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Recommended dietary intake for chronic kidney and end-stage renal disease patients*

Recommended dietary intake for chronic kidney and end-stage renal disease patients*
  Chronic kidney disease Maintenance hemodialysis
Protein 0.8 to 1.0 g/kg/dayΔ of high biological value protein >1.2 to 1.3 g/kg/day
Energy ≥35 kcal/kg/day; if the body weight is greater than 120 percent of normal or the patient is greater than 60 years of age a lower amount may be prescribed
Fat, percent of total energy intake 30 to 40 30 to 40
Polyunsaturated-to-saturated ratio (fatty acid ratio) 1.0:1.0 1.0:1.0
Carbohydrate Balance of nonprotein calories
Total fiber, g/day 20 to 25 20 to 25
Minerals, range of intake
Sodium, mg/day <2000 <2000
Potassium, meq/day 40 to 70 40 to 70
Phosphorus, mg/day 600 to 800 600 to 800
Calcium, mg/day 1400 to 1600 1400 to 1600
Magnesium, mg/day 200 to 300 200 to 300
Iron, mg/day ≥10 to 18§ ≥10 to 18§
Zinc, mg/day 15 15
Water, mL/day Up to 3000 as tolerated Usually 750 to 1500
* The nutritional intake is adjusted based upon individual needs. This is particularly important for the carbohydrate, lipid, and mineral contents of the diet.
¶ GFR <70 mL/min/1.73 m2 with evidence for progression.
Δ Some recommend 0.56 to 0.75 g/kg/day, with 0.35 g/kg/day of high biological value protein. The protein intake is increased by 1 g/day of high biological value protein for each gram per day of urinary protein loss. This is performed under close supervision and dietary counseling.
Phosphate binders often are also needed to maintain normal serum phosphorus levels.
§ 10 mg/day for males and nonmenstruating females, 18 mg/day for menstruating females.
Data from:
  1. Ahmed K, Kopple J. Nutritional management of renal disease. In: Primer on Kidney Diseases, Greenberg A (Ed). Academic Press, San Diego, CA, 1994, p.289.
  2. Ikizler IA. Nutrition and kidney disease. In: Primer on Kidney Diseases, Greenberg A (Ed). Elsevier, Philadelphia, 2005, p.496.
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