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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
FDA Issues Warning on Weight Loss Supplement Que She - Article from Health News. - July 8, 2010
Alterations in appetite-regulating hormones influence protein–energy wasting in pediatric patients with chronic kidney disease - Article from Pediatric Nephrology. - July 7, 2010
Fast food 'fuelling Asia diabetes boom' - Article from BBC. - July 7, 2010
The Redox State of Albumin and Serious Cardiovascular Incidence in Hemodialysis Patients - Early View abstract from Therapeutic Apheresis and Dialysis. - July 6, 2010
Lanthanum Carbonate Provides Control of Phosphorus Levels in Patients New to Phosphate Binder Therapy and Patients Changed From Other Phosphate Binders - Abstract from the Journal of Renal Nutrition. - July 5, 2010
Predictors of Incident Albuminuria in the Framingham Offspring Cohort - Article in press from AJKD. - July 5, 2010
The Effects of Vitamin D Therapy on Left Ventricular Structure and Function – Are These the Underlying Explanations for Improved CKD Patient Survival - Free, full-text, Issue-in-Progress article from Nephron Clinical Practice. Also see this story from the Endocrine Society: - July 2, 2010
Low vitamin D linked to the metabolic syndrome in elderly people
Association of Cystatin C and Depression in Healthy Elders: The Health, Aging and Body Composition Study - Issue-in-Progress abstract from Nephron Clinical Practice. - July 2, 2010
Study: High-Fructose Diets May Raise Blood Pressure - Article from WebMD. - July 1, 2010
Independent and Joint Associations of Nutritional Status Indicators With Mortality Risk Among Chronic Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) - Article from the Journal of Renal Nutrition. - July 2010
Protein Powder and Protein Liquid Supplements Pricing and Ordering Information - Article from the Journal of Renal Nutrition. - July 2010
New Evidence for the Phosphorus-Lowering Effects of Niacin - Free full-text letter to the editor from AJKD. - July 2010
Malnutrition-Inflammation Score Independently Determined Cardiovascular and Infection Risk in Peritoneal Dialysis Patients - Issue-in-Progress abstract from Blood Purification. - July 2010
Toxic Fluid Flux? - Free full-text editorial from AJKD. - July 2010
ADA: Meaty Diets May Increase Men's Diabetes Risk - Article from Medpage Today. - June 30, 2010
Dietary Potassium Intake and Mortality in Long-term Hemodialysis Patients - Article in Press abstract from the American Journal of Kidney Diseases. - June 28, 2010
Trimethoprim-Sulfamethoxazole–Induced Hyperkalemia in Patients Receiving Inhibitors of the Renin-Angiotensin System - Article from the Archives of Internal Medicine. - June 28, 2010
Dark chocolate lowers blood pressure - Article from Biomed Central. - June 28, 2010
Relationship Between Body Mass Index and Mortality in Adults on Maintenance Hemodialysis: A Systematic Review - Article from the Journal of Renal Nutrition - June 28, 2010
The Effect of Resistance Exercise to Augment Long-term Benefits of Intradialytic Oral Nutritional Supplementation in Chronic Hemodialysis Patients - Article from the Journal of Renal Nutrition - June 28, 2010
New Type of Diabetes Drug Drops Weight With Blood Sugar - Article from WebMD - June 25, 2010
Improving Volume Status by Comprehensive Dietary and Dialytic Sodium Management in Chronic Hemodialysis Patients - Article from Blood Purification. - June 25, 2010
Health Care Reform in Action — Calorie Labeling Goes National - Article from The New England Journal of Medicine. - June 24, 2010
Transparency at the Food and Drug Administration - Article from The New England Journal of Medicine. - June 24, 2010
90% in U.S. Get Too Much Sodium; 5 Foods Blamed - Article from WebMD. - June 24, 2010
Protein Nutrition Index as a Function of Patient Survival Rate in Peritoneal Dialysis - Issue-in-Progress abstract from Kidney and Blood Pressure Research. - June 23, 2010
Study Examines Outcomes of Lowering Homocysteine Levels with Folic Acid and Vitamin B12 - Press release and abstract from the Journal of the American Medical Association. - June 22, 2010
Vegetarian supplemented low-protein diets. A safe option for pregnant CKD patients: report of 12 pregnancies in 11 patients - Article from NDT. - June 22, 2010
Vitamin D deficiency and toxicity in chronic kidney disease: in search of the therapeutic window - Article from Pediatric Nephrology. - June 21, 2010
Low Vitamin D Linked to Poor Diabetes Control - Article from WebMD. - June 21, 2010
Metabolic Syndrome In Living Kidney Donors Worsens Function Of Remaining Kidney - Press release from the e Endocrine Society. - June 20, 2010
No salt, no hypertension - Blog article from the Renal Fellow Network. - June 19, 2010
Vitamin D supplementation and recombinant human erythropoietin utilization in vitamin D-deficient hemodialysis patients - Article from Journal of Nephrology. - June 16, 2010
Dietary Phosphorus Restriction in Advanced Chronic Kidney Disease: Merits, Challenges, and Emerging Strategies - Article from Seminars in Dialysis. - June 14, 2010
Epidemiology of Dietary Nutrient Intake in ESRD - Article from Seminars in Dialysis. - June 14, 2010
Trace Element Status in Hemodialysis Patients - Article from Seminars in Dialysis. - June 14, 2010
Brown Rice over White to Cut Diabetes Risk - Article from Medpage Today. - June 14, 2010
Omega-3 Fatty Acids May Beneft Dialysis Patients - Article from Renal & Urology News. - June 10, 2010
Overview Guide for Dietitians: Treating CKD Patients Who Are Not on Dialysis - Resource page from the National Kidney Disease Education Program. - June 2010
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  WEB RESOURCES
Latest Scientific Journal Articles on Nutrition - list compiled by RenalWEB's Journal Watch
Table of Contents of the latest issue of the Journal of Renal Nutrition with abstracts
American Society for Parenteral and Enternal Nutrition web site
The American College of Nutrition web site
American Dietetic Association web site
Council on Renal Nutrition of The National Kidney Foundation web site
Cause or Casualty? The Impact and Role of the Kidney on Inflammation, Metabolic Syndrome and Atherogenesis (pdf) free CE program from the National Kidney Foundation (NKF) web site
Chronic Kidney Disease: Preventing and Treating Malnutrition (pdf) article from the National Kidney Foundation web site
Eating Healthy From the Start: Kid and Kidney-Friendly Nutrition Tips (pdf) resource from the ESRD Network #15 web site
GETTING TO GOAL: A Multidisciplinary Approach to Phosphorus Management (pdf) from the National Kidney Foundation web site
Guidelines for Care of ESRD Patients (pdf format requires Adobe Acrobat Reader) - from the End Stage Renal Disease Network 4 web site
Net Nutrition A-Z - Practical Web-Based Tools for Renal Clinicians to Improve Nutrition Outcomes from Satellite Healthcare (includes tools for assessments, calculations, and modeling)
Nutrition Counter from the American Association of Kidney Patients (AAKP) web site
Online Clinical Calculator for Body Surface Area/Body Mass Index from Division of General Internal Medicine, Medical College of Wisconsin web site
Practical Approaches to a Complex Science: Effective Management of the Metabolic Syndrome in the CKD Patient with Diabetes - webcast from the National Kidney Foundation (NKF)
Renal Dietitians Practice Group from the American Dietetic Association web site
Renal Nutrition Resources from NKF - Council on Renal Nutrition
Revised European Best Practice Guidelines for Hemodialysis - Nutrition Part I (pdf) and Revised European Best Practice Guidelines for Hemodialysis - Nutrition Part 2 (pdf) - guidelines endorsed by the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)
A Team Approach to Managing Bone Disease in CKD Stage 5 (pdf) from the National Kidney Foundation web site
30 Ways to Eat More Protein! (pdf) one month menu calendar from the ESRD Network #15 web site
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 RENAL DIET RESOURCES
AAKP Diet Tips and Bits from the American Association of Kidney Patients (AAKP) web site
aakpDelicious! from the American Association of Kidney Patients (AAKP) web site
Assessing “Low-Carb” Products from the Journal of Renal Nutrition
Brilliant Eats Cookbook from PKD Foundation web site
Culinary Kidney Cooks web site
DaVita Diet Helper from the DaVita web site
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
Fast Food, Phosphorus Containing Food Additives, and the Renal Diet from Case Wesstern Reserve University
Kidney Kitchen 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) - June 2010
Phosphorus Education Materials for Patients and Professionals resources from Case Western Reserve University
Phosphorous: What is it and Why is it Important? from KidneyTimes™
Recipes for Living Well from the American Kidney Fund web site
So Just What Can I Eat? Nutritional Care in Patients with Diabetes Mellitus and Chronic Kidney Disease - Continuing education article from the American Nephrology Nurses Association. - September/October 2009
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 Global Gourmet web site
Food and Nutrition Topics from A to Z compiled by the Food and Nutrition Information Center ARS/USDA. WARNING: This is NOT information specific to Renal Diets, but about nutrition topics in general. Do not confuse the general public nutritional guidelines found through this link with renal patient nutritional guidelines.


  PUBMED SEARCHES (National Library of Medicine's MEDLINE Database)
dialysis and diet articles   Continually Updated!
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 from the National Kidney Foundation (NKF) web site
Clinical Practice Guidelines for Nutrition in Children with CKD - 2008 Update (pdf format requires Adobe Acrobat reader)  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
Living Well on Dialysis:A Cookbook for Patients and Their Families (pdf) from the National Kidney Foundation web site
The Renal Gourmet a cook book by a kidney patient
Cooking for David: A Culinary Dialysis Cookbook by Sara Colman, RD, CDE, Renal Dietitian,
Nutrition Educator & Dorothy Gordon, BS, RN, experienced culinary dialysis diet cook - from Culinary Kidney Cooks
Cleveland Clinic Foundation Renal Diet Cookbooks
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
Kidney Helpers (Food Guides and Cookbook) from the Consumer MedHelp web site
Rediscovering Food & Flavours - The KidneyCare Cookbook by Lawrence Keogh (chef and transplant patient)
(The) Renal Family Cookbook from the MultiMed web site

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).

Cookbooks for Renal Patients from the National Kidney Foundation web site
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  UPCOMING EVENTS
Listing of local ESRD Network Annual Meetings
Listing of NKF Local Council Professional Education Meetings and Activities
Listing of American Dietetic Association 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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