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Renal Dialysis Nutrition Assessment

for Hemodialysis and Peritoneal Dialysis Patients

This tool is designed to support dietitians, nurses, and healthcare professionals in assessing the dietary intake of patients undergoing renal dialysis. It may also be used by patients under professional guidance.

By entering basic demographic information and recent dietary records, the system generates a personalized nutrition assessment focusing on key nutrients relevant to dialysis care, including energy, protein, sodium, potassium, and phosphorus. The results aim to help identify potential nutritional risks and support further clinical evaluation.

⚠ Please note:
This tool is intended for dietary nutrition assessment and risk screening only. It does not replace medical diagnosis, laboratory testing, or clinical decision-making. All results should be interpreted in conjunction with the patient’s medical condition and professional judgment.

Basic Information

1. Name
2.Age
5. Females only: specific period
8. Dialysis Type
3.Physical Activity Level
6. Height
cm
4. Gender
7. Weight
kg
9. Dialysis Freq

Medical History & Special Conditions (Optional)

10. Comorbidities (Multiple Selection)
Comorbidities
11. Edema
12. Anemia
13. Serum Albumin Level (most recent) 
(g/L)
14. Dietary Preferences or Restrictions
Diet Preferences
15. Appetite
Appetite

Dietary Records

To accurately assess the nutritional status of dialysis patients, please record all foods consumed per meal, including breakfast, lunch, dinner, and snacks.

Whenever possible, we recommend weighing each food item. If weighing is not feasible, refer to the standard portion size guide to assist with estimation. The more accurate the entry, the more reliable the analysis.

For each food entry, please provide:

  • Food Name: Type keywords and select the best match from the suggestion list

  • Amount (in grams): e.g., “Fried egg 60g”, “Whole wheat bread 40g”

  • Day: If recording 2–3 days of intake, use the “Which day?” dropdown to specify whether the item belongs to Day 1, Day 2, or Day 3

We recommend selecting 1 to 3 representative days from the current dialysis cycle. Up to 12 food entries per meal are supported, which is sufficient for a complete nutritional analysis.

The final report will be based on the average daily intake and include targeted nutrient evaluations and practical dietary recommendations.

How many days would you record?
Breakfast

Food Name

Quantity (g)

Day

suggestions

suggestions

suggestions

lunch

Food Name

Quantity (g)

Day

suggestions

suggestions

suggestions

Dinner

Food Name

Quantity (g)

Day

suggestions

suggestions

suggestions

Other Intake (snack or non-meal intake)

Food Name

Quantity (g)

Day

suggestions

suggestions

suggestions

Water/Liquid Intake

ml

*If you record more than one day, please enter the total amount of beverages consumed across all recorded days
(water, tea, coffee, drinks; excluding water from foods).

report

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