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Last Updated 07/15/18
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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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Free, Full-Text Articles from NDT - July 2018

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Free, Full-Text Articles from Journal of Renal Nutrition - July 2018

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Efficiency and Nutritional Parameters in an Elderly High Risk Population on Hemodialysis and Hemodiafiltration in Italy and France: Different Treatments with Similar Names? - Free, Open Access article from BMC Nephrology. - July 9, 2018

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Obese HD Patients Need Less Erythropoietin to Treat Anemia - Article from Renal & Urology News. - July 6, 2018

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Diagnostic Usefulness of the Protein Energy Wasting Score in Prevalent Hemodialysis Patients - Article in Press abstract from Journal of Renal Nutrition. - July 5, 2018

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The Carbohydrate-Insulin Model of Obesity — Beyond "Calories In, Calories Out - Free, full-text, New Online special communication and editorial extract from JAMA Internal Medicine. - July 2, 2018

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Potential Policy Approaches to Address Diet-Related Diseases - Free, full-text, New Online viewpoint article from the Journal of the American Medical Association. - June 28, 2018

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Once-Weekly Hemodialysis Combined with Low-Protein and Low-Salt Dietary Treatment As a Favorable Therapeutic Modality for Selected Patients with End-Stage Renal Failure: a Prospective Observational Study in Japanese Patients - Free, Open Access Article from BMC Nephrology. - June 28, 2018

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Rx: Zucchini, Brown Rice, Turkey Soup. Medicaid Plan Offers Food As Medicine - Article/Summary from Kaiser Health News. - June 25, 2018

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Subjective Global Assessment-Dialysis Malnutrition Score and Cardiovascular Risk in Hemodialysis Patients: an Observational Cohort Study - First Online abstract from Journal of Nephrology. - June 23, 2018

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Serum Albumin, Inflammation, and Nutrition in End-Stage Renal Disease: C-Reactive Protein Is Needed for Optimal Assessment - Early View abstract from Seminars in Dialysis. - June 21, 2018

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Why Obese People Find It So Tough To Slim Down - June 20, 2018

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Obesity Plagues Rural America - Article from HealthDay. Press release from JAMA. - June 19, 2018

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Dietary Protein and Nutritional Supplements in Conventional Hemodialysis - Early View Abstract from Seminars In Dialysis. - June 17, 2018

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Food Based Dietary Patterns and Chronic Disease Prevention - Free, full-text article from The BMJ. - June 13, 2018

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Clinical Efficacy and Feasibility of Whey Protein Isolates Supplementation in Malnourished Peritoneal Dialysis Patients: a Multicenter, Parallel, Open Label Randomized Controlled Trial - Free, Open Access article from Clinical Nutrition ESPEN. - April 6, 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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