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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
Red grape's antioxidant benefits identified - article from Nutra Ingredients - April 10, 2008
New onset of alopecia in a young woman with end-stage renal disease - full-text case report from NDT Plus - April 10, 2008
The long forgotten salt factor and the benefits of using a 5-g-salt-restricted diet in all ESRD patients - full text editorial comment from Nephrology Dialysis Transplantation - April 9, 2008
Use (or misuse) of vitamin D treatment in CKD and dialysis patients - full text editorial comment from Nephrology Dialysis Transplantation - April 9, 2008
Impact of Activated Vitamin D and Race on Survival among Hemodialysis Patients - abstract from the Journal of the American Society of Nephrology - April 9, 2008
Lower target levels for blood pressure, LDL-cholesterol may provide cardiovascular benefits - article from JAMA and Archives Journals/EurekAlert! - April 8, 2008
Obesity as a Predictor of Vascular Access Outcomes: Analysis of the USRDS DMMS Wave II Study - abstract from Seminars in Dialysis - April 6, 2008
A Randomized, Double-Blind, Placebo-Controlled Trial of Niacinamide for Reduction of Phosphorus in Hemodialysis Patients - abstract from the Clinical Journal of the American Society of Nephrology - April 2, 2008
Research debunks health value of guzzling water - article from Yahoo!News - April 2, 2008
Prevalence and severity of disordered mineral metabolism in Blacks with chronic kidney disease - abstract from Kidney International - April 2008
Should Patients Eat During Hemodialysis Treatments? - article from Nephrology Nursing Journal - March/April 2008
A Population-Based Screening for Microalbuminuria Among Relatives of CKD Patients: The Kidney Evaluation and Awareness Program in Sheffield (KEAPS) - abstract from the American Journal of Kidney Diseases - March 26, 2008
Vitamin D Metabolism and Treatment in Chronic Kidney Disease - article from MedScape - March 25, 2008 free registration required)
Grape skin compound fights the complications of diabetes - article from The Peninsula College of Medicine and Dentistry/EurekAlert! - March 18, 2008
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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
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
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
Alleready Foods offers a line of frozen specialty foods that meet the needs of people who are on a dialysis diet.
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
Nutrition and Fluids for People on Dialysis from the Kidney School web site
Assessing “Low-Carb” Products from the Journal of Renal Nutrition
Spice Up Your Diet from the National Kidney Foundation 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
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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 Renal Patients 2006 Update (pdf) from the Journal of Renal Nutrition
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
(The) Renal Family Cookbook from the MultiMed web site
Kidney Friendly Cookbooks from the Fosrenol web site
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
October 25-28, 2008 - American Dietetic Association (ADA), Food & Nutrition Conference & Expo (FNCE), McCormick Place, Chicago, IL - conference web page, ADA web site, (866) 451-6444, fax (708) 344-4444 
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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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