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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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Overview of the 2017 KDIGO CKD-MBD Update: Practice Implications for Adult Hemodialysis Patients - Free, full-text article from Journal of Renal Nutrition. - January 2019

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Plant-Based Diets in CKD - Free, full-text Published Ahead of Print article from the Clinical Journal of the American Society of Nephrology. - January 2019

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Dietary Fiber, Whole Grains Associated with Lower Disease Risk - News brief from NEJM Journal Watch. - January 11, 2019

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Draft AKI and Nutrition Clinical Practice Guidelines Now Available for Review - Notice from The Renal Association (UK). - January 9, 2019

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High Sodium Intake Increases Blood Pressure and Risk of Kidney Disease. From the Science of Salt: a Regularly Updated Systematic Review of Salt and Health Outcomes (August 2016 to March 2017) - Free, full-text article from The Journal of Clinical Hypertension. - January 7, 2019

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Carbohydrate and Lipid Prescription, Administration, and Oxidation in Critically Ill Patients With Acute Kidney Injury: A Post Hoc Analysis - Article in Press abstract from Journal of Renal Nutrition. - January 7, 2019

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High Rates of Protein Intake Are Associated with an Accelerated Rate of Decline of Residual Kidney Function in Incident Peritoneal Dialysis Patients - Advance Article abstract from NDT. - January 4, 2019

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Mediterranean Edges Out DASH for Best Diet of 2019 - (Registration required, but free.) Article via Medscape. - January 2, 2019

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Moderate Alcohol Intake Linked to Longer Survival in Heart Failure - News brief from NEJM Journal Watch. - January 2, 2019

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Fasting-Evoked Hypoglycemia in Diabetes Is Prevalent - Article from Renal & Urology News. - December 28, 2018

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Sugar Sweetened Beverage Pattern Linked to Higher Kidney Disease Risk - Press release from the American Society of Nephrology. Article from HealthDay.  - December 27, 2018
Free, full-text, Published Ahead of Print CJASN articles:

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Coenzyme Q10 Supplementation on Metabolic Profiles of Patients with Chronic Kidney Disease - Press release from Current Pharmaceutical Design. - December 27, 2018

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Evaluation of Vitamin K Status and Rationale for Vitamin K Supplementation in Dialysis Patients - Advance Article abstract from NDT. - December 26, 2018

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Psychosocial Consequences of Gastrointestinal Symptoms and Dietary Changes in People Receiving Automated Peritoneal Dialysis - Early View abstract from Journal of Renal Care. - December 25, 2018

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Articles in Press Abstracts from Journal of Renal Nutrition - December 24, 2018

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Short-Term Effect of the New Nordic Renal Diet on Phosphorus Homeostasis in Chronic Kidney Disease Stages 3 and 4 - Advance Articles Abstract from NDT. - December 24, 2018

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Articles in Press Abstracts from Journal Of Renal Nutrition - December 20, 2018

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Weight Loss Implant Simulates Food Inside Stomach - Article from MedGadget. - December 20, 2018

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Active Vitamin D in Chronic Kidney Disease: Getting Right Back Where We Started from? - Free, Full-Text, Online First Article from Kidney Diseases. - December 19, 2018

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Articles in Press Abstracts from Journal Of Renal Nutrition - December 19, 2018

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Replacing Meat With Egg White May Help Control Hyperphosphatemia - Article from Renal & Urology News. - December 18, 2018

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Effects of Probiotic Supplements on the Progression of Chronic Kidney Disease: a Meta-Analysis - Accepted Article abstract from Nephrology. - December 18, 2018

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Phosphate Binders Do Not Interfere with Nutrition - Article from Renal & Urology News. - December 17, 2018

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Association of Geriatric Nutritional Risk Index with Mortality in Hemodialysis Patients: A Meta-Analysis of Cohort Studies - Free, Full-Text, Online First Article from Kidney and Blood Pressure Research. - December 14, 2018

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Articles from Renal & Urology News - December 14, 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
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new Overview of the 2017 KDIGO CKD-MBD Update: Practice Implications for Adult Hemodialysis Patients from the Journal of Renal Nutrition: January 2019

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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