium and sodium in mac and cheese ingredients

The table lists USDA FoodData Central SR Legacy entries per 100 grams, a standard unit for comparing foods rather than an amount anyone eats; protein is rounded to one decimal. [2] The phosphorus-per-gram-of-protein column is calculated from the USDA values and rounded to a whole number, because a kidney nutrition review notes that dietary counseling for chronic kidney disease should address both the amount of phosphorus and the phosphorus-to-protein ratio in foods. [6] The ratio is not calculated for foods with less than 3 g of protein per 100 grams, where a small protein value makes it swing widely.

Limits of this comparison. SR Legacy is USDA’s historical dataset; its final update was in 2018, and these entries were published in April 2019. Its values are generic, not those of any product you can buy. The low-sodium cheese and unsalted butter entries report no data points for sodium, the mozzarella sodium value comes from a label claim, the rice milk values come from a product label, and the almond milk values rest on one data point. [2] Additive phosphorus is more readily absorbed than the phosphorus that occurs naturally in food, and nutrient databases may underreport it and not tell the two apart. [6] The label of the product you buy is the better guide.

What the table shows. Cheese carries most of the phosphorus: per 100 grams, the cheeses list 107 mg (cream cheese) to 641 mg (process American), against 58 mg for cooked pasta. The low-sodium cheddar or colby entry lists 21 mg of sodium but 484 mg of phosphorus, so lower sodium does not mean lower phosphorus. Process American cheese lists the most phosphorus per gram of protein among the cheeses, 35 mg, against 20 mg for cheddar. Ricotta lists the most potassium among the cheeses, 219 mg, and evaporated milk 303 mg. Pasta cooked with added salt lists 131 mg of sodium, against 1 mg without. [2]

Recipe example: Mac in a Flash (macaroni and cheese)

This recipe is from Kidney Kitchen, the American Kidney Fund’s recipe site, which credits it to Northwest Kidney Centers in Seattle, Washington. The ingredients, amounts, yield, times and nutrition are as Kidney Kitchen lists them; the directions are paraphrased. [3]

Portion. Kidney Kitchen tags this recipe low protein, low phosphorus, low sodium and low potassium; those values are for one serving, a quarter of the batch, and the recipe page gives no weight or cup measure for a serving. [3] NIDDK notes that a large serving of a lower-potassium food may have more potassium than a small serving of a higher-potassium food, so two servings mean twice the listed amounts. [1]

Ingredient choices. The listed values assume the ingredients the recipe names, and the recipe lists no salt. [3] Swapping ingredients changes the numbers: in the USDA data above, process American cheese lists 641 mg of phosphorus per 100 grams against 455 mg for cheddar, and pasta cooked with added salt lists 131 mg of sodium against 1 mg without. [2] NIDDK suggests looking for “PHOS” words on ingredient lists, which applies to the cheese and noodles you buy as well. [1]

Protein. A low-protein tag is not a goal for everyone with kidney disease: NIDDK notes that people on dialysis may need to eat more protein, and that protein needs may change over time. [1]

Your plan. Kidney Kitchen says it is not designed to prescribe an eating plan for any stage of kidney disease and advises asking a medical professional or registered dietitian about your diet. [7] Whether this recipe fits your plan, and in what portion, is a question for your kidney care team, which may include a renal dietitian.

What store mac and cheese labels show

USDA’s Branded Foods label data converts the values on each product’s Nutrition Facts label to a basis of 100 grams. [8] Limited to products sold in the United States, with one record per product barcode and mac and cheeses with added meat, vegetables or other foods left out, it holds 752 boxed, cup and pouch mixes, whose values are for the dry product as sold, and 279 frozen or refrigerated mac and cheeses sold ready to heat. The median is the middle label in each group, and the middle half is the range covered by the central 50% of labels; both are rounded to the nearest 10 mg. [2]

• Phosphorus additives. 679 of the 752 mixes and 156 of the 279 frozen or refrigerated products list an ingredient with “phos” in its name. Among the mixes, 662 list a sodium phosphate, 109 a calcium phosphate and 79 a potassium phosphate. [2]
• Phosphorus on the label. None of the mixes and 2 of the frozen or refrigerated products report phosphorus. [2] A missing value is not a zero; it means the manufacturer did not supply it. [8]
• Potassium chloride. 147 of the mixes and 37 of the frozen or refrigerated products list potassium chloride. [2]
• Potassium on the label. 428 mixes report potassium: median about 330 mg per 100 grams as sold, middle half 210 to 410 mg. 161 frozen or refrigerated products report it: median about 110 mg, middle half 70 to 140 mg. [2]
• Sodium. Mixes: median about 810 mg per 100 grams as sold, middle half 770 to 880 mg. Frozen or refrigerated: median about 360 mg, middle half 290 to 420 mg. 751 of the mixes and all 279 frozen or refrigerated products list salt. [2]

Dry-mix values are for the pasta and cheese powder before cooking, so the milk and butter added at home change the totals. In USDA’s reference data, a boxed dinner prepared with 2% milk and margarine lists 112 mg of phosphorus, 129 mg of potassium and 338 mg of sodium per 100 grams. [2] Most of these label records date from 2021 to 2023, and formulas change; label rounding adds variability to the per-100 values. [8] The data does not cover every product on the market, so check the current label of the package you buy.

Why phosphorus additives matter in mac and cheese

NIDDK notes that phosphorus is found naturally in protein-rich foods such as dairy products, that it is also added to many foods, and that phosphorus additives are the primary source of phosphorus for many people. Foods and drinks with added phosphorus may raise blood phosphorus more than foods that naturally contain it. [1] The NIH Office of Dietary Supplements lists phosphoric acid, sodium phosphate and sodium polyphosphate as examples of these additives, and notes that in severe chronic kidney disease the kidneys cannot get rid of excess phosphorus. [9]

Cheese is one way these additives reach mac and cheese. The federal standard for pasteurized process cheese allows emulsifying agents including sodium phosphates, dipotassium phosphate and potassium citrate, at no more than 3 percent of the cheese’s weight. [10] For people with chronic kidney disease, NIDDK suggests looking for “phosphorus” or words with “PHOS,” such as disodium phosphate, on the ingredient list. [1]

Why phosphorus is often missing from the label

Federal labeling rules require potassium on the Nutrition Facts label but leave most other minerals, phosphorus among them, to the manufacturer’s choice. A mineral included only for a technological purpose and named only in the ingredient list need not be declared in the nutrition panel when the label does not otherwise refer to it. [11] That is why the label data above shows potassium values for many products and phosphorus values for almost none. The ingredient list is where added phosphorus shows up. [1]

Potassium chloride and salt substitutes

If your potassium level is high, NIDDK says your health care professional may recommend limiting foods with potassium chloride on the ingredient list, because it is sometimes used in place of salt in packaged foods, and using spices and herbs instead of salt substitutes. NIDDK also notes that a large serving of a lower-potassium food may have more potassium than a small serving of a higher-potassium food. [1] An analysis of an earlier release of the same USDA label data found potassium additives in 14.7% of products, and potassium additives in mixed foods were associated with 71% more potassium per serving. [12]

Sodium on the label

FDA lists the Daily Value for sodium as less than 2,300 mg per day and, as a general guide, considers 5% DV or less of sodium per serving low and 20% DV or more high. Sodium can vary significantly between similar foods. [13] NIDDK advises working with a health care professional to determine your own sodium limit. [1] “No salt added” on a package means no salt was added during processing; it does not mean the food is sodium-free. [13]

Questions to bring to your kidney care team

A health care professional can check your phosphorus and potassium levels with blood tests and may suggest changes to what you eat and drink. [1] Questions that can help turn the numbers on this page into your own plan:

• How much phosphorus, potassium, sodium and protein should one serving of a dish like this fit within for me?
• Should I avoid ingredients with “PHOS” or potassium chloride, and does that apply to the cheese, the milk or a milk substitute?
• If I take a phosphate binder, how should I take it with a meal like this? NIDDK notes that people with advancing kidney disease may need a binder with meals. [1]
• If I am on dialysis, has my protein need changed? NIDDK notes that people on dialysis may need more protein. [1]

Allergens in mac and cheese

FDA recognizes nine major food allergens: milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soybeans and sesame, and gives almonds as an example of a tree nut. [5] Mac and cheese is made with cheese, so it contains milk unless a label says otherwise; in the recipe example, the cheese and butter are milk products, so check the noodle package for wheat. In the label data, 706 of the 752 mixes and 240 of the 279 frozen or refrigerated products list wheat. [2] FDA’s first tip for people with food allergies is to always read food labels. [5]

Food safety for mac and cheese leftovers

• If you are not serving it right away, keep cooked food hot, at 140°F (60°C) or above. [14]
• Refrigerate perishable foods within 2 hours, in a refrigerator set to 40°F (4°C) or below. [14]
• Reheat leftovers to 165°F (74°C), checked with a food thermometer. [15]
• FoodSafety.gov’s Cold Food Storage Chart says its freezer times are for quality only and points to its FoodKeeper app for storage tips on specific foods. [16]

Where to go next

This guide covers one recipe example plus phosphorus, potassium, sodium, protein, allergens and food safety. It does not assess calories, portion size or how a dish fits an overall meal plan. For practice reading %DV and serving sizes, see the food label reading worksheet. For seasoning with herbs and spices rather than salt, see the guide to low salt chicken seasoning, which also covers the salt-substitute caution. More guides are listed under Heart-healthy recipes.

Common questions

Is there a kidney friendly mac and cheese that suits everyone with kidney disease?

No. Nutritional needs change as chronic kidney disease advances, and NIDDK advises working with a health care professional to find the right amounts of potassium and sodium for you. [1] This page shows where the phosphorus, potassium and sodium in mac and cheese come from; your care team decides what fits your plan.

Which cheese has the least phosphorus for mac and cheese?

Among the cheeses in USDA’s reference data, cream cheese lists 107 mg of phosphorus per 100 grams and whole-milk ricotta 154 mg, against 455 mg for cheddar and 641 mg for process American cheese. Cream cheese and ricotta also list less protein, and ricotta lists the most potassium of the cheeses, 219 mg. [2]

Does low-sodium cheese have less phosphorus?

Not in USDA’s reference data: the low-sodium cheddar or colby entry lists 21 mg of sodium and 484 mg of phosphorus per 100 grams, against 653 mg of sodium and 455 mg of phosphorus for regular cheddar. [2]

Why doesn’t the Nutrition Facts label show phosphorus?

Federal rules require potassium but leave most other minerals, including phosphorus, to the manufacturer’s choice, and an additive used only for a technological purpose can appear in the ingredient list alone. [11] NIDDK suggests checking the ingredient list for “PHOS.” [1]

How big is one serving of the Mac in a Flash recipe?

Kidney Kitchen lists the recipe as making 4 servings with a serving size of 1 serving, and gives no weight or cup measure; its nutrition values are for one of those 4 servings. [3]

How should leftover mac and cheese be handled?

Refrigerate it within 2 hours in a refrigerator at 40°F (4°C) or below [14], and reheat it to 165°F (74°C). [15]

Kidney diets differ from person to person. Before changing what you eat, go over these numbers with your kidney care team, which may include a renal dietitian; a health care professional can check your phosphorus and potassium levels with blood tests. [1]

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Sources and limitations

1. National Institute of Diabetes and Digestive and Kidney Diseases: Healthy Eating for Adults with Chronic Kidney Disease. Last reviewed January 2025. General guidance for adults with chronic kidney disease; individual eating plans come from their health care team.
2. U.S. Department of Agriculture: FoodData Central. SR Legacy dataset, published April 2019; Branded Foods dataset, April 2026 release. SR Legacy entries by FDC ID: 169737, 169751, 168910, 170851, 173418, 170845, 173414, 173440, 171251, 171247, 171290, 171265, 171267, 171276, 171942, 174832, 173430, 168894, 173340, 173341, 173342. Branded Foods label data supplied by food brands, here 752 boxed, cup and pouch mac and cheese mixes and 279 frozen or refrigerated mac and cheeses sold in the United States, one record per product barcode. Search each FDC ID on the FoodData Central site. SR Legacy values are generic, its final update was in 2018, and they do not separate added from natural phosphorus; branded values are as reported by manufacturers and may not match current products.
3. American Kidney Fund, Kidney Kitchen: Mac in a Flash (Macaroni and Cheese), recipe contributed by Northwest Kidney Centers. Modified March 23, 2023. Source of the recipe example; per-serving nutrition is as listed for 1 of 4 servings, with no serving weight or brand of noodles or cheese.
4. NIH Office of Dietary Supplements: Potassium, Fact Sheet for Consumers. Updated March 22, 2021. General overview; it does not list individual products or set limits for any person.
5. U.S. Food and Drug Administration: Food Allergies: What You Need to Know. Content current as of August 16, 2024. Lists the major food allergens recognized in the United States; it does not assess individual products.
6. Kalantar-Zadeh K, Gutekunst L, Mehrotra R, et al. Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clinical Journal of the American Society of Nephrology. Published March 2010. A review written for clinicians; this page cites only statements in its abstract.
7. American Kidney Fund, Kidney Kitchen: About Kidney Kitchen. Modified February 29, 2024. Describes the recipe site and its scope; it does not evaluate any individual diet.
8. U.S. Department of Agriculture: USDA Global Branded Food Products Database Documentation. April 2024. Explains the conversion of label values to a 100 g basis, missing values and label rounding.
9. NIH Office of Dietary Supplements: Phosphorus, Fact Sheet for Consumers. Updated March 22, 2021. General overview; it does not list individual products or set limits for any person.
10. Electronic Code of Federal Regulations: 21 CFR 133.169, Pasteurized process cheese. Current regulation text. Sets the standard of identity, including permitted emulsifying agents; it does not state phosphorus, potassium or sodium amounts.
11. Electronic Code of Federal Regulations: 21 CFR 101.9, Nutrition labeling of food. Current regulation text. Applies to package labels and labeling, not to home cooking.
12. Picard K, Picard C, Mager DR, Richard C. Potassium content of the American food supply and implications for the management of hyperkalemia in dialysis: An analysis of the Branded Product Database. Seminars in Dialysis. Published online July 29, 2021. Analyzed an earlier release of the same USDA label data; reports associations, not measured amounts in any one product. This page cites only its abstract.
13. U.S. Food and Drug Administration: Sodium in Your Diet. Content current as of March 5, 2024. Consumer guidance for the general public; not individual dietary advice.
14. FoodSafety.gov: 4 Steps to Food Safety. Last reviewed September 18, 2023. Home kitchen guidance on cleaning, separating, cooking and chilling.
15. FoodSafety.gov: Safe Minimum Internal Temperatures. Last reviewed November 21, 2024. Cooking and reheating temperatures; does not address flavor or texture.
16. FoodSafety.gov: Cold Food Storage Chart. Last reviewed September 19, 2023. Refrigerator and freezer storage times for listed foods; freezer times are for quality. Macaroni and cheese is not listed.