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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 - May 2019

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No 'One-Size-Fits-All' Diet for Diabetics, Expert Panel Says - Article from HealthDay. - April 18, 2019

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Novel Obesity Tx OK'd; Sugar Labels to Prevent Diabetes — News and Commentary from the Endocrinology World - (Registration required, but free.) Article from MedPage Today. - April 18, 2019

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Cardiovascular Benefits of a Diet Enriched in Fruits and Vegetables - Free, full-text, Online First editorial and related abstract from American Journal of Nephrology. - April 17, 2019

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Best Dietary Practices for Patients with CKD - Article from Healio. - April 17, 2019

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Added Sugar Labeling Could Reduce CVD, Diabetes Cases - Article from HealthDay. - April 15, 2019

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Clinical Taste Perception Test for Patients With End-Stage Kidney Disease on Dialysis - Article in Press abstract from Journal of Renal Nutrition. - April 9, 2019

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Epicardial Fat, Cardiovascular Risk Factors and Calcifications in Patients with Chronic Kidney Disease - Free, full-text, Advance Article from Clinical Kidney Journal. - April 8, 2019

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FLAVIS and the NKF Team-Up to Promote Kidney Health Through Diet - Press release from the National Kidney Foundation. - April 8, 2019

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Association between BMI Changes and Mortality Risk in Children with End-Stage Renal Disease - First Online abstract from Pediatric Nephrology. - April 8, 2019

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Dietary Supplements Do Nothing for You: Study - Article from HealthDay. - April 8, 2019

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Too Much of a Good Thing? High Doses of Vitamin D Can Lead to Kidney Failure - Press release from the Canadian Medical Association Journal. - April 8, 2019

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Impact of Salt Taste Dysfunction on Interdialytic Weight Gain for Hemodialysis Patients; a Cross-Sectional Study - Free, Open Access article from BMC Nephrology. - April 5, 2019

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Articles in Press Abstracts from Journal of Renal Nutrition - March 17 - April 4, 2019

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Online First Abstracts from Blood Purification - April 3, 2019

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Effect of Progression in Malnutrition and Inflammatory Conditions on Adverse Events and Mortality in Patients on Maintenance Hemodialysis - Online First abstract from Blood Purification. - April 3, 2019

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Results from the Randomized Controlled IHOPE Trial Suggest No Effects of Oral Protein Supplementation and Exercise Training on Physical Function in Hemodialysis Patients - Articles in Press Abstract from Kidney International. - April 2, 2019

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Obesity As a Barrier to Kidney Transplantation: Time to Eliminate the Body Weight Bias? - Early View abstract from Seminars in Dialysis. - April 2, 2019

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Gout Treatment May Help Prevent Obesity-Related Type 2 Diabetes, Suggests Small NIH Study - Media advisory from the National Institutes of Health. - April 2, 2019

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Probiotics Are Touted As Good for the Gut. They May Be Trouble for the Immune System - Article from STAT. - April 2, 2019

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Coffee on Your Mind? Even Thinking About It 'Arouses' the Brain - April 1, 2019

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A Bottle of Wine Has the Cancer-Causing Potential of 510 Cigarettes - News brief from NEJM Journal Watch. - March 28, 2019

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Major Medical Groups Call for Soda Taxes - Article from HealthDay. - March 25, 2019

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Dietary Fiber Intake, Myocardial Injury and Major Adverse Cardiovascular Events among End-Stage Kidney Disease Patients: A Prospective Cohort Study - Free, Full-Text, Articles in Press from Kidney International Reports. - March 20, 2019

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Prescribing Healthy Food in Medicare/Medicaid Is Cost Effective, Could Improve Health - Press release from Tufts University. - March 19, 2019

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Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults - Ahead of Print abstract and full-text article (13-page pdf) from Circulation. - March 18, 2019

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Assessment of Nutritional Status in the Maintenance of Hemodialysis Patients: a Cross-Sectional Study from Palestine - Free, Open Access article from BMC Nephrology. - March 15, 2019

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The Effect of a Hemodialysis Patient Education Program on Fluid Control and Dietary Compliance - Early View Abstract from Hemodialysis International. - March 12, 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

new Nutrition Care for Your Kidney Transplant - owner's manual from Journal of Renal Nutrition

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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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