Part of the renal range, this resource provides information for people with kidney disease and a poor appetite to help them have a more nourishing diet to feel better.

Guidance published in July 2023, advises pregnant women and those with a weakened immune system to avoid eating ready-to-eat cold-smoked or cured fish, due to increased risk of severe illness from listeriosis. Older people should also consider the risks associated with eating these products. Products include smoked salmon, smoked trout and gravlax.

Please consider and advise your patients accordingly when using this resource.

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To support the dietary education for long-term condition management of people with chronic kidney disease and requiring extra nourishment.

The tagret group will understand:

  • that they must inform their dietitian about any changes in appetite
  • techniques to ensure they meet their dietary needs when their appetite is poor
  • that normal restrictions may be relaxed when appetite is poor.

The target group will be able to identify and know how to include high energy foods.

The target group will know:

  • that phosphate binders are/may be needed to achieve their target blood serum phosphate levels and are only effective/appropriate when taken with foods containing phosphate
  • that they must seek their dietitian's guidance before taking any vitamin/mineral supplements.
  • NICE Guideline (NG203) Chronic kidney disease: assessment and management. 2021.
  • The Renal Association. Clinical practice guideline on undernutrition in chronic kidney disease. 2019.
  • National Kidney Foundation. KDOQI Clinical Practice Guidelines for Nutrition in Chronic Kidney Disease: 2020 Update.
  • ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease. 2021.
  • Association of British Clinical Diabetologists and The Renal Association. Managing hyperglycaemia in people with diabetes and chronic kidney disease. London: ABCD, 2021.
  • British Dietetic Association 2021. BDA Renal Nutrition Specialist Group. Phosphorus in Foods: Considerations in Chronic Kidney Disease. An evidence-based summary.
  • European Guidelines for the Nutritional Care of Adult Renal Patients (EDTNA) 2003.
  • McCance and Widdowson’s Composition of Foods Integrated dataset (CoDID, 2015 accessed from https://www.gov.uk/government/publications/composition-of-foods-integrated-dataset-cofid).
  • Fouque D. et al (2007). European Best Practice Guideline on Nutrition. Nephrology Dialysis Transplantation, Volume 22, Issue suppl_2
  • NICE (2013) Hyperphosphataemia in chronic kidney disease: Management of hyperphosphataemia in patients with stage 4 or 5 chronic kidney disease. Clinical guideline 157.
  • Kalantar-Zadeh K., Gutekunst L., Mehrotra R., Kovesdy C.P., Bross R., Shinaberger C.S., Noori N., Hirschberg R., Benner D., Nissenson A.R. and Kopple J.D. (2010) Understanding Sources of Dietary Phosphorus in the Treatment of Patients with Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology, 5, pp. 519-530.
  • National Kidney Federation. (2009) KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney International,113, pp.S1-130.
  • Christian S Shinaberger (2008). Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease? The American Journal of Clinical Nutrition, Volume 88, Issue 6, 1 December 2008, Pages 1511–1518
  • British Dietetic Association (2013). Renal Nutrition Specialist Group – low phosphate diet rationale.
  • Schlemmer et al (2009). Phytate in foods and significance for humans: Food sources, intake, processing, bioavailability, protective role and analysis. Mol. Nutr. Food Res. 2009, 53, S330 –S375
  • Hannah J et al (2017). Phosphorus in food: new insights and recommendations for practice. Journal of Kidney Care, vol 2 no 3 p 66-72.
  • NHS 5-a-day portion sizes. https://www.nhs.uk/live-well/eat-well/5-a-day-portion-sizes/ (Accessed 2019).
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NDR-UK Ref No: 9472
Publication Format: A5 leaflet
Classification: DT
Pack size: 10
Publication date: 2019
Last Review: 2022
Last Update: 2019

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