Nutrition Suggestions for Predialysis Patients

predialysis ia a common kidney treatment for CKD patients when their kidneys are damaged severely, and they also need to pay attention to their daily diet, which can help reduce the kidney burden and protect the kidneys. In this article, we will give some nutrition suggestions for predialysis patients.

Nutrition is an important element in the management of chronic kidney disease. In general, for predialysis stages it is recommended that your intake (or “kidney diet”) consists of:

- Low amounts of protein
- Sufficient calories
- Low amounts of table salt (i.e. sodium)
- Low amounts of phosphate
- Low amounts of potassium
- Variable amounts of calcium (depending on your individual needs)
- Sufficient but not too much fluid

Protein and energy intake in predialysis

High amounts of protein damage the nephrons in your kidneys and thus accelerate the progression of chronic kidney disease. Therefore, protein intake should be limited at least to the recommended intake of 0.7–0.8 g/kg ideal body weight/day. If the GFR decreases below the value of 60 to 50 ml/min (stages 3 to 5), a more intense protein restriction is recommended. To prevent protein malnutrition, essential keto acids/amino acidsare often taken as supplementation to protein-restricted diets. Please note: In any kind of protein restriction it is important to take in sufficient amounts of energy and other essential nutrients (e.g. minerals and vitamins).

Other food ingredients

You should reduce your intake of table salt, because it containssodium. By holding water in the body, sodium elevates blood pressure, which is accompanied by a higher protein excretion too. Both can damage your kidneys.

You should also reduce your intake of phosphate, because high blood phosphate levels may cause itching and may result in losing calcium from your bones. As many protein-rich foods contain phosphate in abundance, a protein-restricted diet will help you to ingest less phosphate too.

It is useful to reduce the intake of potassium too, as high potassium levels in your blood may cause nausea and irregular heartbeat. Additionally to the diminished potassium elimination by your kidneys there are several other factors that may contribute to an increase in potassium blood levels.

Particularly in early stages of chronic kidney disease, calcium blood levels in many patients are too low. Together with the high blood levels of phosphate this may contribute to the development of bone disease (renal osteodystrophy). That means bones may become fragile or painful.

In early stages of chronic kidney disease (stage 1-4), you do not need to limit your fluid intake much as long as your urine output is normal. However, your fluid intake should not be more than 2.5 litres per day. As your kidneys become worse (stage 5) and you recognise a swelling of your ankles and feet or weight gain, you have to strongly restrict your fluid intake.


above are the nutrition suggestions for CKD patients. however, since the specific illnss condition will be different from case to case, so predialysis patients need to take the kidney-friendly diet depending on thier own illness condition. they can first consult thier doctor, who can give them the most professional suggestions.