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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

Reduced Plasma Zinc Levels, Lipid Peroxidation, and Inflammation Biomarkers Levels in Hemodialysis Patients: Implications for Cardiovascular Mortality - Early Online abstract from Renal Failure. - June 2013

Fish Oil Supplements Don't Protect Against Heart Trouble: Study - Article from HealthDay.  - May 8, 2013

Nutritional and Metabolic Alterations during Continuous Renal Replacement Therapy - Free, full-text, Issue in Progress, in-depth review article from Blood Purification. - May 8, 2013

Impact of Low- or High-Flux Haemodialysis and Online Haemodiafiltration on Inflammatory Markers and Lipid Profile in Chronic Haemodialysis Patients - Issue in Progress Abstract from Blood Purification - May 2013

FDA Approves New Lipid Lowering Combination Tablet - May 6, 2013

Association of Frailty With Body Composition Among Patients on Hemodialysis - Article in Press abstract from Journal of Renal Nutrition. - May 6, 2013

CKD Risk Lower in Big Water Drinkers - May 2, 2013

Free, Full-Text Articles from Kidney International - May 2013
• Need to Quickly Excrete K+? Turn off NCC
• A Balanced View of Calcium and Phosphate Homeostasis in Chronic Kidney Disease
• Vitamin K: Key Vitamin in Controlling Vascular Calcification in Chronic Kidney Disease

Dyslipidemia Is Associated With Tunneled-Cuffed Catheter-Related Central Venous Thrombosis in Hemodialysis Patients: A Retrospective, Multicenter Study - Early View abstract from Artificial Organs. - May 2, 2013

Numerous Protein-Bound Solutes Are Cleared by the Kidney with High Efficiency - Advance Online Abstract from Kidney International - May 1, 2013

PDI in Press Abstracts - May 1, 2013
• Pre-Treatment of Dairy and Breastmilk with Sevelamer Hydrochloride and Sevelamer Carbonate to Reduce Phosphate
• Hyponatremia in Peritoneal Dialysis: Epidemiology and a Single Center in Correlation with Clinical and Biochemical Parameters

Safe Upper Limit of Vitamin D Identified for First Time - May 1, 2013

Physicians Less Empathetic in Communicating with Heavy Patients - May 1, 2013

Let Them Eat During Dialysis: An Overlooked Opportunity to Improve Outcomes in Maintenance Hemodialysis Patients - Free, full-text article from Journal of Renal Nutrition.  - May 2013

Articles in Press Abstracts from Journal of Renal Nutrition - April 29, 2013
• Influence of Psychosocial Factors on the Energy and Protein Intake of Older People on Dialysis
• Association of Serum Phosphorus Concentration With Mortality in Elderly and Nonelderly Hemodialysis Patients

Removing Salt Sachets from Ward Meal-Trays Does Not Affect Patients Nutritional Intake - Early View abstract from Journal of Renal Care. - April 29, 2013

Fighting Obesity Long-Term Will Save Money - Article from MedPage Today. - April 27, 2013

Articles in Press Abstracts from Journal of Renal Nutrition - April 26, 2013
• Is 3-Compartment Bioimpedance Spectroscopy Useful to Assess Body Composition in Renal Transplant Patients?
• Prealbumin is Associated With Visceral Fat Mass in Patients Receiving Hemodialysis

Soft Drinks Can Raise Diabetes Risk by 22 Percent - April 24, 2013

The Effect of Vitamin D Status on Risk Factors for Cardiovascular Disease - Advance Online abstract from Nature Reviews Nephrology. - April 23, 2013

Rise in Sodium Intake in US over Last Decade Despite Health Officials' Call for Reduction - Press release from FoodMinds LLC. - April 22, 2013

The Right Diet May Help Prevent Kidney Disease, New Study Finds - Press release from the National Kidney Foundation. - April 17, 2013

Hyperkalemia, Medical Management - Posting from the Precious Bodily Fluids blog.  - April 16, 2013

Endothelial Dysfunction, Inflammation and Malnutrition Markers As Predictors of Mortality in Dialysis Patients: Multimarker Approach - Online First Abstract from International Urology and Nephrology - April 2013

Clinical and Experimental Use of Probiotic Formulations for Management of End-Stage Renal Disease: an Update - Online First abstract from International Urology and Nephrology. - April 2013

Comparison of Bioimpedance and Dual-Energy X-Ray Absorptiometry for Measurement of Fat Mass in Hemodialysis Patients - Issue-in-Progress abstract from Nephron Clinical Practice. - March 2013
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  WEB RESOURCES
Latest Scientific Journal Articles on Nutrition
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

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
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: Nutrition Basics - Free, Full-text Article from Journal of Renal Nutrition - July 2011
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
Estimating Lean Body Mass in Hemodialysis Patients - Informative article from Renal and Urology News. - June 8, 2011
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

Kidney Diet Info at Your Fingertips - KidneyTalk podcast from Renal Support Network.
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
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)
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
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
Brilliant Eats Cookbook from PKD Foundation web site
Chinese Nutrition Educational Materials for Renal Patients: A 2010 Update - Free, full-text article from Journal of Renal Nutrition. - March 2011
Culinary Kidney Cooks web site
DaVita Diet Helper from the DaVita web site
Delicious! - AAKP recipe cookbook
Dialysis Dining on the "Go" - New publication for sale covering fast foods, casual dining, and convenience foods.
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
Kidney Kitchen from the National Kidney Foundation web site
MagicKitchen.com - offers frozen meals for Renal Diet

Mom's Meals - home meal delivery for many with stage 5 kidney disease
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
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
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
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

Delicious! - AAKP recipe cookbook
Kidney Friendly Recipes from the American Association of Kidney Patients (AAKP) web site

List of Cookbooks for Kidney Patients from the National Kidney Foundation web site
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).

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 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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