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Last Updated 09/10/17
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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.

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Evaluation of the Impact of Gut Microbiota on Uremic Solute Accumulation by a CE-TOFMS–based Metabolomics Approach - Free, Full-Text Article from Kidney International. - September 2017

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Free, Full-Text Articles from Journal Of Renal Nutrition - September 2017

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Nutrition Counseling in Clinical Practice — How Clinicians Can Do Better - Free, full-text, New Online viewpoint article from the Journal of the American Medical Association. - September 7, 2017

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Probiotic Supplementation in Chronic Kidney Disease: A Double-blind, Randomized, Placebo-controlled Trial - Article in Press abstract from Journal of Renal Nutrition. - September 6, 2017

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Health Beliefs of Salt Intake among Patients Undergoing Hemodialysis - Early View abstract from Journal of Renal Care. - September 5, 2017

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Heparin Stimulates Food Intake and Body Weight Gain in Mice - September 5, 2017

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Eating Meat Linked to Higher Risk of Diabetes - September 5, 2017

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Has Salt Gotten An Unfair Shake? - September 3, 2017

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Associations of Body Mass Index and Body Fat With Markers of Inflammation and Nutrition Among Patients Receiving Hemodialysis - Article in Press abstract from American Journal of Kidney Diseases. - September 1, 2017

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New Findings May Help Protect the Kidney Health of Individuals with Obesity - August 31, 2017

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U.S. Obesity Rate Holding Steady, but still High - Article from HealthDay. - August 31, 2017

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Variation in Sodium Intake and Intra-Individual Change in Blood Pressure in Chronic Kidney Disease - Article in Press abstract from Journal of Renal Nutrition. - August 30, 2017

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Obesity and Synergistic Risk Factors for Chronic Kidney Disease in African American Adults: the Jackson Heart Study - Advance Article abstract from NDT. - August 30, 2017

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Eating Protein Three Times A Day Could Make Our Seniors Stronger - August 30, 2017

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Pooled Analysis of Phase III Trials Indicate Contrasting Influences of Renal Function on Blood Pressure, Body Weight, and HbA1c Reductions with Empagliflozin - Article in Press abstract from Kidney International. - August 30, 2017

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Association of a Low-Protein Diet with Slower Progression of Chronic Kidney Disease - 29-page pdf- Article in Press Abstract and Full-Text PDF from Kidney International Reports. - August 29, 2017

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High Salt Intake Associated with Doubled Risk of Heart Failure - Press release from the European Society of Cardiology. - August 27, 2017

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Why One Florida Hospital is Trying its Hand at Farming - Article from Hospitals & Health Networks. - August 25, 2017

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Association of Serum Albumin Levels with Kidney Function Decline and Incident Chronic Kidney Disease in Elders - Advance Article Abstract from NDT. - August 23, 2017

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Adherence to the Mediterranean Dietary Pattern and Incidence of Nephrolithiasis in the Seguimiento Universidad de Navarra Follow-up (SUN) Cohort - Articles in Press Abstract from American Journal of Kidney Diseases. - August 22, 2017

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Global Obesity Epidemic Worsening - Article from JAMA Forum. - August 15, 2017

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Laparoscopic Sleeve Gastrectomy Improves Renal Transplant Candidacy and Post-Transplant Outcomes in Morbidly Obese Patients - Early View/Accepted Abstract from American Journal of Transplantation. - August 14, 2017

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Associations of Physical Activity Energy Expenditure with Nutritional-Inflammatory Markers in Hemodialysis Patients - Advance Online Abstract from the International Journal of Artificial Organs. - August 11, 2017

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Drug Treatments Didn't Work. Can a Simple Diet Help Change These Children's Lives? - Article From STAT. The children at this Florida camp are living with a rare kidney disorder called focal segmental glomerulosclerosis. - August 9, 2017

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Impact of Nutritional Index on the Association between Phosphorus Concentrations and Mortality in Hemodialysis Patients: a Cohort Study from Dialysis Outcomes and Practice Pattern Study in Japan - Free, full-text article from BMJ Open. - August 1, 2017

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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
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American Association of Kidney Patients (AAKP) Nutrition App

American Dietetic Association web site
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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

blue ball NIDDK Publications On-line from the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)
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Nutrition Information for Hemodialysis Nurses - 3-page pdf from the EDTNA/ERCA website (Europe).

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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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

Kidney-Friendly Frozen Meal Tips and Suggestions “In A Pinch” full-text article from Journal of Renal Nutrition - September 2012 - 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)
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

Bowes & Church's Food Values of Portions Commonly Used by Jean A. T., Ph.D. Pennington, Anna De Planter Bowes, Helen n Church - from
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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Renal Diet Questions & Issues Discussion Forum on RenalWEB
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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 - 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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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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E-mail to RenalWEB on the Patient Nutrition Resources Page
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