CHAPTER PART 9 OF 9
Each of these is in circulation in Indian renal practice, appears in handouts, and is not in any current guideline. Retiring them is part of adopting this chapter.
Each of these is in circulation in Indian renal practice, appears in handouts, and is not in any current guideline. Retiring them is part of adopting this chapter.
| Commonly taught | What is actually the case |
|---|---|
| "Potassium 2,000 to 3,000 mg a day" | No numeric potassium ceiling exists in KDOQI 2020 or KDIGO 2024. Both titrate to the serum value. |
| "Phosphorus 800 to 1,000 mg a day" | Legacy KDOQI 2003. Current guidance says only: adjust intake to normalise serum phosphate, weighting the source. |
| "25 to 35 kcal per kg ideal body weight" | KDOQI says only "body weight" and defers to clinical judgement. ESPEN is the only body that defines the reference weight, and it excludes actual body weight for protein. |
| "Fluid equals 1,000 ml plus urine output" | In no current guideline. Interdialytic weight gain under 4 to 4.5 percent of body weight is the citable target. |
| "Fibre 25 to 30 g a day in CKD" | From the plant-dominant low protein diet paper, not a guideline. No guideline gives a fibre number. |
| "Aim for nPCR above 1.0 to 1.2" | Legacy KDOQI 2000. The current guideline sets no nPCR target and grades nPCR 2D. |
| "HbA1c under 7 percent on dialysis" | KDIGO's 6.5 to 8.0 range explicitly excludes dialysis. No body sets a dialysis target. |
| "Time in range above 70 percent" | The high-risk tier borrowed for CKD is above 50 percent, with time under 70 mg/dL below 1 percent. |
| "Serum albumin tells you the nutrition status" | Graded 1A as a predictor of hospitalisation and death, and explicitly not to be interpreted in isolation as a nutrition marker. |
| "Potassium binders let the patient eat fruit again" | A reasonable hypothesis under trial. The registration trials did not liberalise diet, and no guideline says this. |
| "Ash gourd is a low potassium vegetable" | 372 mg per 100 g in IFCT 2017. Higher than brinjal or carrot. Reclassify. |
| "Use rock salt, it is better for the kidneys" | Rock salt is sodium chloride. Low-sodium salt is potassium chloride. Neither helps and one is dangerous. |
| "Restrict potassium in every CKD patient" | Restriction treats hyperkalaemia. It does not prevent it, and applied to a normokalaemic patient it causes harm. |
Where a statement is expert practice rather than guideline, it is flagged in the text. Two items below are drafts or non-guideline reviews and are marked as such.