Stage

Description

GFR (ml/min/1.73m2)

1

Kidney damage with normal kidney function

> 90

2

Kidney damage with mild decrease in kidney function

60 to 89

3

Moderate decrease in kidney function

30 to 59

4

Severe decrease in kidney function

15 to 29

5

Kidney failure (dialysis or transplant needed)

< 15

Nutrient

Chronic Kidney Disease

Hemodialysis

Peritoneal Dialysis

Protein

Stages 1 to 3: Recommended Daily Allowance
Glomerular filtration rate < 25 milliliters per minute per 1.73 meters squared; 0.6 to 0.75 grams of protein per kilogram body weight with > 50% high biological value

> 1.2 grams per kilogram of body weight with > 50% high biological value

> 1.2 to 1.3 grams per kilogram body weight with > 50% high biological value

Calories

30 to 35 kilocalories per kilogram of body weight for patients over the age of 60; 35 kilocalories per kilogram body weight for patients under the age of 60

Same

Same, include dialysate calories

Sodium

In long-term care, use no added salt diet and avoid salty meats, luncheon meats, salty seasonings, canned soups, and salty snacks.

Same

Same

Potassium

Generally unrestricted until dialysis is initiated

2 to 3 grams per day. Work with dialysis dietitian to adjust to serum levels. In long-term care, avoid citrus, bananas, tomato products, and potatoes. 

3 to 4 grams per day; other recommendations same as for hemodialysis

Phosphorus

Normal amounts are needed for bone metabolism. Protein-restricted diets will limit high-phosphorus sources of food. If phosphorus is elevated, limit milk and dairy to 8 ounces per day and/or consider phosphorus binders.

Limit milk and dairy to one serving (8 ounces milk or one equivalent dairy serving). Work with dialysis dietitian to determine need for phosphorus binders.

Same as hemodialysis

Calcium

Limit to 1 to 1.5 grams per day, < 2.0 to 2.5 grams, including binder load

< 2.0 to 2.5 grams per day, including binder load

Same as hemodialysis

Fluid

Usually unrestricted; exceptions include congestive heart failure, edema, or uncontrolled hypertension

Output plus 1,000 milliliters or restrict to achieve < 2 to 3 kilograms of weight gain between treatments

Maintain fluid balance; most patients can tolerate approximately 2,000 milliliters per day

Vitamins and Minerals

Recommended Daily Allowance: B complex and vitamin C; individualize vitamin D, iron, and zinc

Water-soluble vitamin:   
2 milligrams of B6, 1 milligram of folate, 3 micrograms of B12, Recommended Daily Allowance for other B vitamins, 60 to 100 milligrams of vitamin C, Recommended Daily Allowance for vitamin E and zinc, individualize iron and vitamin D

Same as hemodialysis