Evidence map›Paper›PMID 25649719›Full record

ReviewSeminars in dialysis

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 P Kovesdy

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Seminars in dialysis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
95citing papers in PubMed, 6 pooled it
11.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

95 citing papers in PubMed, 6 syntheses or guidelines pooled it, 216 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Effect of high-protein meals during hemodialysis combined with lanthanum carbonate in hypoalbuminemic dialysis patients: findings from the FrEDI randomized controlled trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2017
    Trial
  8. Ten tips for the first hemodialysis sessions.Clinical kidney journal · 2026
    Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. A Qualitative Study to Investigate the Nutrition Perspectives and Experiences of Veterans with CKD.Clinical journal of the American Society of Nephrology : CJASN · 2025
    Article
  17. ASN Kidney Health Guidance on Potassium and Phosphorus Food Additives.Journal of the American Society of Nephrology : JASN · 2025
    Article
  18. Article
  19. A Pilot Clinical Trial of a Nutrition Education Program on Quality of Life in CKD.Clinical journal of the American Society of Nephrology : CJASN · 2025
    Article
  20. Article

35 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Kamyar Kalantar-ZadehDivision 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.
Amanda R Tortorici
Joline L T Chen
Mohammad Kamgar
Wei-Ling Lau
Hamid Moradi
Connie M Rhee
Elani Streja
Csaba P Kovesdy
University of California, Irvine · USLong Beach Memorial Medical Center · USLos Angeles Biomedical Research Institute · USMemphis VA Medical Center · USVA Long Beach Healthcare System · US

Funding

University of California Health Participation in the National COVID Cohort Collaborative (N3C)UL1TR001414 · NCATS · UNIVERSITY OF CALIFORNIA-IRVINE · PI COOPER, DAN M, VILAIN, ERIC J. · 2015 to 2023
$35.1M
MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
Examining Racial and Cardiovascular Paradoxes in Chronic Kidney DiseaseR01DK078106 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALANTAR-ZADEH, KAMYAR · 2007 to 2011
$1.1M
HDL function and mortality in end stage renal diseaseIK2CX001043 · VA · VETERANS HEALTH ADMINISTRATION · PI MORADI, HAMID · 2015 to 2020
–
CSRD VA IK2 CX001043NCATS NIH HHS UL1 TR001414NIDDK NIH HHS K24 DK091419NIDDK NIH HHS K24-DK091419NIDDK NIH HHS R01 DK078106NIDDK NIH HHS R01-DK078106
6 · The paper itself

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.

Indexed as

EatingRenal DialysisDiet, ReducingHumansKidney Failure, Chronic

Identifiers

PMID25649719
PMCPMC4385746
OpenAlexW2038799795

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.