Nephrology · Clinical Calculator · CKD Nutrition

CKD Nutrition Prescription Protein · Energy · K · P · Na & Fluid Targets

Enter weight, height, age, CKD stage, and clinical modifiers to generate personalized daily targets for protein, energy, potassium, phosphorus, sodium, and fluid — adjusted by CKD stage and dialysis status using KDOQI 2020 nutrition equations.

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Instructions
  1. Choose your units (metric, hybrid, or imperial) so the weight and height inputs match what you have.
  2. Enter weight (use dry weight if on dialysis), height, age, sex, and the patient's CKD stage or dialysis modality, plus activity level and daily urine output.
  3. Tick any relevant clinical modifiers (diabetes, hyperkalemia, hyperphosphatemia, protein-energy wasting, heavy proteinuria, ketoanalogue use, etc.) — these adjust the targets.
  4. Optionally set a weight goal and target BMI, and add allergies for the sample meal plan.
  5. Press Calculate My Daily Targets to generate protein, energy, mineral (potassium, phosphorus, sodium, calcium), fluid, and vitamin targets, a diet-prescription summary, and a prototype 7-day plan. Targets are referenced to ideal/adjusted body weight where appropriate.

All computation runs in your browser; no values are stored or transmitted.

When to Use

Use this tool when writing or reviewing a dietary prescription for a patient across the spectrum of kidney health — from a healthy adult through CKD stages 1–5 and onto hemodialysis or peritoneal dialysis. It applies KDOQI 2020 nutrition recommendations to a specific weight, stage, and clinical profile to produce daily protein, energy, potassium, phosphorus, sodium, and fluid targets in one place, so the prescription matches the stage rather than a generic "renal diet."

Appropriate population

Adults at any kidney stage who need individualized nutrition targets — especially when protein needs change sharply across stages (lower in non-dialysis CKD to slow progression, higher on dialysis to offset losses). Most useful alongside a renal dietitian when setting protein g/kg, energy, and electrolyte and fluid limits.

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When NOT to rely on it

These are population-based starting estimates, not a substitute for individualized assessment by a nephrologist and renal dietitian using the patient's actual serum potassium, phosphorus, albumin, urine output, and medications. Restrictive protein prescriptions are dangerous without supervision — protein-energy wasting is common and harmful in CKD. Targets must be set against measured labs and dry weight, and re-checked as status changes.

Pearls & Pitfalls
💡

Protein flips at dialysis

Non-dialysis CKD usually calls for protein restriction (around 0.55–0.6 g/kg/day, or lower with ketoanalogues) to slow progression, but once dialysis starts the target rises to 1.0–1.2 g/kg/day to replace losses. Applying the wrong side of this flip is a common and harmful error.

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Energy first, then protein restriction

Adequate energy (25–35 kcal/kg/day) must be secured before restricting protein — without it, dietary and body protein are burned for fuel and wasting accelerates. Reference per-kg targets to ideal or adjusted body weight, not actual weight, in obesity.

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Pitfalls

(1) Do not start a restrictive or very-low-protein diet without dietitian supervision and ketoanalogue cover where indicated — protein-energy wasting is dangerous. (2) Potassium and phosphorus limits should track measured serum levels, not be applied blindly. (3) Phosphorus from additives is far more bioavailable than from natural foods — target additives first. (4) Fluid limits must account for residual urine output; over-restriction risks volume depletion.

Why Use It

Nutrition in CKD is stage-specific and frequently gets it backwards in practice: a protein target that is correct for early CKD can worsen wasting on dialysis, while a target appropriate for dialysis can accelerate progression in pre-dialysis CKD. Energy needs, and potassium, phosphorus, sodium, and fluid limits, all shift with stage and modality. Anchoring the prescription to the right weight (ideal or adjusted body weight) and the correct stage-based g/kg target keeps protein and energy in the safe window — enough to prevent wasting without overburdening failing kidneys — and standardizes the electrolyte and fluid advice that drives day-to-day control.

Enter Your Profile

Enter your profile below to calculate your personalized daily nutrient targets. Dietary requirements in CKD change dramatically by stage — what is correct for Stage 2 may be harmful at Stage 4. This calculator applies NKF KDOQI 2020 and KDIGO equations to your specific profile. If you have moderate or high malnutrition risk, your nephrologist or renal dietitian should review these targets before you make any dietary changes. Always confirm targets with your nephrologist and renal dietitian.

Your Nutrition Prescription Calculator

Results are computed locally — no data is stored or transmitted.

Units
kg & cm
Use dry weight if on dialysis (weight after a dialysis session).
Most CKD patients are sedentary or lightly active. Activity level adjusts your calorie target.
Relevant for fluid target on dialysis.
These will be noted alongside your 7-day meal plan.
Maintain weight: calorie targets set to your CKD-adjusted baseline needs.
Logo auto-loads for: rcuona (Renal Care Unit, ONA–RLMMC) · sjrc (St. Josef Renal Care) · sjbdc (St. John Biocare & Dialysis Center)

Your CKD Dietary Reference Intakes

Based on your weight, stage, and clinical profile

Macronutrients & Energy
Nutrient Recommended / Day Upper Limit CKD Note
Suggested protein distribution across meals
Minerals & Electrolytes
Mineral Recommended / Day Upper Limit CKD Note
Vitamins — CKD-Adjusted
Vitamin Recommended / Day Upper Limit CKD Note

⚠ Vitamin Cautions Specific to CKD

    Clinical Priorities for Your Stage

      Rx
      Diet Prescription Summary
      Key Dietary Instructions
        Educational estimates only. Calculated using KDIGO 2024 and NKF KDOQI Nutrition 2020 equations. Actual targets must be individualized by your nephrologist and renal dietitian based on your complete laboratory results (serum potassium, phosphorus, albumin, urine output) and medications. Never start a restrictive diet without professional supervision — protein-energy wasting is common in CKD and is dangerous. Results are not stored.
        Next Steps

        Use the result to support — not replace — clinical judgment.

        • Interpret the value against the targets shown in the calculator and the Evidence section below, in the context of the full clinical picture.
        • Trend serial measurements rather than acting on a single result; confirm abnormal or unexpected values before changing management.
        • Apply the relevant KDIGO / specialty-guideline threshold and document the indication.
        • Escalate or refer to nephrology when results are out of range, rapidly changing, or discordant with the clinical picture — and discuss the implications with the patient.
        Evidence & References

        Formula & Equations

        QuantityBasis
        Energy (kcal/day)25–35 kcal/kg/day × weight, adjusted by age and activity (KDOQI 2020)
        Protein — CKD G3–G5, non-dialysis, no diabetes0.55–0.60 g/kg/day (low-protein diet)
        Protein — CKD G3–G5 with diabetes0.6–0.8 g/kg/day
        Protein — with ketoanalogues (very-low-protein diet)0.28–0.43 g/kg/day + keto acid analogues
        Protein — hemodialysis / peritoneal dialysis1.0–1.2 g/kg/day
        Sodium< 2.0–2.3 g/day (< 100 mmol/day)
        PotassiumIndividualized to maintain normal serum K⁺ (restrict if hyperkalemic)
        PhosphorusAdjust intake to maintain normal serum phosphate (limit additives)
        Fluid (anuric dialysis)≈ urine output + 500–1000 mL/day insensible allowance
        Ketoanalogue dose≈ 1 tablet per 5 kg body weight per day, taken with meals

        Per-kilogram protein and energy targets are applied to ideal or adjusted body weight rather than actual weight in over- or underweight patients. KDOQI 2020 frames protein, energy, sodium, potassium, phosphorus, and micronutrient recommendations by CKD stage, dialysis modality, and diabetes status; the calculator combines these with the entered clinical modifiers.

        Evidence & References

        Targets follow the KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update, the consensus reference for protein, energy, sodium, potassium, phosphorus, and micronutrient prescriptions across CKD stages and dialysis modalities. Protein recommendations differ by stage, diabetes status, and whether ketoanalogues are used, and energy is set per kilogram of an appropriate reference body weight.

        1. Ikizler TA, Burrowes JD, Byham-Gray LD, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020;76(3 Suppl 1):S1–S107.
        Important: This calculator is an educational aid for clinicians and patients and does not replace individualized assessment. CKD nutrition prescriptions depend on measured serum potassium, phosphorus, albumin, urine output, dry weight, and medications. Do not start a restrictive diet or change protein, electrolyte, or fluid intake based on these estimates without your nephrologist and renal dietitian.

        Use this with

        References 4 sources
        1. KDIGO CKD 2024
        2. NKF KDOQI Nutrition in CKD 2020
        3. USDA DRI Reference Tables
        4. NKF KDOQI HD Adequacy 2015
        Dr. W Rivero, MD

        W Rivero, MD, FPCP, DPSN

        Specialist in Internal Medicine, Nephrology, and Clinical Nutrition. Practicing integrative and evidence-based nephrology across Quezon City, Pampanga, and Bulacan.

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