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Last Updated 10/22/17
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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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An Increasingly Complex Relationship Between Salt and Water - Free, Full-Text Article from American Journal Of Kidney Diseases. - November 2017

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Dietary Magnesium Supplementation Prevents and Reverses Vascular and Soft Tissue Calcifications in Uremic Rats - Free, Full-Text Article from Kidney International. - November 2017

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Metabolic Effects of Diet and Exercise in Patients with Moderate to Severe CKD: A Randomized Clinical Trial - JASN Express abstract. - October 16, 2017

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Low Serum Calcium Linked to Sudden Cardiac Arrest Risk - (Registration required, but free.) Article from Medscape Nephrology. - October 13, 2017

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Chronic Kidney Disease Stage Affects Small, Dense Low-Density Lipoprotein but Not Glycated Low-Density Lipoprotein in Younger Chronic Kidney Disease Patients: a Cross-Sectional Study - Free, Full-Text, Advance Articles from Clinical Kidney Journal. - October 12, 2017

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The Meat And Potatoes of Potassium - Latest News article from the National Kidney Foundation. - October 2017

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Patiromer Lowers Serum Potassium When Taken without Food: Comparison to Dosing with Food from an Open-Label, Randomized, Parallel Group Hyperkalemia Study - Free, Open Access, Issue-in-Progress article from American Journal of Nephrology. - October 11, 2017

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Potassium Homeostasis in Health and Disease: A Scientific Workshop Cosponsored by the National Kidney Foundation and the American Society of Hypertension - Article in Press from American Journal of Kidney Diseases. - October 10, 2017

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Childhood Obesity Up Worldwide Almost 10-Fold over 4 Decades - Article from HealthDay. - October 10, 2017

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#RenalDietChallenge: How Much Phosphorus Is In This Meal? - Posting from the AJKD blog. - October 9, 2017

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Eat Right–Live Well! Supermarket Intervention Impact on Sales of Healthy Foods and Behavioral Impact Framework to Reduce Population Salt Consumption – JNEB's Best Article and GEM - Press release from the Society for Nutrition Education and Behavior.  - October 9, 2017
Articles cited:

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Low Serum Calcium May Increase Risk of Sudden Cardiac Arrest - October 5, 2017

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Gut Bacteria Metabolism May Factor into Hypertension - October 3, 2017

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Effect of Restricted Protein Diet Supplemented with Keto Analogues in End-Stage Renal Disease: a Systematic Review and Meta-Analysis - First Online abstract from International Urology and Nephrology. - October 3, 2017

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Obesity Linked to 13 Types of Cancer - Article from HealthDay. Free, full-text, New Online viewpoint article from the Journal of the American Medical Association. - October 3, 2017

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Treatment of Severe Hyperkalemia: Confronting Four Fallacies - 26-page pdf - Open Access PDF Articles in Press from Kidney International Reports. - October 2, 2017

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Overhydration, Underhydration, and Total Body Sodium: a Tricky "Ménage a Trois" in Dialysis Patients - Early View abstract from Seminars in Dialysis. - October 1, 2017

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Still a Reasonable Goal: Targeting Cholesterol in Dialysis and Advanced Chronic Kidney Disease Patients - Free, Full-Text Editorial from Seminars In Dialysis. - September/October 2017

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Free, Full-Text Articles from Advances in Chronic Kidney Disease - September 2017

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Are SGL2 Inhibitors Ready for Prime Time for CKD? - Free, Full-Text, CJASN Express Article. - September 2017

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Early Continuous Renal Replacement Therapy Improves Nutrition Delivery in Neonates During Extracorporeal Life Support - Article in Press abstract from Journal of Renal Nutrition. - September 27, 2017

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Want to Fix America's Health Care? We Need to Focus on Food - Posting from the KevinMD blog. - September 27, 2017

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Health Beliefs About Salt Intake Low Among Dialysis Patients - Article from Renal & Urology News. - September 26, 2017

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New Survey of People with Chronic Kidney Disease Finds High Potassium Is Among Top Health Concerns - NKF press release. - September 26, 2017

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Weight Loss for Adults at Any Age Leads to Cost Savings, Study Suggests - September 26, 2017

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Diet Quality in Patients with End-Stage Kidney Disease Undergoing Dialysis - Early View abstract from Journal of Renal Care. - September 24, 2017

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Vitamin D and Osteoporosis in Chronic Kidney Disease - Free, Open Access, First Online Article from Journal of Nephrology. - September 23, 2017

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Hyperkalemia Linked to Poor Outcomes in Diabetes Patients - (Registration required, but free.) Article from Medscape Nephrology. - September 22, 2017

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Body Composition and Inflammation in Hemodialysis Patients - Early View abstract from Therapeutic Apheresis and Dialysis. - September 22, 2017

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Dynamics of Nutritional Competence in the Last Year Before Death in a Large Cohort of US Hemodialysis Patients - Article in Press abstract from Journal of Renal Nutrition. - September 21, 2017

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Obesity Rates Have Stopped Rising for Young Americans - September 19, 2017

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The Misuse of Meta-analysis in Nutrition Research - Free, full-text, New Online viewpoint article from the Journal of the American Medical Association. - September 18, 2017

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Nutrition in Renal Supportive Care: Patient Driven and Flexible - Free, full-text review article from Nephrology. - September 17, 2017

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Comparison of a Handheld Indirect Calorimetry Device and Predictive Energy Equations Among Individuals on Maintenance Hemodialysis - Article in Press abstract from Journal of Renal Nutrition. - September 16, 2017

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Validity and Reproducibility of a Short Food Frequency Questionnaire among Patients with Chronic Kidney Disease - Free, Open Access article from BMC Nephrology. - September 15, 2017

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Nutritional Considerations for Older Patients on Dialysis - (Registration required, but free.) Article from NDT via Medscape Nephrology. - September 15, 2017

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Sodium (Salt) Intake Is Associated with a Risk of Developing Type 2 Diabetes - Press release from Diabetologia. Article from HealthDay. - September 14, 2017

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Press release from DIABETOLOGIA - September 13, 2017

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Risk of Heart Disease in Urban 'Food Deserts' Is Associated with Individual's Income Rather Than Access to Healthy Food - Press release from the American Heart Association. - September 13, 2017

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Laparoscopic Sleeve Gastrectomy Improves Renal Transplant Candidacy and Posttransplant Outcomes in Morbidly Obese Patients - Early View Abstract from American Journal of Transplantation. - September 12, 2017

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Randomized, Controlled Trial of the Effect of Dietary Potassium Restriction on Nerve Function in CKD - CJASN Express abstract. - September 11, 2017

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Even Small Weight Gain Increases Heart Failure - Article from Renal & Urology News. - September 11, 2017

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An Increasingly Complex Relationship Between Salt and Water - Free, full-text, Article in Press from American Journal of Kidney Diseases. - September 9, 2017

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Mediterranean Diet As the Diet of Choice in CKD Patients - Posting from the European Nephrology Portal. - August 31, 2017

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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
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American Association of Kidney Patients (AAKP) Nutrition App

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

blue ball NIDDK Publications On-line from the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)
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Nutrition Information for Hemodialysis Nurses - 3-page pdf from the EDTNA/ERCA website (Europe).

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

Kidney-Friendly Frozen Meal Tips and Suggestions “In A Pinch” full-text article from Journal of Renal Nutrition - September 2012
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)
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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