Stage	Description	GFR (ml/min/1.73m^2)
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

Table 1: Stages of Chronic Kidney Disease2

Table 2: Summary of Nutrient Needs in Long-term Care

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

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