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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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Free, Full-Text Articles from Journal Of Renal Nutrition - March 2019

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Geriatric Nutritional Risk Index Is Predictive of Subjective Global Assessment and Dialysis Malnutrition Scores in Elderly Patients on Hemodialysis - Article in Press abstract from Journal of Renal Nutrition. - March 7, 2019

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Articles in Press Abstracts from Journal Of Renal Nutrition - March 6, 2019

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Effects of Excessive Body Fat Accumulation on Long-Term Outcomes during Peritoneal Dialysis - PDI in Press Abstract. - March 6, 2019

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Feeding Modality Is a Barrier to Adequate Protein Provision in Children Receiving Continuous Renal Replacement Therapy (CRRT) - First Online Abstract from Pediatric Nephrology. - March 6, 2019

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Sodium and Potassium Dietary Reference Intake Values Updated in New Report; Introduces New Category for Sodium Based on Chronic Disease Risk Reduction - Press release from the National Academies of Sciences, Engineering and Medicine. - March 5, 2019

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Nutritional Supplements Cannot Prevent Depression, Research Shows - Press release from the University of Exeter. Abstract from the Journal of the American Medical Association. - March 5, 2019

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Revamping the 'Renal' Diet: Using Foods to Control Phosphorus Physiology - Free, Full-Text, Advance Articles from NDT. - February 25, 2019

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Association of Lean Body Mass Index and Peritoneal Protein Clearance in Peritoneal Dialysis Patients - Free, Open Access, Online First Article from Kidney & Blood Pressure Research. - February 22, 2019

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The Effects of OMEGA-3 Fatty Acid Supplementation Upon Interleukin-12 and Interleukin-18 in Chronic Kidney Disease Patients - Article in Press abstract from Journal of Renal Nutrition. - February 22, 2019

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High Dietary Intake of Vegetable Protein is Associated with Lower Prevalence of Renal Function Impairment: Results of the Dutch DIALECT-1 Cohort - Free, Open Access, Article in Press from Kidney International Reports. - February 21, 2019

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Relationship between Serum Vitamin D Levels and Health-Related Quality of Life in Maintenance Hemodialysis Patients - Online First abstract from Blood Purification. - February 21, 2019

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Being Overweight in Adolescence May Increase Kidney Cancer Risk Later in Life - Press release from International Journal of Cancer. - February 21, 2019

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Addressing Medicine's Bias Against Patients Who Are Overweight - Free, full-text, New Online perspective piece from the Journal of the American Medical Association. - February 20, 2019

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Vitamin D Deficiency and Treatment Versus Risk of Infection in End-Stage Renal Disease Patients Under Dialysis — A Systematic Review and Meta-analysis - Registration required, but free.) Free, full-text article from NDT via Medscape Nephrology. - February 20, 2019

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A Possible Link between Polyunsaturated Fatty Acids and Uremic Toxins from the Gut Microbiota in Hemodialysis Patients: A Hypothesis - Early View abstract from Hemodialysis International. - February 19, 2019

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Oral Nutritional Supplements and 30-Day Readmission Rate in Hypoalbuminemic Maintenance Hemodialysis Patients - Early View Abstract from Hemodialysis International. - February 14, 2019

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Development and Preliminary Results on the Feasibility of a Renal Diet Specific Question Prompt Sheet for Use in Nephrology Clinics - Free, Open Access article from BMC Nephrology. - February 12, 2019

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FDA To Target Products That Claim To Cure Serious Disease As It Beefs Up Oversight Of Sprawling Supplement Industry - News summary from Kaiser Health News. - February 12, 2019

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Vitamin D Supplementation for the Improvement of Vascular Function in Patients with Chronic Kidney Disease: a Meta-Analysis of Randomized Controlled Trials - First Online Abstract from International Urology And Nephrology. - February 8, 2019

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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
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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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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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. - 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

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

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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