Nutrition for Advanced Chronic 

Kidney Disease in Adults 

National Kidney and Urologic Diseases Information Clearinghouse 

U.S. Department 

of Health and 

Human Services 

NATIONAL 

INSTITUTES 

OF HEALTH 

Why is nutrition important 

for someone with advanced 

chronic kidney disease 

(CKD)? 

A person may prevent or delay some health 

problems from CKD by eating the right 

foods and avoiding foods high in sodium, 

potassium, and phosphorus. Learning 

about calories, fats, proteins, and fluids is 

important for a person with advanced CKD. 

Protein foods such as meat and dairy products break down into waste products that 

healthy kidneys remove from the blood. 

As CKD progresses, nutritional needs 

change. A health care provider may recommend that a patient with reduced kidney 

function choose foods carefully. 

What do the kidneys do? 

The kidneys remove wastes and extra water 

from the blood and make urine. To keep the 

body working properly, the kidneys balance 

the salts and minerals—such as calcium, 

phosphorus, sodium, and potassium—that 

circulate in the blood. The kidneys also 

release hormones that help make red blood 

cells, regulate blood pressure, and keep 

bones strong. 

What are the effects of CKD? 

CKD usually takes a long time to develop 

and does not go away. In CKD, the kidneys 

continue to work—just not as well as they 

should. Wastes may build up so gradually that the body becomes used to having 

those wastes in the blood. Salts containing 

phosphorus and potassium may rise to unsafe 

levels, causing heart and bone problems. 

Anemia—low red blood cell count—can 

result from CKD because the kidneys stop 

making enough erythropoietin, a hormone 

that causes bone marrow to make red blood 

cells. After months or years, CKD may 

progress to permanent kidney failure, which 

requires a person to have a kidney transplant 

or regular blood filtering treatments called 

dialysis. 

What is medical nutrition 

therapy (MNT)? 

MNT is the use of nutrition counseling by a 

registered dietitian to help promote a medical or health goal. A health care provider 

may refer a patient to a registered dietitian 

to help with the patient’s food plan. Many 

insurance policies cover MNT when recommended by a health care provider. Anyone 

who qualifies for Medicare can receive a 

benefit for MNT from a registered dietitian 

or nutrition professional when a health care 

provider provides a referral indicating that 

the person has diabetes or kidney disease. 

One way to locate a qualified dietitian is to 

contact the American Dietetic Association 

at www.eatright.org and click on “Find a 

Registered Dietitian.” Users can enter their 

address or ZIP code for a list of dietitians 

in their area. A person looking for dietary 

advice to prevent kidney damage should 

click on “Renal (Kidney) Nutrition” in the 

specialty field. Dietitians who specialize in 

helping people with CKD are called renal 

dietitians. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Why is knowing about 

calories important for 

someone with advanced 

CKD? 

As CKD progresses, people often lose their 

appetites because they find that foods do not 

taste the same. As a result, they consume 

fewer calories—important units of energy in 

food—and may lose too much weight. Renal 

dietitians can help people with advanced 

CKD find healthy ways to add calories to 

their diet if they are losing too much weight. 

Why is knowing about 

protein important for 

someone with advanced 

CKD? 

Protein is an essential part of any diet. 

Proteins help build and maintain muscle, 

bone, skin, connective tissue, internal organs, 

and blood. They help fight disease and 

heal wounds. But proteins also 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. 

Health care providers recommend that 

people with CKD eat moderate or reduced 

amounts of protein. However, restricting 

protein could lead to malnutrition, so people 

with CKD need to be careful. The typical 

American diet contains more than enough 

protein. Learning about portion sizes can 

help people limit protein intake without 

endangering their health. 

What is the right meat 

portion size? 

Most people—with or without CKD—can 

get the daily protein they need by eating two 

3-ounce servings of meat or meat substitute. 

A 3-ounce serving of meat is about the size of 

a deck of cards or the palm of a person’s hand. 

A renal dietitian can help people learn about 

the amount and sources of protein in their 

diet. Animal protein in egg whites, cheese, 

chicken, fish, and red meats contain more of 

the essential nutrients a body needs. With 

careful meal planning, a well-balanced vegetarian diet can also provide these nutrients. A 

renal dietitian can help people with advanced 

CKD make small adjustments in their eating 

habits that can result in significant protein 

reduction. For example, people can lower 

their protein intake by making sandwiches 

using thinner slices of meat and adding lettuce, cucumber slices, apple slices, and other 

garnishes. The following table lists some highprotein foods and suggestions for low-protein 

alternatives that are better choices for people 

with CKD trying to limit their protein intake. 

High- and Low-protein Foods
�

High-protein Foods Low-protein 

Alternatives 

Ground beef 

Halibut 

Salmon 

Tuna 

Roasted turkey 

Chili con carne 

Egg substitutes 

Shrimp 

Tofu 

Imitation crab meat

Roasted chicken 

Beef stew 

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 21, 2010. 

2 Nutrition for Advanced Chronic Kidney Disease in Adults 
 

 

3 Nutrition for Advanced Chronic Kidney Disease in Adults 

When kidney function declines to the point 

where dialysis becomes necessary, patients 

should include more protein in their diet 

because dialysis removes large amounts of 

protein from the blood. 

Why is knowing about fat 

important for someone with 

advanced CKD? 

Everyone should know about fat sources 

because eating the wrong kinds of fat and 

too much fat increases the risk of clogged 

blood vessels and heart problems. Fat 

provides energy, helps produce hormonelike 

substances that regulate blood pressure and 

other heart functions, and carries fat-soluble 

vitamins. Everyone needs dietary fat, but 

some fats are healthier than others. People 

with CKD are at higher risk of having a heart 

attack or stroke. Therefore, people with 

CKD should be especially careful about how 

dietary fat affects their heart health. 

People with advanced CKD should talk 

with a dietitian about healthy and unhealthy 

sources of fat. Saturated fats and trans-fatty 

acids can raise blood cholesterol levels and 

clog blood vessels. Saturated fats are found 

in animal products such as red meat, poultry, 

whole milk, and butter. These fats are usually solid at room temperature. Trans-fatty 

acids are often found in commercially baked 

goods such as cookies and cakes and in fried 

foods like doughnuts and french fries. 

A dietitian can suggest healthy ways to 

include fat in the diet, especially if more calories are needed. Vegetable oils such as corn 

or safflower oil are healthier than animal fats 

such as butter or lard. Hydrogenated vegetable oils should be avoided because they are 

high in trans-fatty acids. Monounsaturated 

fats—olive, peanut, and canola oils—are 

healthy alternatives to animal fats. The table 

below shows the sources of fats, broken down 

into three types of fats that should be eaten 

less often and good fats that can be eaten 

more often. 

Sources of Fats

Eat Less Often Eat More Often 

Saturated fats 

• red meat 

• poultry 

• whole milk 

• butter 

• lard 

Monounsaturated fats 

• corn oil 

• safflower oil 

• olive oil 

• peanut oil 

• canola oil 

Trans-fatty acids 

• commercially 

baked goods 

• french fries 

• doughnuts 

Hydrogenated 

vegetable oils 

• margarine 

• shortening 
 

 

Why is knowing about 

sodium important for 

someone with advanced 

CKD? 

Too much sodium in a person’s diet can be 

harmful because it causes blood to hold 

fluid. People with CKD need to be careful not to let too much fluid build up in 

their bodies. The extra fluid raises blood 

pressure and puts a strain on the heart and 

kidneys. A dietitian can help people find 

ways to reduce the amount of sodium in 

their diet. Nutrition labels provide information about the sodium content in food. The 

U.S. Food and Drug Administration advises 

that healthy people should limit their daily 

sodium intake to no more than 2,300 milligrams (mg), the amount found in 1 teaspoon 

of table salt. People who are at risk for a 

heart attack or stroke because of a condition 

such as high blood pressure or kidney disease 

should limit their daily sodium intake to no 

more than 1,500 mg. Choosing sodium-free 

or low-sodium food products will help them 

reach that goal. 

Sodium is found in ordinary table salt and 

many salty seasonings such as soy sauce and 

teriyaki sauce. Canned foods, some frozen 

foods, and most processed meats have large 

amounts of salt. Snack foods such as chips 

and crackers are also high in salt. 

Alternative seasonings such as lemon juice, 

salt-free seasoning mixes, and hot pepper 

sauce can help people reduce their salt 

intake. People with advanced CKD should 

avoid salt substitutes that use potassium, 

such as AlsoSalt or Nu-Salt, because CKD 

limits the body’s ability to eliminate potassium from the blood. The table below 

provides some high-sodium foods and suggestions for low-sodium alternatives that are 

healthier for people with any level of CKD 

who have high blood pressure. 

High- and Low-sodium Foods
�

High-sodium Foods Low-sodium 

Alternatives 

Salt 

Regular canned 

vegetables 

Hot dogs and 

canned meat 

Packaged rice with 

sauce 

Packaged noodles 

with sauce 

Frozen vegetables

with sauce 

Frozen prepared

meals 

Canned soup 

Regular tomato 

sauce 

Snack foods 

Salt-free herb 

seasonings 

Low-sodium canned 

foods 

Frozen vegetables 

without sauce 

Fresh, cooked meat 

Plain rice without sauce 

Plain noodles without 

 sauce 

Fresh vegetables 

 without sauce 

Homemade soup with 

fresh ingredients 

Reduced-sodium 

tomato sauce 

Unsalted pretzels 

Unsalted popcorn 

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/ 

sr22w307.pdf. Released September 2009. Accessed 

July 21, 2010. 

4 Nutrition for Advanced Chronic Kidney Disease in Adults 
 

 

Why is knowing about 

potassium important for 

someone with advanced 

CKD? 

Keeping the proper level of potassium in 

the blood is essential. Potassium keeps the 

heart beating regularly and muscles working right. Problems can occur when blood 

potassium levels are either too low or too 

high. Damaged kidneys allow potassium to 

build up in the blood, causing serious heart 

problems. Potassium is found in many fruits 

and vegetables, such as bananas, potatoes, 

avocados, and melons. People with advanced 

CKD may need to avoid some fruits and 

vegetables. Blood tests can indicate when 

potassium levels have climbed above normal 

range. A renal dietitian can help people with 

advanced CKD find ways to limit the amount 

of potassium they eat. The potassium 

content of potatoes and other vegetables 

can be reduced by boiling them in water. 

The following table gives examples of some 

high-potassium foods and suggestions for 

low-potassium alternatives for people with 

advanced 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 pears

Strawberries, 

blueberries, 

raspberries

Pineapple

Cabbage

Boiled cauliflower

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. 

5 Nutrition for Advanced Chronic Kidney Disease in Adults 
 

 

Why is knowing about 

phosphorus important for 

someone with advanced 

CKD? 

Damaged kidneys allow phosphorus, a mineral found in many foods, to build up in the 

blood. Too much phosphorus in the blood 

pulls calcium from the bones, making the 

bones weak and likely to break. Too much 

phosphorus may also make skin itch. Foods 

such as milk and cheese, dried beans, peas, 

colas, canned iced teas and lemonade, nuts, 

and peanut butter are high in phosphorus. A 

renal dietitian can help people with advanced 

CKD learn how to limit phosphorus in their 

diet. 

As CKD progresses, a person may need to 

take a phosphate binder such as sevelamer 

hydrochloride (Renagel), lanthanum carbonate (Fosrenol), calcium acetate (PhosLo), 

or calcium carbonate (Tums) to control the 

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, the phosphorus does not get into 

the blood. Instead, it is removed from the 

body in the stool. 

The table below lists some high-phosphorus 

foods and suggestions for low-phosphorus 

alternatives that are healthier for people with 

advanced CKD. 

High- and Low-phosphorus Foods
�

High-phosphorus 

Foods 

Low-phosphorus 

Alternatives 

Liquid nondairy

 creamer 

Sherbet
�

Cooked rice 

Rice, wheat, and 

 corn cereals
�

Popcorn 

Peas 

Lemon-lime soda 

Root beer 

Powdered iced tea 

and lemonade 

mixes 

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 

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. 

6 Nutrition for Advanced Chronic Kidney Disease in Adults 
 

Why is regulating fluid 

intake important for 

someone with advanced 

CKD? 

People with advanced CKD may need to 

limit how much they drink because damaged 

kidneys can’t remove extra fluid. The fluid 

builds up in the body and strains the heart. 

Patients should tell their health care provider 

about any swelling around the eyes or in the 

legs, arms, or abdomen. 

How can understanding 

and keeping track of lab 

reports help someone with 

advanced CKD make healthy 

food choices? 

Learning how to read and understand lab 

reports lets a person see how different foods 

can affect the kidneys. A health care provider should order regular blood tests for 

people with CKD. Patients can ask their 

health care provider for copies of their lab 

reports and ask to have them explained, 

noting any results out of the normal range. 

Keeping track of these lab results can help 

people see whether they are making progress 

or getting worse. People with CKD should 

talk with their health care provider or dietitian about how they can make healthier food 

choices. For example, if a test shows that a 

person with advanced CKD has a high potassium level, that person should concentrate 

on reducing potassium in the diet by limiting 

high-potassium foods. 

Points to Remember 

•	� A person may prevent or delay some 

health problems from chronic kidney 

disease (CKD) by eating the right foods 

and avoiding foods high in sodium, 

potassium, and phosphorus. 

•	� The kidneys remove wastes and extra 

water from the blood and make urine. 

•	� Medical nutrition therapy (MNT) is the 

use of counseling by a registered dietitian to help promote a medical or health 

goal. 

•	� Dietitians who specialize in helping people with CKD are called renal dietitians. 

•	� People with advanced CKD often lose 

their appetites and consume fewer 

calories—important units of energy in 

food—and may lose too much weight. 

•	� Eating more protein than the body 

needs may put an extra burden on the 

kidneys and cause kidney function to 

decline faster. Most people—with or 

without CKD—can get the daily protein 

they need by eating two 3-ounce servings of meat or meat substitute. 

•	� People with CKD are at higher risk of 

having a heart attack or stroke. 

•	� Everyone needs dietary fat, but some 

fats are healthier than others. 

•	� Too much sodium in a person’s diet can 

be harmful because it causes blood to 

hold fluid. People with CKD need to be 

careful not to let too much fluid build 

up in their bodies. 

7 Nutrition for Advanced Chronic Kidney Disease in Adults 
 

•	� People with advanced CKD should 

avoid salt substitutes that use potassium 

because CKD limits the body’s ability to 

eliminate potassium from the blood. 

•	� Damaged kidneys allow potassium to 

build up in the blood, causing serious 

heart problems. Potassium is found 

in many fruits and vegetables, such 

as bananas, potatoes, avocados, and 

melons. 

•	� Too much phosphorus in the blood pulls 

calcium from the bones, making the 

bones weak and likely to break. 

•	� People with advanced CKD may need to 

limit how much they drink because damaged kidneys can’t remove extra fluid. 

•	� Many patients find that keeping track 

of their test results helps them see how 

their treatment is working. Patients can 

ask their health care provider for copies of their lab reports and ask to have 

them explained, noting any results out 

of the normal range. 

Hope through Research 

The National Institute of Diabetes and 

Digestive and Kidney Diseases (NIDDK) has 

many research programs aimed at slowing 

the progression of CKD. For example, the 

NIDDK is sponsoring the Chronic Renal 

Insufficiency Cohort study to determine 

the risk factors for rapid decline in kidney 

function and development of cardiovascular 

disease. This study of about 3,000 patients 

with chronic renal insufficiency, another way 

of describing CKD, will reflect the racial, 

ethnic, and gender composition of the people 

in the United States who have permanent 

kidney failure. The data collected and specimens obtained from people in this study will 

serve as a national resource for investigating CKD, as well as cardiovascular disease. 

Establishing this group of patients and following them into the future will also provide 

an opportunity to examine genetic, environmental, behavioral, nutritional, quality-oflife, and health resource use factors in this 

population. The main part of the study will 

consist of monitoring participants and following up at regular clinic visits with kidney 

function measurements, cardiovascular studies, and lab tests. In addition, participants 

will answer questionnaires to assess various 

demographic, nutritional, and quality-of-life 

factors. 

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. 

8	� Nutrition for Advanced Chronic Kidney Disease in Adults 
 

 

Additional Reading 

The following fact sheets and brochures, as 

well as other information, are available on 

request from the organizations listed. 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 and Chronic Kidney Disease 

National Kidney Foundation 

30 East 33rd Street 

New York, NY 10016 

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

Internet: www.kidney.org 

Facts About the DASH Eating Plan 

National Heart, Lung, and Blood Institute 

Information Center 

P.O. Box 30105 

Bethesda, MD 20824–0105 

Phone: 301–592–8573 

TTY: 240–629–3255 

Fax: 301–592–8563 

Email: nhlbiinfo@nhlbi.nih.gov 

Internet: www.nhlbi.nih.gov 

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 

Kidney Beginnings: A Patient’s Guide to Living 

with Reduced Kidney Function 

American Association of Kidney Patients 

3505 East Frontage Road, Suite 315 

Tampa, FL 33607 

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

Email: info@aakp.org 

Internet: www.aakp.org 

What I need to know about Eating and Diabetes 

National Diabetes Information 

Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

Email: ndic@info.niddk.nih.gov 

Internet: www.diabetes.niddk.nih.gov 

Eating Right for Kidney Health: Tips for People 

with Chronic Kidney Disease (CKD) (online 

only) 

Your Kidney Test Results (online only) 

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 

9 Nutrition for Advanced Chronic Kidney Disease in Adults 
 

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 

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 

The information in this fact sheet should 

not be used in the nutritional counseling of 

infants, children, and adolescents with CKD. 

Families of pediatric patients with CKD 

should seek age-appropriate nutritional 

counseling from a pediatric renal dietitian. 

About the Nutrition for 

Chronic Kidney Disease 

Series 

The NIDDK Nutrition for Chronic Kidney 

Disease Series includes three fact sheets: 

•	� Nutrition for Early Chronic Kidney 

Disease in Adults
�

•	� Nutrition for Advanced Chronic Kidney 

Disease in Adults 

•	� 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. 

Acknowledgments 

Publications produced by the Clearinghouse 

are carefully reviewed by both NIDDK 

scientists and outside experts. This publication was originally reviewed by Lisa 

Murphy-Gutekunst, M.S.Ed., R.D., C.S.R., 

Cleve-Hill Dialysis, Buffalo, NY, and Marcy 

Bushman, M.P.H., R.D., L.D.N., Sigma-Tau 

Pharmaceuticals. 

10 Nutrition for Advanced Chronic Kidney Disease in Adults 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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. 

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 

toll-free 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. 

11 Nutrition for Advanced Chronic Kidney Disease in Adults 
 

 

 

 

 

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. 

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. 11–5572 

April 2011 

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