Dietary restrictions in dialysis patients: is there anything left to eat? (bibtex)
by Kamyar Kalantar-Zadeh, Amanda R Tortorici, Joline L T Chen, Mohammad Kamgar, Wei-Ling Lau, Hamid Moradi, Connie M Rhee, Elani Streja and Csaba P Kovesdy
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.
Reference:
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 and Csaba P Kovesdy), In Semin Dial, volume 28, 2015.
Bibtex Entry:
@article{Kalantar-Zadeh:2015aa,
	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.},
	address = {Division of Nephrology and Hypertension, Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, Orange, California; Long Beach Veterans Affairs Healthcare System, Long Beach, California; Department of Epidemiology, UCLA Fielding School of Public Health, University of California Los Angeles, Los Angeles, California; Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, California.},
	author = {Kalantar-Zadeh, Kamyar and Tortorici, Amanda R and Chen, Joline L T and Kamgar, Mohammad and Lau, Wei-Ling and Moradi, Hamid and Rhee, Connie M and Streja, Elani and Kovesdy, Csaba P},
	cois = {Potential Conflicts of Interest: KKZ has received honoraria from Abbott, Abbvie, Fresenius, Keryx, Shire, Vifor, and other manufacturers of phosphorus binders, nutritional supplements, or medications and items related to dialysis patients.},
	copyright = {{\copyright}2015 Wiley Periodicals, Inc.},
	crdt = {2015/02/05 06:00},
	date = {2015 Mar-Apr},
	date-added = {2023-07-16 20:05:16 +0100},
	date-modified = {2023-07-16 20:06:31 +0100},
	dcom = {20151208},
	dep = {20150203},
	doi = {10.1111/sdi.12348},
	edat = {2015/02/05 06:00},
	gr = {R01-DK078106/DK/NIDDK NIH HHS/United States; R01 DK078106/DK/NIDDK NIH HHS/United States; IK2 CX001043/CX/CSRD VA/United States; K24 DK091419/DK/NIDDK NIH HHS/United States; UL1 TR001414/TR/NCATS NIH HHS/United States; K24-DK091419/DK/NIDDK NIH HHS/United States},
	issn = {1525-139X (Electronic); 0894-0959 (Print); 0894-0959 (Linking)},
	jid = {8911629},
	journal = {Semin Dial},
	jt = {Seminars in dialysis},
	keywords = {Diet, Dietary Restrictions},
	language = {eng},
	lid = {10.1111/sdi.12348 {$[$}doi{$]$}},
	lr = {20220321},
	mh = {Diet, Reducing/*methods; *Eating; Humans; Kidney Failure, Chronic/*therapy; *Renal Dialysis},
	mhda = {2015/12/15 06:00},
	mid = {NIHMS661247},
	month = {Mar-Apr},
	number = {2},
	own = {NLM},
	pages = {159--168},
	phst = {2015/02/05 06:00 {$[$}entrez{$]$}; 2015/02/05 06:00 {$[$}pubmed{$]$}; 2015/12/15 06:00 {$[$}medline{$]$}},
	pl = {United States},
	pmc = {PMC4385746},
	pmid = {25649719},
	pst = {ppublish},
	pt = {Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review},
	sb = {IM},
	status = {MEDLINE},
	title = {Dietary restrictions in dialysis patients: is there anything left to eat?},
	volume = {28},
	year = {2015},
	bdsk-url-1 = {https://doi.org/10.1111/sdi.12348}}
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