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Once a patient begins dialysis treatments, there are four main restrictions to their "renal diet":

Fluids, Sodium (Na), Potassium (K), and Phosphorus (P).

Fluids are usually restricted to prevent excessive accumulation of water in the body. Too much water can lead to hypertension (high blood pressure), cardiovascular disease, and other complications such as pulmonary edema (water in the lungs).

Sodium is restricted as it plays major roles in hypertension and thirst. Cutting back on salt is essential in the renal diet.

Potassium is restricted as it may lead to irregular heart function. Patients must become knowledgeable about the foods that have high amounts of potassium.

Phosphorus is restricted because high levels of phosphorus will result in low levels of free calcium in the patient's blood. When the body senses low levels of calcium in the blood, it draws calcium out of the bones, which leads to brittle and fragile bones that can easily break.

Protein may or may not be restricted, depending on remaining renal function and other individual-based factors. Consult with your nephrologist and renal dietitian for guidance on your optimal protein intake.

Warning:  Changes should never be made in a patient's treatment or care based solely on the information found here.  Every patient has unique healthcare concerns and considerations and all these factors must all be taken into account before any changes can be safely made.  All medical and therapeutic decisions must come from a qualified health care provider.  Read RenalWEB's Legal Disclaimer before proceeding.

  NEWS & LATEST ARTICLES
Vitamins K and D Status in Stages 3–5 Chronic Kidney Disease - CJASN Express abstract. - February 18, 2010
Pressure Mounts for Herbal Medicines Regulation - Article from OnMedica. - February 18, 2010
High Levels of Vitamin D in Older People Can Reduce Heart Disease and Diabetes - Article from Warwick Medical School. - February 15, 2010
Betcha Don't Know How Much Sugar Is Dissolved in Your Total Blood Volume - Blog entry from Precious Bodily Fluids. - February 12, 2010
Research Warns of Risks of Low Potassium in Heart Failure Patients with CKD - Press release from the University of Alabama at Birmingham. - February 8, 2010
Association between Malnutrition, Integrin Expression and Impaired Granulocyte Adhesion in Chronically Hemodialyzed Patients - Article in Press abstract from the Journal of Nephrology. - February 5, 2010

CMS Forming Technical Expert Panels for 6 New ESRD Quality Measures - February 4, 2010

  • Anemia Management (Target value for Serum Ferritin, Target value for Transferrin Saturation)
  • Mineral Metabolism (Target value for Calcium, Target value for Phosphorus)
  • Vascular Access Infection Rate (Catheter Infection Rate)
  • Pediatric Adequacy (Hemodialysis [HD], Peritoneal Dialysis [PD])
  • Pediatric Anemia (Anemia Management)
  • Fluid Weight Management

Editor's Note: Where are the quality-of-life measures?
Study Fails To Link Saturated Fat, Heart Disease - Article from Reuters. - February 4, 2010
Vitamin D Receptor Gene, Biochemical Bone Markers and Bone Mineral Density in Mexican Women on Dialysis - Advance Access abstract from NDT. - February 2, 2010
As Use of Herbal Remedies Soars, Patients Taking These and Cardiovascular Medications May be at Heightened Risk of Dangerous, Potentially Life-Threatening Interactions - Article from the Mayo Clinic. - February 1, 2010
Risks of Kidney Failure Associated With Consumption of Herbal Products Containing Mu Tong or Fangchi: A Population-Based Case-Control Study - Article in Press abstract from the American Journal of Kidney Diseases. Related article from MedPage Today. - February 1, 2010
Potential New Target for Drugs To Treat Iron Deficiency and Overload Discovered - Press release from the Medical College of Georgia. - January 28, 2010
Iron, Inflammation, Dialysis Adequacy, Nutritional Status, and Hyperparathyroidism Modify Erythropoietic Response - abstract from CJASN. - January 28, 2010
If Fat is Good, Is Muscle Better? - Commentary from Renal & Urology News. - January 27, 2010
In related news:
Overweight' adults age 70 or older are less likely to die over a 10-year period
Low-carb Diet Effective at Lowering Blood Pressure - Release from Duke University Medical Center. - January 25, 2010
Albuminuria and Heart Disease Linked Only in White Diabetics - Article from Renal and Urology News. - January 22, 2010
Understanding Sources of Dietary Phosphorus in the Treatment of Patients with Chronic Kidney Disease - CJASN Express abstract. - January 21, 2010
Big Benefits From Eating Less Salt Include Saving 92,000 US Lives per Year - Articles from The New York Times and MedPage Today. - January 20, 2010
Reassessment of Albumin as a Nutritional Marker in Kidney Disease - JASN Express abstract. - January 14, 2010
Both Low Muscle Mass and Low Fat Are Associated with Higher All-Cause Mortality in Hemodialysis Patients - Advance online abstract from Kidney International. - January 13, 2010

The cookbook series Spice it up! - Renal recipe web site from Canada. Spice it up! booklets are available in English and French, but they are not for sale. They are distributed by renal dietitians to dialysis patients (free of charge). - January 2010
Adipokines and Nutritional Status for Patients on Maintenance Hemodialysis - Article in Press abstract from the Journal of Renal Nutrition. - January 13, 2010

The Truth About Protein - Article from KidneyTimes™. - January 2010
Independent and Joint Associations of Nutritional Status Indicators With Mortality Risk Among Chronic Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) - Article in Press abstract from the Journal of Renal Nutrition. - January 11, 2010
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  WEB RESOURCES
Latest Scientific Journal Articles on Nutrition - list compiled by RenalWEB's Journal Watch
Table of Contents of the latest issue of the Journal of Renal Nutrition with abstracts
American Society for Parenteral and Enternal Nutrition web site
The American College of Nutrition web site
American Dietetic Association web site
Council on Renal Nutrition of The National Kidney Foundation web site
Cause or Casualty? The Impact and Role of the Kidney on Inflammation, Metabolic Syndrome and Atherogenesis (pdf) free CE program from the National Kidney Foundation (NKF) web site
Chronic Kidney Disease: Preventing and Treating Malnutrition (pdf) article from the National Kidney Foundation web site
Eating Healthy From the Start: Kid and Kidney-Friendly Nutrition Tips (pdf) resource from the ESRD Network #15 web site
GETTING TO GOAL: A Multidisciplinary Approach to Phosphorus Management (pdf) from the National Kidney Foundation web site
Guidelines for Care of ESRD Patients (pdf format requires Adobe Acrobat Reader) - from the End Stage Renal Disease Network 4 web site
Net Nutrition A-Z - Practical Web-Based Tools for Renal Clinicians to Improve Nutrition Outcomes from Satellite Healthcare (includes tools for assessments, calculations, and modeling)
Nutrition Counter from the American Association of Kidney Patients (AAKP) web site

The Obesity Paradox - Video from Medscape Nephrology. - April 14, 2009

Online Clinical Calculator for Body Surface Area/Body Mass Index from Division of General Internal Medicine, Medical College of Wisconsin web site
Practical Approaches to a Complex Science: Effective Management of the Metabolic Syndrome in the CKD Patient with Diabetes - webcast from the National Kidney Foundation (NKF)
Renal Dietitians Practice Group from the American Dietetic Association web site
Renal Nutrition Resources from NKF - Council on Renal Nutrition
Revised European Best Practice Guidelines for Hemodialysis - Nutrition Part I (pdf) and Revised European Best Practice Guidelines for Hemodialysis - Nutrition Part 2 (pdf) - guidelines endorsed by the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)
A Team Approach to Managing Bone Disease in CKD Stage 5 (pdf) from the National Kidney Foundation web site
<30 Ways to Eat More Protein! (pdf) one month menu calendar from the ESRD Network #15 web site
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 RENAL DIET RESOURCES
AAKP Diet Tips and Bits from the American Association of Kidney Patients (AAKP) web site
aakpDelicious! from the American Association of Kidney Patients (AAKP) web site
Assessing “Low-Carb” Products from the Journal of Renal Nutrition
Brilliant Eats Cookbook from PKD Foundation web site
Culinary Kidney Cooks web site
DaVita Diet Helper from the DaVita web site
Diet Information from the Kidney Patient's Guide (UK site) web site
"Dining Out With Confidence" Guide from the National Kidney Foundation web site
Eat Right to Feel Right on Hemodialysis from the NIDDK web site
Fast Food, Phosphorus Containing Food Additives, and the Renal Diet from Case Wesstern Reserve University
Kidney Kitchen from the National Kidney Foundation web site
Nutrition and Fluids for People on Dialysis from the Kidney School web site
Phosphorus Education Materials for Patients and Professionals resources from Case Western Reserve University
Phosphorous: What is it and Why is it Important? from KidneyTimes™
Recipes for Living Well from the American Kidney Fund web site
So Just What Can I Eat? Nutritional Care in Patients with Diabetes Mellitus and Chronic Kidney Disease - Continuing education article from the American Nephrology Nurses Association. - September/October 2009
Spice Up Your Diet from the National Kidney Foundation web site
Vitamin D Basics from the Renal Fellow Network web site

  GENERAL FOOD INFORMATION - NOT RENAL SPECIFIC
Bowes & Church's Food Values of Portions Commonly Used by Jean A. T., Ph.D. Pennington, Anna De Planter Bowes, Helen n Church - from amazon.com
Cooking Measures and Conversion Calculator from the Global Gourmet web site
Food and Nutrition Topics from A to Z compiled by the Food and Nutrition Information Center ARS/USDA. WARNING: This is NOT information specific to Renal Diets, but about nutrition topics in general. Do not confuse the general public nutritional guidelines found through this link with renal patient nutritional guidelines.

  PUBMED SEARCHES (National Library of Medicine's MEDLINE Database)
dialysis and diet articles   Continually Updated!
fluid restriction and ESRD articles   Continually Updated!
nutrition management and ESRD articles   Continually Updated!
PCR and dialysis (protein catabolic rate)  Continually Updated!
IDPN and dialysis (intradialytic parenteral nutrition) articles  Continually Updated!
MEDLINE / Pubmed Information from the National Library of Medicine
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  K/DOQI™ - Kidney Disease Outcomes Quality Initiative
Clinical Practice Guidelines for Nutrition in Chronic Renal Failure from the National Kidney Foundation (NKF) web site
Clinical Practice Guidelines for Nutrition in Children with CKD - 2008 Update (pdf format requires Adobe Acrobat reader)  from the National Kidney Foundation (NKF) web site
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  DISCUSSION FORUM
Renal Diet Questions & Issues Discussion Forum on RenalWEB
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  PRODUCTS
 
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  RENAL DIET COOKBOOKS
Cookbooks for CKD Patients—2009 Update
Living Well on Dialysis:A Cookbook for Patients and Their Families (pdf) from the National Kidney Foundation web site
The Renal Gourmet a cook book by a kidney patient
Cooking for David: A Culinary Dialysis Cookbook by Sara Colman, RD, CDE, Renal Dietitian,
Nutrition Educator & Dorothy Gordon, BS, RN, experienced culinary dialysis diet cook - from Culinary Kidney Cooks
Cleveland Clinic Foundation Renal Diet Cookbooks
The Renal Patient's Guide to Good Eating : A Cookbook for Patients by a Patient - by Judith A. Curtis, Thomas Batis (Illustrator) from amazon.com - 1989
Kidney Helpers (Food Guides and Cookbook) from the Consumer MedHelp web site
Rediscovering Food & Flavours - The KidneyCare Cookbook by Lawrence Keogh (chef and transplant patient)
(The) Renal Family Cookbook from the MultiMed web site

Spice it up! - Renal recipe web site from Canada. Spice it up! booklets are available in English and French, but they are not for sale. They are distributed by renal dietitians to dialysis patients (free of charge).

Cookbooks for Renal Patients from the National Kidney Foundation web site
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  UPCOMING EVENTS
Listing of local ESRD Network Annual Meetings
Listing of NKF Local Council Professional Education Meetings and Activities
Listing of American Dietetic Association Education Conferences and Events
Calendar of American Society for Parenteral and Enteral Nutrition Meetings and Activities
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  YOUR WORDS
 
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  INPUT / SUGGESTIONS
E-mail to RenalWEB on the Patient Nutrition Resources Page
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