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Last Updated 08/12/18
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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.

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Validating the Use of Bioimpedance Spectroscopy for Assessment of Fluid Status in Children - Free, Open Access Article from Pediatric Nephrology. - September 2018

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Medical Nutrition Therapy Can Slow Progression of CKD, Reduce Health Care Costs - Article from Healio. - August 2018

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Sodium Reduction Programs May Only Be Appropriate for Communities with Very High Salt Intake - Press releases from The Lancet and McMaster University. - August 9, 2018

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Hypoalbuminemia: a Price Worth Paying for Improved Dialytic Removal of Middle-Molecular-Weight Uremic Toxins? - Advance Articles Abstract from NDT. - August 8, 2018

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Salt Intake and All-Cause Mortality in Hemodialysis Patients - OnlineFirst abstract from American Journal of Nephrology. - August 7, 2018

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Articles in Press Abstracts from Journal Of Renal Nutrition - August 7, 2018

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Bariatric Surgery for Diabetes May Halve the Risk for Microvascular Disease - News brief from NEJM Journal Watch. - August 7, 2018

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Improvement in Hyperphosphatemia Using Phosphate Education and Planning Talks - Article in Press abstract from Journal of Renal Nutrition. - August 6, 2018

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Too Many Kidney Disease Patients in the Dark About Diet - Article from HealthDay. - August 1, 2018

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Self-reported Intentional Weight Loss and Risk of Death in Moderate Chronic Kidney Disease in the United States - Article in Press abstract from Journal of Renal Nutrition. - August 1, 2018

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Only 10 Percent of Non-Dialysis Kidney Patients Ever See a Dietitian - Press release from Loyola University Health System. - August 1, 2018

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Sarcopenia and Frailty in PD: Impact on Mortality, Malnutrition, and Inflammation - PDI in Press Abstract. - July 31, 2018

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Articles from Healio - July 30, 2018

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Vitamin D Deficiency and Treatment Versus Risk of Infection in End-Stage Renal Disease Patients under Dialysis: a Systematic Review and Meta-Analysis - Advance Article Abstract from NDT. - July 27, 2018

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Alteration of HDL Protein Composition with Hemodialysis Initiation - CJASN Express abstract. - July 25, 2018

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Food Additives Causing Harm, Reforms Urgently Needed, American Academy of Pediatrics Says - Article from HealthDay. Policy statement from AAP. - July 23, 2018

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Albuminuria and Allograft Failure, Cardiovascular Disease Events, and All-Cause Death in Stable Kidney Transplant Recipients: A Cohort Analysis of the FAVORIT Trial - Articles in Press Abstract American Journal of Kidney Diseases. - July 20, 2018

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Association Between Interdialytic Weight Gain, Perception About Dry Weight, and Dietary and Fluid Behaviors Based on Body Mass Index Among Patients on Hemodialysis - Article in Press abstract from Journal of Renal Nutrition. - July 17, 2018

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Patients Receiving Dialysis Do Not Have Increased Energy Needs Compared with Healthy Adults - Early View abstract from Journal of Renal Care. - July 16, 2018

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Managing Protein-Energy Wasting in Hemodialysis Patients: a Comparison of Animal-and Plant-Based Protein Foods - Early View Abstract from Seminars in Dialysis. - July 15, 2018

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Wireless, Intraoral Hybrid Electronics for Real-Time Quantification of Sodium Intake toward Hypertension Management - Abstract from Proceedings of the National Academy of Sciences. - May 7, 2018

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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

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
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

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
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 - 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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