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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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Sodium Zirconium Cyclosilicate among Individuals with Hyperkalemia - Free, Full-Text CJASN Article. - June 2019
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Caffeine Consumption and Mortality in Chronic Kidney Disease: a Nationally Representative Analysis - Free, full-text article from NDT. - June 2019
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Poor Accordance to a DASH Dietary Pattern Is Associated with Higher Risk of ESRD among Adults with Moderate Chronic Kidney Disease and Hypertension - Free, Full-Text Article from Kidney International. - June 2019
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Risk of Hospitalization for Serious Adverse Gastrointestinal Events Associated With Sodium Polystyrene Sulfonate Use in Patients of Advanced Age - New Online abstract and editorial extract from JAMA Internal Medicine. - June 10, 2019
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Research Reveals How Diet Influences Diabetes Risk - Press release from American Society for Nutrition. - June 8, 2019
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D2d: Vitamin D Doesn't Stop Diabetes in Those With Prediabetes - Article from Medscape Nephrology (registration required). - June 7, 2019
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Sodium Zirconium Cyclosilicate among Individuals with Hyperkalemia - Published Ahead of Print CJASN abstract and related editorial extract. - June 7, 2019
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Red and White Meats Are Equally Bad for Cholesterol - Press release from UCSF. - June 4, 2019
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Micronutrient and Amino Acid Losses During Renal Replacement Therapy for Acute Kidney Injury - Free, full-text, Article in Press from Kidney International Reports. - June 3, 2019
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A Cigarette Tax Has Saved Millions of Lives. A Soda Tax Could Too - Op-ed from Los Angeles Times. - June 3, 2019
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Impact of Serum Albumin Levels on the Body Fluid Response to Tolvaptan in Chronic Kidney Disease Patients - First Online Abstract from International Urology And Nephrology. - June 3, 2019

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Hyperkalemia in Real-World Patients under Continuous Medical Care in Japan - Free, Full-Text, Articles in Press from Kidney International Reports. - May 29, 2019
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Energy Drinks Prolong QTc Interval, Elevate Blood Pressure - Article from HealthDay. - May 29, 2019
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More Evidence That Fasting Isn't Necessary Before Lipid Tests - News brief from NEJM Journal Watch. - May 29, 2019
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Protein C and Protein S Deficiencies May Be Related to Survival among Hemodialysis Patients - Free, Open Access Article from BMC Nephrology. - May 28, 2019
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2018 Cholesterol Clinical Practice Guidelines: Synopsis of the 2018 American Heart Association/American College of Cardiology/Multisociety Cholesterol Guideline - Free, full-text, Latest Article clinical guidelines from Annals of Internal Medicine. - May 28, 2019
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A Lower Serum Albumin Level Is Associated with an Increased Risk for Loss of Residual Kidney Function in Patients Receiving Peritoneal Dialysis - Accepted Article abstract from Therapeutic Apheresis and Dialysis. - May 24, 2019
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Management of Hyperkalemia in Patients with Kidney Disease: a Position Paper Endorsed by the Italian Society of Nephrology - Free, Open Access, First Online article from Journal of Nephrology. - May 22, 2019
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Association of Serum IL-18 with Protein Energy Wasting in End-Stage Renal Disease Patients on Hemodialysis -First Online abstract from International Urology and Nephrology. - May 22, 2019
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The Effect of Intradialytic Exercise Twice a Week on the Physical Capacity, Inflammation, and Nutritional Status of Dialysis Patients: A Randomized Controlled Trial - Early View abstract from Hemodialysis International. - May 17, 2019
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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
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). - 2013
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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 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
Eating Right with Kidney Failure 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.
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 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

  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

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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