Simplified Diet Manual – Low Protein Modified Renal Diet

The Modified Renal Diet may be prescribed for individuals with end-stage renal disease (ESRD) who are on dialysis and reside in a healthcare setting. These individuals often have other medical conditions and a high incidence of malnutrition related to poor appetite and gastrointestinal intolerances such as nausea and vomiting. (1) Many individuals with renal disease in long-term care will not need a strict therapeutic diet because their appetite is already so limited. The use of the Modified Renal Diet in this setting can allow the person to enjoy the main menu with relatively few changes, a key factor in satisfaction and diet adherence. (2)


The diet principles that follow should be implemented on initiation of the diet. The registered dietitian nutritionists’ in the facility and in the dialysis unit should collaborate to individualize nutrition therapy and promote consistency for the best overall health outcome for the individual. (3, 4)

Adjustments to the renal diet will depend on the person’s individual laboratory results and tolerance of dialysis treatments. (5) If the individual is transported from the facility to a dialysis unit for treatments, a nourishing snack or sack meal may need to be planned and sent alongwith the individual, depending on the timing of meals, see “Carry-Out Meals and Snacks” below.


Low Protein Modified Renal Diet

The purpose of a low protein diet is to slow the progression to end stage renal disease. The Low Protein Modified Renal Diet may be prescribed for individuals with chronic kidney disease (CKD) stages 3, 4, and 5, and end-stage renal disease (ESRD) who are not on dialysis. These individuals often have other medical conditions such as hypertension, cardiovascular disease, and diabetes. As CKD progresses, they may have a high incidence of malnutrition related to poor appetite and gastrointestinal intolerances such as nausea and vomiting. (1) Many people with renal disease in long-term care will not need a strict therapeutic diet because their appetite is already so limited. The use of the Low Protein Modified Renal Diet in this setting can allow the person to enjoy the main menu with relatively few changes, a key factor in satisfaction and diet adherence. (2)


For more information Contact the Iowa Academy of Nutrition and Dietetics.

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