Nutrition for Chronic Kidney 

Disease in Children 

What is chronic kidney disease 

(CKD)? 

U.S. Department of Health 
 


and Human Services 


NATIONAL INSTITUTES OF HEALTH 

National Kidney and Urologic Diseases 

Information Clearinghouse

Chronic kidney disease is any disease 

that causes the kidneys to function 

less efficiently over a long period 

of time. In the early stages of CKD, the 

kidneys continue to work. They just don’t 

do their job as well as healthy kidneys. 

Because the decline in kidney function 

happens slowly, a child’s body may adapt, 

without causing any change in the way 

the child looks or feels. Over time, small 

changes, such as small increases in blood 

phosphorus, can build up to unhealthy 

levels. As the kidney disease worsens, the 

child may develop more severe symptoms 

of CKD, such as weak bones, lack of appetite, lack of energy, and slowed growth. 

Why is nutrition important for 

children with CKD? 

Health problems from CKD can be prevented or delayed by eating the right foods. 

Every child needs good nutrition, but learning about nutrition is vital for the parents 

or guardians of a child with kidney disease 

because the child’s diet can affect kidney 

function. In turn, the kidneys can affect the 

child’s health and growth. 

The kidneys do many things to keep the 

body working properly. The kidneys 

remove wastes and extra water from the 

blood and make urine. They balance the 

salts—sodium, potassium, calcium, and 

phosphorus—that circulate in the blood. 

And they control the release of natural 

chemicals called hormones that help make 

red blood cells, control blood pressure, and 

keep bones strong. 

When the kidneys don’t work normally, a 

child’s growth may slow down. The child’s 

health care team will work with the child’s 

caretakers to make sure the child gets the 

right amount of nutrients to maintain 

growth. At different times, the team may 

suggest changes in both the amount and 

the types of food the child needs to eat. 

Learning about nutrients in foods will help 

caretakers understand what changes need 

to be made to their child’s diet. Caretakers should always consult with their child’s 

health care team before making any major 

changes in the child’s diet. 

Why is energy important for 

children with CKD? 

Everyone needs energy from food to grow 

and be active. Children with CKD tend to 

avoid eating because they have poor appetites. Taking in too little energy can lead 

to decreased activity, poor growth, and 

decreased resistance to infection. Growth 

is evaluated by comparing a child’s height 

and weight with a growth chart that shows 

the normal ranges for children according to age. A child’s energy needs change 

depending on age, height, and weight. The 

amount of energy in the diet is measured 

by counting calories in the food a person 

eats. The health care team can determine 

the child’s daily caloric needs. If a child 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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is not growing as well as possible, the health care 

team can suggest healthy ways to add calories to the 

child’s diet. While feeding tubes are most often used 

for infants, situations occur when older children and 

adolescents also benefit from them. 

Why is knowing about protein 

important for children with CKD? 

Protein is an essential part of any diet. Protein helps 

build and maintain muscle, bone, skin, organs, and 

blood. Some proteins help fight disease and heal 

wounds. All proteins break down into waste products 

that must be removed from the blood by the kidneys. 

Eating more protein than the body needs may put an 

extra burden on the kidneys and cause kidney function 

to decline faster. The table below shows the protein 

content of some common foods, by serving size, listed 

from highest to lowest protein content. 

Protein Content of Foods 

Food Serving Size 

Turkey breast 41 grams/cup 

Large hamburger with vegetables 

and condiments 

34 grams/8-ounce (oz) 

sandwich 

Tuna sub 30 grams/6-inch sub 

Cottage cheese 25 grams/cup 

Chili con carne 24 grams/cup 

Cold-cut sub 21 grams/6-inch sub 

Fast-food taco 20 grams/6-oz taco 

Fish sandwich with tartar sauce 

and cheese 20 grams/6.5-oz sandwich 

Baked beans 17 grams/cup 

Chicken nuggets 16 grams/6 nuggets 

Yogurt 13 grams/8-oz container 

Beef stew 11 grams/cup 

Fast-food burrito with meat and 

beans 11 grams/4-oz burrito 

Cooked peas 8 grams/cup 

Chicken noodle soup 6 grams/cup 

Source: United States Department of Agriculture (USDA) 

National Nutrient Database for Standard Reference, Release 

22. USDA website. www.ars.usda.gov/SP2UserFiles/ 

Place/12354500/Data/SR22/nutrlist/sr22w203.pdf. 

Released September 2009. Accessed July 22, 2010. 

Doctors sometimes recommend that people with 

CKD eat moderate or reduced amounts of protein. 

In children with CKD, however, restricting protein 

can prevent adequate growth and may lead to malnutrition. For children with CKD, the goal is to eat 

enough protein for growth but avoid high protein 

intake. 

Caretakers should talk with the health care team 

about the amount of protein and the sources of protein in their child’s diet. Animal sources such as eggs, 

milk, cheese, chicken, fish, and red meats contain 

more of the essential amino acids the body needs, but 

a well-balanced vegetarian diet can also provide these 

nutrients. The health care team can suggest dietary 

changes to help meet the child’s protein needs. 

The following table provides the daily protein needs 

by age and weight for children with CKD. 

Daily Protein Needs for 

Children with CKD 

Age Range 

Grams of Protein Needed 

per Pound of Body Weight 

Predialysis Hemodialysis Peritoneal 

Dialysis 

Infant 0–6 

months 1 1.2 1.3–1.4 

7–12 

months 0.73 1.1 1.0–1.1 

Toddler 1–3 years 0.5 0.7 0.9 

Child 4–6 years 0.5 0.7 0.9 

7–10 years 0.45 0.6 0.8 

Adolescents 11–14 years 0.45 0.6 0.8 

15–18 years 0.4 Girls Boys 0.6–0.7 

0.5 0.6 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Because dialysis removes protein from the blood, 

a child on dialysis needs to eat more protein. The 

amount of protein needed depends on the type of 

dialysis. In hemodialysis, the blood is filtered by 

flowing through tubes to a filter outside the body and 

then back through another set of tubes to the body. 

In peritoneal dialysis, the blood is filtered when a 

fluid called dialysis solution is drained from a bag 

into the child’s abdomen, where it soaks up wastes 

and extra water from the blood and is then drained 

from the abdomen. Peritoneal dialysis removes more 

protein than hemodialysis. 

For example, according to the chart, a 10-year-old 

boy with pre-dialysis CKD would need 0.45 grams 

of protein a day for each pound of his body weight. 

To find his daily protein requirement, his weight 

in pounds should be multiplied by 0.45. If the boy 

weighs 60 pounds, he would need 27 grams of protein a day. 

[child’s weight in pounds] × [value from age chart] = 

[daily protein requirement] 

60 × 0.45 = 27 

Limiting a child to this amount of protein may be difficult because some foods contain that much protein 

in a single serving. Sandwiches should be cut in half. 

Smaller portions of soups and vegetables, which also 

contain protein, should be served. 

If this same boy starts hemodialysis, he will need 

0.6 grams of protein for each pound of his body 

weight. His daily protein needs would go up to 

36 grams. 

60 × 0.6 = 36 

On peritoneal dialysis, the boy’s daily requirement 

goes up to 0.8 grams per pound. Therefore, he 

would need 48 grams of protein a day. 

60 × 0.8 = 48 

A child’s protein needs vary over time, so caretakers 

should discuss these needs with the health care team. 

Why is knowing about sodium 

important for children with CKD? 

Sodium, a mineral, is important for many body functions. In some children with CKD, too little sodium 

can lead to dehydration and poor weight gain. On 

the other hand, too much sodium can increase thirst, 

raise blood pressure, and cause water retention that 

may lead to excess weight gain or fluid buildup in the 

lungs. 

Sodium is found in ordinary table salt and many 

seasonings such as soy sauce and teriyaki sauce. The 

recommended daily intake of sodium for adults is 

no more than 2,300 milligrams (mg), the amount 

found in 1 teaspoon of table salt. Canned foods, 

some frozen foods, and most processed foods have 

large amounts of table salt. Some snack foods such 

as chips and crackers are also high in salt. Figuring 

out how much sodium a child needs is complicated 

by the type and severity of CKD the child has, the 

child’s age, and sometimes other factors. Caretakers may need either to limit or to add sodium to the 

child’s diet. Caretakers should talk with their child’s 

health care team about how much sodium their child 

should have. 

The sodium content of foods is listed on the nutrition labels. Choosing “sodium-free” or “lowsodium” food products can help reduce sodium in 

a child’s diet. Nearly all fresh vegetables and fresh, 

unprocessed meat are preferable to processed foods. 

Sodium-free or low-sodium seasonings such as lemon 

juice or hot pepper sauce can also help reduce sodium intake while adding flavor. Salt substitutes that 

use potassium should be avoided. 

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The table below explains what sodium claims on 

food labels such as “sodium-free” or “low-sodium” 

mean, as defined in federal guidelines. 

n	

n

n	

n	

Sodium Claims on Food Labels 

Claim Explanation 

“Sodium-free” Less than 5 mg sodium per serving 

“Salt-free” Meets requirements for sodium-free 

“Low-sodium” 140 mg sodium or less per serving 

“Very low sodium” 35 mg sodium or less per serving 

“Reduced sodium” At least 25 percent less sodium when 

compared with the regular version 

“Light in sodium” 50 percent less sodium per serving; 

restricted to foods with more than 

40 calories per serving 

“Unsalted, no 

added salt: not a 

sodium-free food” 

No salt is added during processing; the 

labeled product resembles or substitutes for 

another product that is normally processed 

with salt 

Source: United States Food and Drug Administration 

(FDA) Food Labeling Guide. IX. Appendix A: Definitions 

of Nutrient Content Claims. FDA website. www.fda.gov/ 

Food/GuidanceComplianceRegulatoryInformation/ 

GuidanceDocuments/FoodLabelingNutrition/ 

FoodLabelingGuide/ucm064911.htm. Revised April 2008. 

Accessed June 21, 2010. 

Why is knowing about potassium 

important for children with CKD? 

Potassium keeps the heart beating regularly and muscles working right. Too little or too much potassium 

can cause heart and muscle problems. When blood 

potassium levels are high, healthy kidneys remove 

extra potassium from the blood and move it to the 

urine. In children with CKD, the kidneys do a poor 

job of removing potassium and blood potassium levels can become dangerously high. 

Potassium is a mineral found in many fruits and 

vegetables such as bananas, potatoes, avocados, and 

melons. Children with CKD should have their blood 

checked regularly to make sure their potassium levels are in the normal range. If the child’s potassium

begins to rise, caretakers should try some of the following ways to limit the amount of potassium in the 

child’s diet: 

avoiding high-potassium fruits and vegetables 

reducing the number and portion sizes of fruits and 

vegetables with moderate amounts of potassium 

boiling potatoes and beans in water to remove the 

potassium 

checking nutrition labels to avoid high-potassium 

foods and foods with potassium additives 

The following table gives some high-potassium foods 

and suggestions for low-potassium alternatives that 

caretakers can serve to their children with CKD. 

High- and Low-potassium Foods 

High-potassium Foods Low-potassium 

Alternatives 

Oranges and orange juice 

Melons 

Apricots 

Bananas 

Potatoes 

Tomatoes 

Sweet potatoes 

Cooked spinach 

Cooked broccoli 

Beans (baked, kidney, lima, 

pinto) 

Apples and apple juice 

Cranberries and cranberry juice 

Canned fruit 

Strawberries, blueberries, 

raspberries 

Pineapple 

Cabbage 

Boiled cauliflower 

Mustard greens 

Frozen or raw broccoli 

Frozen peas 

Source: United States Department of Agriculture (USDA) 

National Nutrient Database for Standard Reference, 

Release 22. USDA website. www.ars.usda.gov/ 

SP2UserFiles/Place/12354500/Data/SR22/nutrlist/ 

sr22w306.pdf. Released September 2009. Accessed 

July 21, 2010. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Why is knowing about phosphorus 

important for children with CKD? 

Phosphorus helps regulate the amount of calcium in 

the bones. When blood phosphorus levels are high, 

healthy kidneys remove extra phosphorus from the 

blood and move it to the urine. In children with 

CKD, the kidneys do a poor job of removing extra 

phosphorus. When a child’s blood phosphorus levels 

are too high, the phosphorus pulls calcium from the 

bones, making the bones weaker and more likely to 

break. Poor bone growth leads to small stature. Too 

much phosphorus can also cause itchy skin and red 

eyes. 

Phosphorus is a mineral found in many foods, 

particularly high-protein foods such as dairy products, meat, dried beans, peas, colas, nuts, and peanut 

butter. Caretakers should learn how much dietary 

phosphorus a child with CKD should have and read 

nutrition labels to help their child stay within those 

limits. The table below lists high-phosphorus foods 

and suggestions for low-phosphorus alternatives that 

caretakers can serve instead. 

High- and Low-phosphorus Foods 

High-phosphorus Foods Low-phosphorus 

Alternatives 

Dairy foods (milk, cheese, 

yogurt) 

Beans (baked, kidney, lima, 

pinto) 

Nuts and peanut butter 

Processed meats (hot dogs, 

canned meat) 

Cola 

Canned iced teas and lemonade 

Bran cereals 

Egg yolks 

Ice cream 

Liquid nondairy creamer 

Green beans 

Popcorn 

Unprocessed meats from a 

butcher 

Lemon-lime soda, root beer 

Powdered iced tea and 

lemonade mixes 

Rice and corn cereals 

Egg whites 

Sorbet 

Source: United States Department of Agriculture (USDA) 

National Nutrient Database for Standard Reference, Release 

22. USDA website. www.ars.usda.gov/SP2UserFiles/ 

Place/12354500/Data/SR22/nutrlist/sr22w305.pdf. 

Released September 2009. Accessed July 21, 2010. 

As CKD progresses, a child may need to take a phosphate binder with meals, such as calcium acetate 

(PhosLo), sevalemer hydrochloride (Renagel), lanthanum carbonate (Fosrenol), or calcium carbonate to 

lower the concentration of phosphorus in the blood. 

These medications act like sponges to soak up, or 

bind, phosphorus while it is in the stomach. Because 

it is bound, not all of the phosphorus gets into the 

blood. Instead, some of it is passed out of the body 

in stool. 

Why is regulating fluid intake important 

for children with CKD? 

Early in kidney disease, a child’s damaged kidneys 

may produce either too much or too little urine. If 

the child produces small amounts of urine, swelling 

in the face, legs, arms, or abdomen or high blood 

pressure may develop. If the kidneys produce too 

much urine, the child is at risk of dehydration. Caretakers should tell the health care team if they notice a 

change in the amount of urine the child produces or 

if they notice any swelling. 

If a child’s kidneys fail and the child begins dialysis, 

caretakers may need to limit how much their child 

drinks because one dialysis session removes only a 

limited amount of fluid. The amount people drink 

is often related to the amount of sodium they eat. If 

thirst is a problem, caretakers should speak with their 

child’s health care team about ways to control excess 

thirst. 

What are some special problems for 

infants with CKD? 

Because infants grow so quickly, the health care team 

will need to follow a child with CKD more closely 

during the first year of life. Often special formulas 

with extra supplements—calorie enhancers—will 

be given to ensure the child gets the right amount 

of fluid and nutrients. If an infant can’t drink the 

amount of formula needed for growth, the doctor 

may suggest tube feeding. While tube feeding may 

sound drastic, experience has shown it is often the 

best way to ensure a child gets the full supply of 

fluid and nutrients needed to promote growth and 

development.
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

How can understanding and keeping 

track of lab reports help a child with 

CKD make healthy food choices? 

If a child has CKD, the child’s health care team will 

order regular blood tests. Many caretakers find that 

keeping track of test results helps them see how well 

their child is doing. Caretakers can request copies 

of their child’s lab reports and ask to have them 

explained, noting any results out of the normal range. 

Learning how to read a child’s reports helps caretakers see how the foods their child eats can affect 

health results. Caretakers should talk with their 

child’s health care team about making healthier food 

choices. 

Points to Remember 

n	 Chronic kidney disease (CKD) is any disease that 

causes the kidneys to function less efficiently over 

a long period of time. 

n	 In children, CKD can cause problems such as 

weak bones, lack of appetite, lack of energy, and 

slowed growth. 

n	 Health problems from CKD can be prevented or 

delayed by eating the right foods. 

n	 Children with CKD tend to avoid eating because 

they have poor appetites. Taking in too little 

energy can lead to decreased activity, poor 

growth, and decreased resistance to infection. 

n	 Caretakers should talk with the health care team 

about the amount of protein and the sources of 

protein in their child’s diet. Protein helps build 

and maintain muscle, bone, skin, organs, and 

blood. But proteins break down into waste products that must be removed from the blood by the 

kidneys. 

n	 Doctors sometimes recommend that people with 

CKD eat moderate or reduced amounts of protein 

to relieve the burden on the kidneys. 

n	 In some children with CKD, too little sodium can 

lead to dehydration and poor weight gain. Too 

much sodium can increase thirst, raise blood pressure, and cause water retention that may lead to 

excess weight gain or fluid buildup in the lungs. 

n	 People with CKD should avoid salt substitutes 

that use potassium. 

n	 Potassium keeps the heart beating regularly and 

muscles working right. Too little or too much 

potassium can cause heart and muscle problems. 

n	 When blood phosphorus levels are high, healthy 

kidneys remove the extra phosphorus from the 

blood and move it to the urine. In children with 

CKD, the kidneys do a poor job of removing 

phosphorus and blood phosphorus levels can 

become too high. 

n	 If a child’s kidneys fail and the child begins dialysis, caretakers may need to limit how much their 

child drinks because one dialysis session removes 

only a limited amount of fluid. 

n	 Many caretakers find that keeping track of test 

results helps them see how well their child is 

doing. 

Hope through Research 

The National Institute of Diabetes and Digestive and 

Kidney Diseases (NIDDK) conducts and supports 

research to help people of all ages with kidney disease. The NIDDK’s Division of Kidney, Urologic, 

and Hematologic Diseases (KUH) maintains the Pediatric Nephrology Program, which supports research 

into the causes, treatment, and prevention of kidney 

disease in children. In 2003, the KUH began the 

Chronic Kidney Disease in Children (CKiD) clinical trial to learn more about the negative effects of 

pediatric kidney disease, including cardiovascular 

disease and growth failure. That study is ongoing. 

More information about the CKiD, funded under 

the National Institutes of Health clinical trial number 

NCT00327860, can be found at www.statepi.jhsph. 

edu/ckid. 

Participants in clinical trials can play a more active 

role in their own health care, gain access to new 

research treatments before they are widely available, 

and help others by contributing to medical research. 

For information about current studies, visit 

www.ClinicalTrials.gov. 

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Additional Reading 

The following fact sheets and brochures, as well as 

other information, are available on request from the 

organizations listed below. Most of these resources 

can also be found online at the web addresses given. 

Dining Out With Confidence: A Guide for Patients 

With Kidney Disease 

Nutrition for Children With Chronic Kidney Disease 

National Kidney Foundation 

30 East 33rd Street 

New York, NY 10016 

Phone: 1–800–622–9010 or 212–889–2210 

Fax: 212–689–9261 

Internet: www.kidney.org 

A Healthy Food Guide for People with Chronic 

Kidney Disease 

American Dietetic Association 

120 South Riverside Plaza, Suite 2000 

Chicago, IL 60606–6995 

Internet: www.eatright.org 

Your Kidney Test Results 

Solving the Diet Dilemma for Children 

American Association of Kidney Patients 

3505 East Frontage Road, Suite 315 

Tampa, FL 33607 

Phone: 1–800–749–2257 or 813–636–8100 

Fax: 813–636–8122 

Email: info@aakp.org 

Internet: www.aakp.org 

For More Information 

American Kidney Fund 

6110 Executive Boulevard, Suite 1010 

Rockville, MD 20852 

Phone: 1–800–638–8299 or 1–866–300–2900 

Fax: 301–881–0898 

Email: helpline@kidneyfund.org 

Internet: www.kidneyfund.org 

American Society of Pediatric Nephrology 

3400 Research Forest Drive, Suite B7 

The Woodlands, TX 77381 

Phone: 281–419–0052 

Fax: 281–419–0082 

Email: info@aspneph.com 

Internet: www.aspneph.com 

Food and Nutrition Information Center 

National Agricultural Library 

10301 Baltimore Avenue, Room 105 

Beltsville, MD 20705–2351 

Phone: 301–504–5414 

Fax: 301–504–6409 

Email: fnic@ars.usda.gov 

Internet: www.nal.usda.gov/fnic 

Life Options 

c/o Medical Education Institute, Inc. 

414 D’Onofrio Drive, Suite 200 

Madison, WI 53719 

Phone: 1–800–468–7777 

Fax: 608–833–8366 

Email: lifeoptions@meiresearch.org 

Internet: www.lifeoptions.org 

About the Nutrition for Chronic Kidney 

Disease Series 

The NIDDK Nutrition for Chronic Kidney Disease 

Series includes three fact sheets: 

n	 Nutrition for Early Chronic Kidney Disease in 

Adults 

n	 Nutrition for Advanced Chronic Kidney Disease in 

Adults 

n	 Nutrition for Chronic Kidney Disease in Children 

For free, single, printed copies of this series, please 

contact the National Kidney and Urologic Diseases 

Information Clearinghouse (NKUDIC). 

Acknowledgments 

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside 

experts. The NKUDIC would like to thank Joseph 

Flynn, M.D., of the American Society of Pediatric 

Nephrology (ASPN), for coordinating the review 

of the original version of this publication by the 

ASPN’s Clinical Affairs Committee: Barbara Fivush, 

M.D., co-chair; Steve Wassner, M.D., co-chair; John 

Brandt, M.D.; Deepa Chand, M.D.; Ira Davis, M.D.; 

Stuart Goldstein, M.D.; Ann Guillot, M.D.; Deborah 

Kees-Folts, M.D.; Juan Kupferman, M.D.; Gary 

Lerner, M.D.; Tej Mattoo, M.D.; Alicia Neu, M.D.; 

Cynthia Pan, M.D.; William Primack, M.D.; and 

Michael Somers, M.D. 

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National Kidney Disease 

Education Program 

3 Kidney Information Way �
 

Bethesda, MD 20892 �
 

Phone: 1–866–4–KIDNEY 

(1–866–454–3639) �
 

TTY: 1–866–569–1162 �
 

Fax: 301–402–8182 �
 

Email: nkdep@info.niddk.nih.gov �
 

Internet: www.nkdep.nih.gov �
 

The National Kidney Disease Education 

Program (NKDEP) is an initiative of the 

National Institute of Diabetes and Digestive 

and Kidney Diseases, National Institutes 

of Health, U.S. Department of Health and 

Human Services. The NKDEP aims to raise 

awareness of the seriousness of kidney disease, the importance of testing those at high 

risk, and the availability of treatment to 

prevent or slow kidney disease. 

National Kidney and Urologic 

Diseases Information Clearinghouse 

3 Information Way 

Bethesda, MD 20892–3580 

Phone: 1–800–891–5390 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: nkudic@info.niddk.nih.gov 

Internet: www.kidney.niddk.nih.gov 

The National Kidney and Urologic Diseases 

Information Clearinghouse (NKUDIC) is a 

service of the National Institute of Diabetes 

and Digestive and Kidney Diseases (NIDDK). 

The NIDDK is part of the National Institutes 

of Health of the U.S. Department of Health 

and Human Services. Established in 1987, 

the Clearinghouse provides information 

about diseases of the kidneys and urologic 

system to people with kidney and urologic 

disorders and to their families, health care 

professionals, and the public. The NKUDIC 

answers inquiries, develops and distributes 

publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about 

kidney and urologic diseases. 

You may also find additional information about this 

topic by visiting MedlinePlus at www.medlineplus.gov. 

This publication may contain information about 

medications. When prepared, this publication 

included the most current information available. 

For updates or for questions about any medications, 

contact the U.S. Food and Drug Administration tollfree at 1–888–INFO–FDA (1–888–463–6332) or visit 

www.fda.gov. Consult your health care provider for 

more information. 

The U.S. Government does not endorse or favor any 

specific commercial product or company. Trade, 

proprietary, or company names appearing in this 

document are used only because they are considered 

necessary in the context of the information provided. 

If a product is not mentioned, the omission does not 

mean or imply that the product is unsatisfactory. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this publication to duplicate and 

distribute as many copies as desired. 

This publication is available at 

www.kidney.niddk.nih.gov. 

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 11–5752 

April 2011 

The NIDDK prints on recycled paper with bio-based ink.