Exact portion sizes, hand-size references, fluid tracking, and a complete nutrient reference table for every food in the meal plans.
For a 70 kg (154 lb) hemodialysis patient. Adjust protein target based on your actual body weight: multiply kg × 1.2 for minimum, × 1.4 for maximum.
| Nutrient | Daily Target | Per Meal Target | Why This Limit | Risk if Exceeded |
|---|---|---|---|---|
| 🥩 Protein | 84–98 g/day | 20–30 g per main meal | Dialysis removes amino acids — must replace | Muscle wasting, malnutrition, increased mortality |
| 🔴 Potassium (K⁺) | < 2,000 mg/day | < 500 mg per meal | Failed kidneys cannot excrete K⁺ between dialysis sessions | Cardiac arrhythmia, sudden cardiac arrest |
| 🟣 Phosphorus | < 1,000 mg/day | < 300 mg per meal | Triggers calcium withdrawal from bones, arterial calcification | Vascular calcification, bone disease, cardiovascular death |
| 🟡 Sodium (Na⁺) | < 2,000 mg/day | < 500 mg per meal | Causes thirst, fluid retention, hypertension | Fluid overload, pulmonary edema, hypertension |
| 💧 Fluid | 32 oz + urine output | ~8 oz per meal (incl. food moisture) | Failed kidneys cannot eliminate excess fluid | Fluid overload, shortness of breath, heart failure |
| 🔥 Calories | 2,100–2,450 kcal | 500–700 per main meal | Prevent malnutrition; dialysis is metabolically demanding | Muscle catabolism, poor outcomes, reduced survival |
| 🦴 Calcium | < 1,000 mg/day (dietary) | < 300 mg per meal | Arterial calcification — excess dietary calcium worsens deposits | Accelerated arterial calcification, stiffened vessels |
When a scale is not available, your hand is a surprisingly reliable measuring tool. These estimates work for most average-sized adults.
All values per 4 oz (113 g) cooked portion unless noted. Sorted by phosphorus content (lowest to highest).
Values per ½ cup cooked (leached where noted). Raw values are slightly higher. Always leach high-potassium vegetables before eating.
| Vegetable | Portion | K⁺ (mg) | Phos (mg) | Notes |
|---|---|---|---|---|
| 🥒 Cucumber (raw) | ½ cup sliced | 80 | 14 | Safest vegetable — eat freely |
| 🥬 Romaine lettuce (raw) | 1 cup shredded | 115 | 15 | Excellent low-K salad base |
| 🫑 Bell pepper (raw) | ¼ cup diced | 88 | 12 | Any color — safe in portions |
| 🥦 Cauliflower (boiled) | ½ cup | 150 | 25 | Excellent potato substitute |
| 🫛 Green beans (boiled) | ½ cup | 185 | 24 | Very safe; great texture |
| 🥬 Cabbage (boiled) | ½ cup | 155 | 18 | Leach first — reduces to ~110 mg |
| 🌿 Asparagus (boiled) | ½ cup (6 spears) | 200 | 40 | Relatively safe; limit to 6 spears |
| 🥬 Bok choy (boiled) | ½ cup | 315 | 30 | Safe; great for stir-fry |
| 🥦 Broccoli (boiled) | ½ cup | 230 | 40 | Leach before cooking; moderate K⁺ |
| 🥕 Carrots (boiled & leached) | ¼ cup | 180 | 24 | Leach 2 hours reduces from ~220 to ~180 |
| 🧅 Onion (cooked) | 2 Tbsp | 55 | 9 | Use as flavoring; very safe |
| 🧄 Garlic (raw) | 1 clove | 12 | 5 | Use liberally for flavor |
| 🥦 Zucchini (boiled & drained) | ½ cup | 250 | 38 | Boil and drain well; safe in portions |
| 🍅 Tomato (raw, 1 slice) ⚠️ | 1 slice | 130 | 11 | Very limited — 1 thin slice only |
| 🥔 Potato (boiled, leached 4 hrs) ⚠️ | ½ cup | 380 | 40 | Even after leaching, still high — rare treat only |
| 🥑 Avocado ❌ | ¼ fruit | 365 | 35 | Avoid entirely |
| Fruit | Safe Portion | K⁺ (mg) | Notes |
|---|---|---|---|
| 🫐 Blueberries (fresh/frozen) | ½ cup | 57 | Best CKD fruit — antioxidants, very low K⁺ |
| 🍓 Strawberries (fresh) | ½ cup | 117 | Low K⁺, great with cream or yogurt |
| 🍇 Grapes (seedless) | ½ cup | 145 | Eat chilled; counts toward fluid slightly |
| 🍎 Apple (fresh, skin on) | 1 small (5 oz) | 148 | Portable, great for dialysis-day snack |
| 🍐 Pear (fresh) | 1 small (5 oz) | 115 | Very safe; gentle on blood sugar |
| 🍑 Peaches (canned, drained & rinsed) | ½ cup | 120 | Rinsing reduces K⁺ ~25%; drain juice completely |
| 🍍 Pineapple (canned, drained) | ½ cup chunks | 132 | Rinse and drain; counts toward fluid |
| 🍒 Cherries (fresh) | ½ cup (about 12) | 160 | Seasonal; safe in portions |
| 🍋 Lemon juice (fresh) | 1–2 Tbsp | 28 | Essential flavoring — use freely as salt substitute |
| 🍊 Mandarin orange ⚠️ | ¼ cup segments | 130 | Very small portion only; not whole fruit |
| 🍉 Watermelon ⚠️ | ½ cup cubes | 85 | Also counts as fluid (92% water); very limited |
| 🍌 Banana ❌ | Avoid | 422 | One banana = 21% of daily K⁺ limit |
| 🍊 Orange ❌ | Avoid | 237 | Juice even higher — avoid completely |
| 🥭 Mango ❌ | Avoid | 277 | Very high K⁺ |
| 🍈 Cantaloupe ❌ | Avoid | 418 | Extremely high K⁺ |
| 🍇 Raisins/Dried fruit ❌ | Avoid | 545/¼ cup | Drying concentrates potassium dramatically |
| Food | Portion | K⁺ (mg) | Phos (mg) | Na (mg) | Notes |
|---|---|---|---|---|---|
| 🍚 White rice (cooked) | ½ cup | 27 | 34 | 1 | Best CKD grain — always cook plain, unsalted |
| 🍝 White pasta (cooked) | ½ cup | 31 | 38 | 1 | Unsalted cooking water essential |
| 🍞 White bread (slice) | 1 slice | 30 | 25 | 130 | Check label — no added calcium phosphate |
| 🥯 White bagel (½) | ½ bagel | 60 | 55 | 280 | Full bagel is a lot of sodium — use half |
| 🥞 White pancakes (2 small) | 2 pancakes | 75 | 65 | 240 | Make with water — not milk |
| 🌾 Cream of Wheat (cooked) | 1 cup (cooked) | 43 | 70 | 160 | Excellent choice — low phos for a cereal |
| 🫓 White tortilla (6-inch) | 1 tortilla | 52 | 70 | 280 | Flour tortilla better than corn (lower K⁺) |
| 🍘 Rice cake (plain) | 2 cakes | 35 | 28 | 70 | Excellent neutral snack base |
| 🥣 Oatmeal (cooked, ¼ cup dry) ⚠️ | ¼ cup dry | 130 | 130 | 65 | Moderate phos — limit to 3x/week max; use water |
| 🌾 Whole wheat bread ❌ | Avoid | 70/slice | 65/slice | — | Much higher phos than white bread |
| 🥣 Bran cereal ❌ | Avoid | 190 | 160 | — | Among highest-phos breakfast foods |
Every liquid counts — including foods with high water content. Track daily. Weigh yourself each morning at the same time.
| Time | Fluid / Food Item | Amount (oz) | Running Total (oz) | Limit |
|---|---|---|---|---|
| Morning | Morning medications with water | 2 oz | 2 | 32 oz + urine output |
| Breakfast | _______________________ | ___ oz | ___ | |
| Lunch | _______________________ | ___ oz | ___ | |
| Afternoon | _______________________ | ___ oz | ___ | |
| Dinner | _______________________ | ___ oz | ___ | |
| Evening | _______________________ | ___ oz | ___ | |
| Morning weight: ______ lbs Yesterday weight: ______ lbs Change: ______ lbs | Alert if > +2 lbs | |||
| Condiment | Amount | Na (mg) | Safe for CKD? |
|---|---|---|---|
| Fresh lemon juice | 1 Tbsp | 0 | ✅ Use freely — best salt substitute |
| Garlic powder | ¼ tsp | 1 | ✅ Use liberally |
| Dried herbs (all) | 1 tsp | <5 | ✅ Use freely |
| Rice vinegar | 1 tsp | 0 | ✅ Good flavor, safe |
| Honey | 1 tsp | 1 | ✅ Low K⁺, no phosphorus |
| Maple syrup | 1 tsp | 1 | ✅ Small amounts safe |
| Unsalted butter | 1 tsp | 1 | ✅ Good calorie source |
| Olive oil | 1 tsp | 0 | ✅ Heart-healthy fat |
| Mayonnaise | 1 Tbsp | 95 | ✅ OK in moderation |
| Yellow mustard | 1 tsp | 65 | ✅ OK in moderation |
| Low-sodium soy sauce | 1 tsp | 140 | ⚠️ Limit to 1 tsp/meal max |
| Worcestershire sauce | 1 tsp | 65 | ⚠️ Small amounts; has K⁺ too |
| Regular soy sauce | 1 tsp | 280 | ❌ Too much sodium — avoid |
| Table salt | ¼ tsp | 575 | ❌ Avoid entirely — use lemon instead |
| Salt substitute (NuSalt, Morton lite) | ¼ tsp | 0 | ❌ DANGEROUS — pure potassium chloride |
| Regular ketchup | 1 Tbsp | 190 | ❌ Also high K⁺ from tomatoes — avoid |
| Salsa | 2 Tbsp | 230 | ❌ High Na + high K⁺ from tomatoes |
| Sour cream | 2 Tbsp | 25 | ⚠️ OK; some phosphorus (60 mg/2 Tbsp) |
3–4 oz (palm-sized) of:
Target: 20–30 g protein per meal
½–¾ cup of:
Provides energy; very low potassium & phosphorus
½ cup cooked (leached) of:
Adds fiber and micronutrients safely