Dietary Restrictions in Dialysis Patients

Is There Anything Left to Eat?

Kamyar Kalantar-Zadeh, Amanda R. Tortorici, Joline L.T. Chen, Mohammad Kamgar, Wei Ling Lau, Hamid Moradi, Connie M. Rhee, Elani Streja, Csaba Kovesdy

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

A significant number of dietary restrictions are imposed traditionally and uniformly on maintenance dialysis patients, whereas there is very little data to support their benefits. Recent studies indicate that dietary restrictions of phosphorus may lead to worse survival and poorer nutritional status. Restricting dietary potassium may deprive dialysis patients of heart-healthy diets and lead to intake of more atherogenic diets. There is little data about the survival benefits of dietary sodium restriction, and limiting fluid intake may inherently lead to lower protein and calorie consumption, when in fact dialysis patients often need higher protein intake to prevent and correct protein-energy wasting. Restricting dietary carbohydrates in diabetic dialysis patients may not be beneficial in those with burnt-out diabetes. Dietary fat including omega-3 fatty acids may be important caloric sources and should not be restricted. Data to justify other dietary restrictions related to calcium, vitamins, and trace elements are scarce and often contradictory. The restriction of eating during hemodialysis treatment is likely another incorrect practice that may worsen hemodialysis induced hypoglycemia and nutritional derangements. We suggest careful relaxation of most dietary restrictions and adoption of a more balanced and individualized approach, thereby easing some of these overzealous restrictions that have not been proven to offer major advantages to patients and their outcomes and which may in fact worsen patients' quality of life and satisfaction. This manuscript critically reviews the current paradigms and practices of recommended dietary regimens in dialysis patients including those related to dietary protein, carbohydrate, fat, phosphorus, potassium, sodium, and calcium, and discusses the feasibility and implications of adherence to ardent dietary restrictions and future research.

Original languageEnglish (US)
Pages (from-to)159-168
Number of pages10
JournalSeminars in Dialysis
Volume28
Issue number2
DOIs
StatePublished - Mar 1 2015

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Dialysis
Dietary Carbohydrates
Renal Dialysis
Dietary Potassium
Dietary Phosphorus
Atherogenic Diet
Calcium
Dietary Sodium
Proteins
Survival
Dietary Proteins
Dietary Fats
Omega-3 Fatty Acids
Trace Elements
Nutritional Status
Hypoglycemia
Vitamins
Phosphorus
Potassium
Eating

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Kalantar-Zadeh, K., Tortorici, A. R., Chen, J. L. T., Kamgar, M., Lau, W. L., Moradi, H., ... Kovesdy, C. (2015). Dietary Restrictions in Dialysis Patients: Is There Anything Left to Eat? Seminars in Dialysis, 28(2), 159-168. https://doi.org/10.1111/sdi.12348

Dietary Restrictions in Dialysis Patients : Is There Anything Left to Eat? / Kalantar-Zadeh, Kamyar; Tortorici, Amanda R.; Chen, Joline L.T.; Kamgar, Mohammad; Lau, Wei Ling; Moradi, Hamid; Rhee, Connie M.; Streja, Elani; Kovesdy, Csaba.

In: Seminars in Dialysis, Vol. 28, No. 2, 01.03.2015, p. 159-168.

Research output: Contribution to journalArticle

Kalantar-Zadeh, K, Tortorici, AR, Chen, JLT, Kamgar, M, Lau, WL, Moradi, H, Rhee, CM, Streja, E & Kovesdy, C 2015, 'Dietary Restrictions in Dialysis Patients: Is There Anything Left to Eat?', Seminars in Dialysis, vol. 28, no. 2, pp. 159-168. https://doi.org/10.1111/sdi.12348
Kalantar-Zadeh K, Tortorici AR, Chen JLT, Kamgar M, Lau WL, Moradi H et al. Dietary Restrictions in Dialysis Patients: Is There Anything Left to Eat? Seminars in Dialysis. 2015 Mar 1;28(2):159-168. https://doi.org/10.1111/sdi.12348
Kalantar-Zadeh, Kamyar ; Tortorici, Amanda R. ; Chen, Joline L.T. ; Kamgar, Mohammad ; Lau, Wei Ling ; Moradi, Hamid ; Rhee, Connie M. ; Streja, Elani ; Kovesdy, Csaba. / Dietary Restrictions in Dialysis Patients : Is There Anything Left to Eat?. In: Seminars in Dialysis. 2015 ; Vol. 28, No. 2. pp. 159-168.
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