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Last Updated 10/21/18
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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
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Dietary Approach to Stop Hypertension (DASH) Diet and Risk of Renal Function Decline and All-Cause Mortality in Renal Transplant Recipients - Free, Full-Text Article from American Journal of Transplantation. - October 2018

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Diet, Gut Microbiome and Indoxyl Sulfate in Chronic Kidney Disease Patients - Free, Full-Text, Accepted Articles from Nephrology. - October 2018

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Probiotics and Antibiotics Create a Killer Combination - Press release from the Massachusetts Institute of Technology. - October 17, 2018

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Differences in Amino Acid Loss Between High-Efficiency Hemodialysis and Postdilution and Predilution Hemodiafiltration Using High Convection Volume Exchange—A New Metabolic Scenario? A Pilot Study - Free, full-text, Article in Press from Journal of Renal Nutrition. - October 16, 2018

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New Meatless Campaign Targets Vital Importance of Kidneys to Overall Health - Press release from the National Kidney Foundation. - October 15, 2018

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Diabetes Can Make Weight-Loss Harder. Here's Help - Article from HealthDay. - October 14, 2018

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Obesity and Risk of End-Stage Renal Disease in Patients with Chronic Kidney Disease: a Cohort Study - Advance Article abstract from The American Journal of Clinical Nutrition. - October 13, 2018

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Liberalizing the Diet of Patients Undergoing Dialysis: Are We Ready? - Free, full-text, Advance Article from NDT. - October 12, 2018

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Articles in Press Abstracts from Journal Of Renal Nutrition - October 12, 2018

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Eliminating the Need for Routine Monthly Postdialysis Serum Urea Nitrogen Measurement: a Method for Monitoring Kt/V and Normalized Protein Catabolic Rate Using Conductivity Determined Dialyzer Clearance - Early View abstract from Seminars In Dialysis. - October 11, 2018

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High Rates of Central Obesity and Sarcopenia in CKD Irrespective of Renal Replacement Therapy — an Observational Cross-Sectional Study - Free, Open Access Article from BMC Nephrology. - October 11, 2018

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Study Challenges Widely Held Belief That Gout Is Primarily Caused by Diet - October 10, 2018

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Therapeutic Fasting Could Be an Alternative to Insulin for Some Diabetes Patients - News brief from NEJM Journal Watch. - October 10, 2018

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Dietary Fiber Intake: Its Relation With Glycation End Products and Arterial Stiffness in End-Stage Renal Disease Patients - Article in Press abstract from Journal of Renal Nutrition. - October 9, 2018

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Gene Mutation Points to New Way to Fight Diabetes, Obesity, Heart Disease - News release from the National Institutes of Health. - October 9, 2018

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Articles in Press Abstracts from Journal Of Renal Nutrition - October 8, 2018

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Vitamin D Supplements No Help for Preventing Fractures, Falls - Posting from the NEJM Journal Watch. - October 5, 2018

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The Efficacy of Low Protein Diets in Delaying the Need for Maintenance Dialysis - News brief from the European Nephrology Portal. Abstract from Cochrane Reviews. - October 4, 2018

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Vitamin D Supplements Won't Build Bone Health in Older Adults: Study - Article from HealthDay. - October 4, 2018

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Intradialytic Parenteral Nutrition in Pediatrics - Free, full-text, review article from Frontiers in Pediatrics. - October 4, 2018

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Diet Rich in Fried and Processed Foods Linked to Increased Hypertension in Black Americans - News release from the National Institutes of Health. - October 3, 2018

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Southern Diet Is Top Factor Associated with Higher Risk of High Blood Pressure among Black Adults - Press release from the Journal of the American Medical Association. - October 2, 2018

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Vitamin B Supplementation May Prevent Nephropathy Progression in Children with Type I Diabetes - Article from Healio. - October 1, 2018

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Vitamin B Supplements May Protect Kidney Function in Children with Diabetes - Press release from the European Society for Pediatric Endocrinology. - September 28, 2018

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How Do Patients and Carers Make Sense of Renal Dietary Advice? A Qualitative Exploration - Early View abstract from Journal of Renal Care. - September 27, 2018

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Treating Endothelial Dysfunction with Vitamin D in Chronic Kidney Disease: a Meta-Analysis - Free, Open Access Article from BMC Nephrology. - September 25, 2018

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Effect of Ascorbic Acid on Mineral and Bone Disorders in Hemodialysis Patients: a Systematic Review and Meta-Analysis - Free, Open Access, Online First Article from Kidney & Blood Pressure Research. - September 24, 2018

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Clinical Trial of the Effects of Coenzyme Q10 Supplementation on Glycemic Control and Markers of Lipid Profiles in Diabetic Hemodialysis Patients - First Online abstract from International Urology and Nephrology. - September 24, 2018

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Amarin Fish Oil Capsule Shows Dramatic Benefit for Cardiovascular Patients, Potentially Upending Market - Article from STAT. - September 24, 2018

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Association of Low Serum Potassium Levels and Risk for All-Cause Mortality in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis - Early View Abstract from Therapeutic Apheresis and Dialysis. - September 21, 2018

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Online Diabetes Prevention Programs Are as Effective as in-Person Programs for Weight Loss, Study Finds - Press release from UCLA. - September 18, 2018

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The Effects of Oral Nutritional Supplements in Patients with Maintenance Dialysis Therapy: a Systematic Review and Meta-Analysis of Randomized Clinical Trials - Free, Open Access Article from PLOS ONE. - September 13, 2018

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  WEB RESOURCES
blue ball Latest Scientific Journal Articles on Nutrition
Table of Contents of the latest issue of the Journal of Renal Nutrition with abstracts
blue ball Advance Care Planning: The Dietitian's Role part 1 and part 2 from the Journal of Renal Nutrition
American Society for Parenteral and Enternal Nutrition web site
The American College of Nutrition web site
American Dietetic Association web site
blue ball AAKP Nutrition Coundter: A Reference for the Kidney Patient from the American Association of Kidney Patients web site

CKD Nutrition Management Training Program - The National Kidney Disease Education Program has developed Chronic Kidney Disease Nutrition Management, a series of five training modules that use engaging activities and case studies to prepare registered dietitians (RDs) for counseling patients who have chronic kidney disease (CKD). - 2012

Council on Renal Nutrition of The National Kidney Foundation web site
Chronic Kidney Disease: Nutrition Basics - Free, Full-text Article from Journal of Renal Nutrition - July 2011
Estimating Lean Body Mass in Hemodialysis Patients - Informative article from Renal and Urology News. - June 8, 2011
blue ball Fluid and Electrolytes - this is a growing library of key high-impact articles in nephrology, chosen by UKidney's contributors as suggested reading for nephrology trainees and practitioners.
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Food Safety for Transplant Recipients - from the U.S. Food and Drug Administration

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The Greatest Potassium Lecture Ever — Parts 1, 2 and 3 - Lectures from Oakland University William Beaumont School of Medicine by Joel Topf, MD via the Precious Bodily Fluids blog. - August 2016

Online Clinical Calculator for Body Surface Area/Body Mass Index from Division of General Internal Medicine, Medical College of Wisconsin web site
Renal Nutrition Resources from NKF - Council on Renal Nutrition
Revised European Best Practice Guidelines for Nutrition (pdf) - guidelines endorsed by the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)
Weight Management Tips for Patients on Hemodialysis - Free, full-text article from the Journal of Renal Nutrition. - September 2010
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 RENAL DIET RESOURCES
Assessing “Low-Carb” Products from the Journal of Renal Nutrition
Chinese Nutrition Educational Materials for Renal Patients: A 2010 Update - Free, full-text article from Journal of Renal Nutrition. - March 2011
DaVita Diet Helper from the DaVita web site
Delicious! - AAKP recipe cookbook
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
Home-Delivered Meal Options for Chronic Kidney Disease Patients full-text article from Journal of Renal Nutrition - September 2012

Kidney Community Kitchen from the Kidney Foundation of Canada Helps Dialysis Patients with Complex Burden of Diet Planning

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Kidney Cooking — Holiday Edition - Cookbook from DCI available for download.

Kidney-Friendly Frozen Meal Tips and Suggestions “In A Pinch” full-text article from Journal of Renal Nutrition - September 2012
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Kidney Smart Food Shopping - YouTube video (1 of 3) from Dialysis Clinics Inc.

MagicKitchen.com - offers frozen meals for Renal Diet

Mom's Meals - home meal delivery for many with stage 5 kidney disease

My Food Coach from the National Kidney Foundation web site
Nutrition and Fluids for People on Dialysis from the Kidney School web site
Nutrition for CKD Patients - Resource page from the National Kidney Disease Education Program (NKDEP)
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Patient-Friendly Renal Nutrition Guide from the Alport Syndrome Foundation - (9-page pdf) Alport Syndrome Foundation web site.

Phosphorous: What is it and Why is it Important? from KidneyTimes™
A Review of Packaged Snack Foods - Free, Full-text Article from Journal of Renal Nutrition - July 2011
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Short How-To Recipe Videos Launch for Kidney Disease and Dialysis Patients - from DaVita Kidney Care

Smoothie Recipe Book for Renal and Heart Health by Victoria L Hulett JD (Author), Jennifer L Waybright RN (Contributor)
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 FoodWine web site


  PUBMED SEARCHES (National Library of Medicine's MEDLINE Database)
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 (pdf) from the National Kidney Foundation (NKF) web site
Clinical Practice Guidelines for Nutrition in Children with CKD - 2008 Update  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
Cleveland Clinic Foundation Renal Diet Cookbooks

Delicious! 2nd Edition- AAKP recipe cookbook

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
Rediscovering Food & Flavours - The KidneyCare Cookbook by Lawrence Keogh (chef and transplant patient)

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).

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  UPCOMING EVENTS
Listing of local ESRD Network Annual Meetings
Listing of NKF Meetings and Activities
Listing of Academy of Nutrition and Dietetics 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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