Consultant Dietitian/President -Nutrition Care Systems, Inc

I am researching appropriate dietary guidelines for people on daily or in-house dialysis treatments. Our dietitians work with many nursing facilities that have in-house dialysis programs. There continues much debate and controversy between dialysis companies and dialysis dietitians as to what is the standard for nutrition intervention for residents/patients in these programs.

The recommendations vary from very strict to very liberal.

Can you discuss the current guidelines from your standpoint, recent research and articles, references?

Thank you.

Hello and thank you for your comment. You are correct that there does seem to be a wide spectrum of practices (from liberal to strict) on how the renal diet is prescribed. Also, opinions about what to eat, limit and avoid vary widely among dietitians, nurses, and physicians - even among members of the same medical team. The National Kidney Foundation KDOQI Guidelines (available at on Nutrition in Chronic Renal Failure provide us with valuable standardized information to use to make dietary recommendations and to provide nutrition care to patients. However, considering the science available to us, many kidney health care providers must use their own professional judgment when forming opinions and recommendations about food. Renal dietitians are highly trained and experienced in customizing renal diets for their patients based on individual factors. This means that patients on dialysis following a renal diet may be counseled to eat differently. For example, while one patient may be told to eat more protein including dairy products another patient may be told to limit or avoid dairy products. It is important that patients on dialysis receive dietary recommendations that are not general, but specifically customized to their current nutritional status, which is reassessed on an ongoing basis. Patients on daily, home, or nocturnal dialysis regimens tend to have more liberal diets than patients on traditional chronic in-center treatment due to improved adequacy of dialysis that comes with increasing frequency and duration of treatments. I hope this helps answer your questions.

Well I can’t contribute in this but I really appreciate your efforts.A healthcare organization to delivering consultation for nutrition .All the best.