Skip to content

Draft: not yet reviewed by a clinician

Use this page to prepare questions for your care team. It does not replace their advice. Your own targets and doses come from your nephrologist, diabetes team and renal dietitian.

Sources

Pages cite these by id, for example [KDIGO 2024 CKD guideline][K24]. The list is generated from handbook/sources.yml; to add or correct a source, edit that file (see Building the handbook). Licence says what the handbook may do with each source: KDIGO guidelines are CC BY-NC-ND, so we cite and paraphrase them and never adapt their tables or figures; pages from kidney charities and dialysis providers are linked and paraphrased, never copied.

Guidelines

  • K24: Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int 2024;105(4S):S117–S314. https://kdigo.org/wp-content/uploads/2024/03/KDIGO-2024-CKD-Guideline.pdf
    Licence: CC BY-NC-ND 4.0: cite and paraphrase only; do not adapt tables or figures. Checked 2026-10-05. Diet-guide source 2.
  • K22: KDIGO Diabetes Work Group. KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int 2022;102(5S):S1–S127. https://kdigo.org/wp-content/uploads/2023/12/KDIGO-2022-Diabetes-Guideline.pdf Also: https://kdigo.org/guidelines/diabetes-ckd/.
    Licence: CC BY-NC-ND 4.0: cite and paraphrase only; do not adapt tables or figures. Checked 2026-10-05. Diet-guide source 3. The 2026 update was still a draft on 2026-10-05 (public review closed 2026-04-13); the 2022 guideline remains current.
  • K26A: Babitt JL, et al. Executive summary of the KDIGO 2026 Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Kidney Int 2026;109:44–56. https://kdigo.org/wp-content/uploads/2026/01/KDIGO-2026-Anemia-in-CKD-Guideline-Executive-Summary.pdf Also: https://kdigo.org/wp-content/uploads/2026/04/KDIGO-2026-Anemia-in-CKD-Guideline.pdf.
    Licence: CC BY-NC-ND 4.0: cite and paraphrase only; do not adapt tables or figures. Checked 2026-10-05.
  • K17: KDIGO CKD-MBD Update Work Group. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl 2017;7(1):1–59. https://pmc.ncbi.nlm.nih.gov/articles/PMC6340919
    Licence: CC BY-NC-ND 4.0: cite and paraphrase only; do not adapt tables or figures. Checked 2026-10-05. Diet-guide source 11.
  • K21BP: Cheung AK, Chang TI, Cushman WC, et al. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int 2021;99(3S):S1–S87. https://doi.org/10.1016/j.kint.2020.11.003 Also: https://kdigo.org/guidelines/blood-pressure-in-ckd/.
    Licence: CC BY-NC-ND 4.0: cite and paraphrase only; do not adapt tables or figures. Checked 2026-10-22. Citation checked 2026-10-22 against Crossref (Kidney Int 2021;99(3S):S1–S87, doi 10.1016/j.kint.2020.11.003) and the guideline PDF at kdigo.org. Recommendation 1.2: 'We suggest that out-of-office BP measurements with ambulatory BP monitoring (ABPM) or home BP monitoring (HBPM) be used to complement standardized office BP readings for the management of high BP (2B).' Recommendation 3.1.1: 'We suggest that adults with high BP and CKD be treated with a target systolic blood pressure (SBP) of <120 mm Hg, when tolerated, using standardized office BP measurement (2B).' Practice Point 3.1.1: it is potentially hazardous to apply that target to BP measurements obtained in a non-standardized manner. The guideline covers adults with CKD who are not receiving dialysis (the Work Group left out the dialysis population). The handbook states none of these targets as the reader's own: it says the goal is the care team's.
  • K20TX: Chadban SJ, et al. KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation. Transplantation 2020;104(4S1):S11–S103; summary Transplantation 2020;104(4):708–714. https://pmc.ncbi.nlm.nih.gov/articles/PMC7147399/
    Licence: Publisher copyright (KDIGO guideline): cite and paraphrase only. Checked 2026-10-06.
  • K09TX: KDIGO Transplant Work Group. KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients. Am J Transplant 2009;9(Suppl 3):S1–S155. https://kdigo.org/guidelines/transplant-recipient/
    Licence: Publisher copyright (KDIGO guideline): cite and paraphrase only. Checked 2026-10-05.
  • Q20: Ikizler TA, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis 2020;76(3 Suppl 1):S1–S107. https://doi.org/10.1053/j.ajkd.2020.05.006 Also: https://www.kidney.org/sites/default/files/Nutrition_GL%2BSubmission_101719_Public_Review_Copy.pdf.
    Licence: © National Kidney Foundation (Elsevier): cite and paraphrase only. Checked 2026-10-05. Diet-guide source 1. Cite the published numbering: protein statements 3.0.1–3.0.4, energy 3.1.1 (the 2019 public-review draft numbered them 3.1.x and 3.0.1). The published text says kg body weight, chosen by the clinician (1.1.6).
  • Q19VA: Lok CE, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis 2020;75(4 Suppl 2):S1–S164. https://doi.org/10.1053/j.ajkd.2019.12.001
    Licence: © National Kidney Foundation (Elsevier): cite and paraphrase only. Checked 2026-10-06.
  • Q15HD: National Kidney Foundation. KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 Update. Am J Kidney Dis 2015;66:884–930. https://doi.org/10.1053/j.ajkd.2015.07.015
    Licence: © National Kidney Foundation (Elsevier): cite and paraphrase only. Checked 2026-10-05.
  • DG10: National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease (2003), Guidelines 4.1–4.3, 5.5. https://www.kidney.org/sites/default/files/docs/boneguidelines.pdf
    Licence: © National Kidney Foundation: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 10.
  • I20PD: Brown EA, et al. International Society for Peritoneal Dialysis practice recommendations: prescribing high-quality goal-directed peritoneal dialysis. Perit Dial Int 2020;40:244–253. https://doi.org/10.1177/0896860819895364
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05.
  • I22P: Li PKT, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int 2022;42:110–153. https://doi.org/10.1177/08968608221080586
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05.
  • JBDS: Frankel AH, et al. Management of adults with diabetes on the haemodialysis unit: summary of guidance from the Joint British Diabetes Societies and the Renal Association. Br J Diabetes 2016;16:69–77. https://bjd-abcd.com/index.php/bjd/article/view/134 Also: https://www.rightdecisions.scot.nhs.uk/nhs-borders-clinical-guidelines/diabetes-and-endocrinology/management-of-adults-with-diabetes-on-dialysis-jbds-ip-national-guidance-external-link.
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. 2016 summary (recommendations re-read in the local PDF text 2026-10-06): HbA1c by HPLC to avoid carbamylation; HbA1c underestimates unless iron deficient; target 58–68 mmol/mol (7.5–8.5 %) with treatments that cause lows; glycated albumin for research; CGM lag longer in kidney failure; start CGM on a non-dialysis day (calibration); glucose most often drops in the last hour of dialysis and is lowest afterwards; hypoglycaemia unawareness common. Updated by JBDS22, which no longer gives the A1c target: cite JBDS22 for current dialysis targets.
  • UKKA19: Wiles K, et al. Clinical practice guideline on pregnancy and renal disease. BMC Nephrol 2019;20:401. https://doi.org/10.1186/s12882-019-1560-2
    Licence: CC BY 4.0 (open access). Checked 2026-10-06. Checked 2026-10-06 (full text, Europe PMC PMC6822421): contraception advice for all women with CKD (3.1.1) and especially within a year of transplant (3.1.2); pre-pregnancy counselling by a team with an obstetrician and nephrologist (3.3.1); higher risk of pre-eclampsia, preterm birth and growth restriction (3.3.2); ACE inhibitor discontinuation plan (3.3.5), ARBs stopped before pregnancy (3.3.6), and in diabetic kidney disease ACE inhibitors continued until conception with regular pregnancy tests (5.4.2); mycophenolate stopped 3 months before conception (2.5); wait usually more than a year after a transplant (5.1.1); long, frequent haemodialysis in pregnancy (5.2.2); PD converted to HD (5.2.4).
  • AASM24: Winkelman JW, et al. Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 2025;21(1):137–152 (published online 2024-09-26). https://doi.org/10.5664/jcsm.11390
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. Abstract read on Europe PMC (PMID 39324694) 2026-10-06. Check ferritin and TSAT; iron if ferritin ≤ 75 ng/mL or TSAT < 20 %; gabapentinoids are strong recommendations; suggests against standard use of dopamine agonists (augmentation). With kidney failure (ESRD): suggests gabapentin, IV iron sucrose when ferritin < 200 ng/mL and TSAT < 20 %, and vitamin C; suggests against standard use of levodopa and rotigotine. Address caffeine, alcohol, antihistamines and untreated sleep apnoea first.
  • A26-5: American Diabetes Association Professional Practice Committee. 5. Facilitating Positive Health Behaviors and Well-being: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl 1):S89–S131. https://pmc.ncbi.nlm.nih.gov/articles/PMC12690188
    Licence: © American Diabetes Association: educational, not-for-profit use with citation, unaltered; cite and paraphrase. Checked 2026-10-05. Diet-guide source 8.
  • A26-6: American Diabetes Association Professional Practice Committee. 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl 1):S132–S149. https://pmc.ncbi.nlm.nih.gov/articles/PMC12690178
    Licence: © American Diabetes Association: educational, not-for-profit use with citation, unaltered; cite and paraphrase. Checked 2026-10-05. Diet-guide source 9.
  • A26-11: American Diabetes Association Professional Practice Committee. 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl 1):S246–S260. https://pmc.ncbi.nlm.nih.gov/articles/PMC12690176 Also: https://pmc.ncbi.nlm.nih.gov/articles/PMC11635029.
    Licence: © American Diabetes Association: educational, not-for-profit use with citation, unaltered; cite and paraphrase. Checked 2026-10-05. Diet-guide source 9. Protein is Rec 11.3 in 2026 (it was Rec 11.8 in the 2025 edition, PMC11635029).
  • A26-7: American Diabetes Association Professional Practice Committee. 7. Diabetes Technology: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl 1):S150–S165. https://pmc.ncbi.nlm.nih.gov/articles/PMC12690173 Also: https://diabetesjournals.org/care/issue/49/Supplement_1.
    Licence: © American Diabetes Association: educational, not-for-profit use with citation, unaltered; cite and paraphrase. Checked 2026-10-05.
  • A26-15: American Diabetes Association Professional Practice Committee. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl 1):S321–S338. https://pmc.ncbi.nlm.nih.gov/articles/PMC12690181 Also: https://diabetesjournals.org/care/issue/49/Supplement_1.
    Licence: © American Diabetes Association: educational, not-for-profit use with citation, unaltered; cite and paraphrase. Checked 2026-10-05.
  • JBDS22: Frankel AH, Wahba M, Ashworth V, et al. Management of adults with diabetes on dialysis: summary of recommendations of the Joint British Diabetes Societies guidelines 2022. Diabet Med 2023;40(4):e15027. Full guideline: JBDS-IP, Management of adults with diabetes on dialysis (JBDS 11, August 2022). https://doi.org/10.1111/dme.15027 Also: https://ukkidney.org/sites/default/files/JBDS_11_Renal_Guide_August_2022.pdf.
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. Updates the 2016 hemodialysis guidance (JBDS) and adds peritoneal dialysis. Read in the full PDF 2026-10-06. Rec 2.7: do not use glucose oxidase or GDH-PQQ meters on dialysis; 2.9: real-time CGM for recurrent lows or lost awareness; 3B.5: lower insulin on hemodialysis days may reduce lows, CGM is a better guide (dose figures deliberately not repeated in the handbook); 5A.1: pre-dialysis glucose under 7 mmol/L (126 mg/dL): 20–30 g low-GI carbohydrate at the start of the session; 5A.2: check before and after hemodialysis; 5A.3: a low treatment always within reach, including on the journey; 5A.4: rescue carbohydrate chosen for fluid, potassium and phosphate limits. PD (section 6): insulin under the skin only, not in the bags (6.8–6.9); glucose dialysate may raise insulin needs (6.10); CAPD can absorb up to 100–200 g glucose a day (400–800 kcal); icodextrin meter interference lasts at least two weeks after stopping; CGM accuracy on PD has limited data (2.8). DKA (5D): rarer but happens on dialysis; ketone levels were lower in ESKD; ketones above 3.0 mmol/L need immediate assessment; signs of dehydration and deep breathing may be missing; people may miss sessions because of DKA symptoms.
  • AHA25BP: Jones DW, Ferdinand KC, Taler SJ, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Hypertension 2025;82(10):e212–e316. https://doi.org/10.1161/HYP.0000000000000249
    Licence: © American Heart Association and American College of Cardiology: link and paraphrase only. Checked 2026-10-22. Citation checked 2026-10-22 against PubMed (PMID 40811516) and Crossref: Hypertension 2025;82(10):e212–e316, doi 10.1161/HYP.0000000000000249. The full text at ahajournals.org could not be fetched (HTTP 403 to the checker), so the device wording was checked against the American Heart Association's news release of 11 December 2025 (AHA-CUFFLESS), which says the guideline 'recommended against using cuffless blood pressure devices for diagnosis or treatment until they demonstrate greater precision and reliability', and against secondary summaries (validated oscillometric home monitors for diagnosis and for adjusting treatment). The handbook says only that: validated devices, and not cuffless watches or rings. Re-read the guideline's home-monitoring section (note 10 header, 'Re-verify') before this page is reviewed.
  • A26-9: American Diabetes Association Professional Practice Committee. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl 1):S183–S215. https://pmc.ncbi.nlm.nih.gov/articles/PMC12690185 Also: https://doi.org/10.2337/dc26-S009.
    Licence: © American Diabetes Association: educational, not-for-profit use with citation, unaltered; cite and paraphrase. Checked 2026-10-06. Rec 9.1 (insulin for type 1); pancreas transplantation reserved for type 1 diabetes with simultaneous or prior kidney transplant, or recurrent DKA or severe hypoglycaemia; successful transplant 'can normalize glucose levels'; lifelong immunosuppression.

Consensus statements

  • K20NOM: Levey AS, et al. Nomenclature for kidney function and disease: report of a KDIGO Consensus Conference. Kidney Int 2020;97:1117–1129. https://doi.org/10.1016/j.kint.2020.02.010 Also: https://kdigo.org/conferences/nomenclature/.
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05.
  • K15SC: Davison SN, et al. Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease. Kidney Int 2015;88:447–459. https://doi.org/10.1038/ki.2015.110
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05.
  • CON20: Davenport MS, et al. Use of intravenous iodinated contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Radiology 2020;294:660–668. https://doi.org/10.1148/radiol.2019192094
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05.
  • GAD21: Weinreb JC, et al. Use of intravenous gadolinium-based contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Radiology 2021;298:28–35. https://doi.org/10.1148/radiol.2020202903
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05.
  • AK22: de Boer IH, et al. Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Diabetes Care 2022;45:3075–3090. https://pmc.ncbi.nlm.nih.gov/articles/PMC9870667
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 54.
  • HC24: Umpierrez GE, et al. Hyperglycemic crises in adults with diabetes: a consensus report. Diabetes Care 2024;47(8):1257–1275. https://doi.org/10.2337/dci24-0032
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05.
  • TIR19: Battelino T, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the International Consensus on Time in Range. Diabetes Care 2019;42:1593–1603. https://doi.org/10.2337/dci19-0028
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05.
  • EX17: Riddell MC, et al. Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol 2017;5:377–390. https://doi.org/10.1016/S2213-8587(17)30014-1
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. Checked 2026-10-06 (full text, Lancet Diabetes Endocrinol 2017, panel 1): before exercise below 90 mg/dL (5 mmol/L) take 10–20 g glucose and wait; above 270 mg/dL (15 mmol/L) unexplained, check blood ketones; up to 1.4 mmol/L light exercise under 30 min only; 1.5 mmol/L or more exercise is contraindicated; 3.0 or more needs urgent care; severe hypoglycaemia in the past 24 h is a contraindication; vigorous exercise and heavy lifting are contraindicated with long-standing poorly controlled diabetes, especially with kidney failure.
  • ISRNM08: Fouque D, et al. A proposed nomenclature and diagnostic criteria for protein–energy wasting in acute and chronic kidney disease (ISRNM). Kidney Int 2008;73:391–398. https://doi.org/10.1038/sj.ki.5002585
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. Serum albumin under 3.8 g/dL (bromocresol green method); unintended weight loss over 5 % in 3 months or over 10 % in 6 months. Criteria table re-checked via its reproduction in PMC4222262 (design note 05 fact-check).

Studies

  • F1: Heerspink HJL, Birkenfeld AL, Cherney DZI, et al. Finerenone in Type 1 Diabetes and Chronic Kidney Disease (FINE-ONE). N Engl J Med 2026;394(10):947–957. https://doi.org/10.1056/NEJMoa2512854
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. DOI confirmed on Crossref 2026-10-05 (published 2026-03-05). Abstract re-read on PubMed (PMID 41780000) 2026-10-06: 242 adults; UACR fell 25 % more than with placebo over 6 months; hyperkalaemia 10.1 % vs 3.3 % (1.7 % stopped for it); eGFR change at 6 months −5.6 vs −2.7 mL/min/1.73 m², approaching baseline after the washout.
  • DG6: Bethke PC, Jansky SH. The effects of boiling and leaching on the content of potassium and other minerals in potatoes. J Food Sci 2008;73(5):H80–H85. https://pubmed.ncbi.nlm.nih.gov/18576999/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 6.
  • DG14a: Noori N, et al. Association of dietary phosphorus intake and phosphorus to protein ratio with mortality in hemodialysis patients. Clin J Am Soc Nephrol 2010;5:683–692. https://pmc.ncbi.nlm.nih.gov/articles/PMC2849686
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 14.
  • DG15: St-Jules DE, et al. Examining the proportion of dietary phosphorus from plants, animals, and food additives excreted in urine. J Ren Nutr 2017;27:78–83. https://escholarship.org/uc/item/0nd4b0xx
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 15.
  • DG28a: Cabrera C, et al. A retrospective, longitudinal study estimating the association between interdialytic weight gain and cardiovascular events and death in hemodialysis patients. BMC Nephrol 2015;16:113. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4510887/
    Licence: CC BY 4.0 (open access). Checked 2026-10-05. Diet-guide source 28.
  • DG30a: Picard K, et al. Handouts for low-potassium diets disproportionately restrict fruits and vegetables. J Ren Nutr 2021;31:210–214 (source of KDIGO 2024 Figure 33). https://doi.org/10.1053/j.jrn.2020.07.001
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 30.
  • DG31: Wickham E. Phosphorus content in commonly consumed beverages. J Ren Nutr 2014;24(1):e1–e4. https://doi.org/10.1053/j.jrn.2013.10.002
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 31. DOI confirmed on Crossref 2026-10-05.
  • DG40: Star fruit (caramboxin) intoxication in kidney disease: case series and review (PMC7735120). https://pmc.ncbi.nlm.nih.gov/articles/PMC7735120
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 40.
  • DG44: Severe symptomatic hypermagnesemia associated with over-the-counter laxatives in a patient with renal failure. Case Rep Nephrol 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3914018/
    Licence: Open access: cite and paraphrase. Checked 2026-10-05. Diet-guide source 44.
  • DG50: Kovesdy CP, et al. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis. Eur Heart J 2018;39:1535–1542. https://doi.org/10.1093/eurheartj/ehy100
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 50. DOI confirmed on Crossref 2026-10-05.
  • DG53: Foley RN, et al. Long interdialytic interval and mortality among patients receiving hemodialysis. N Engl J Med 2011;365:1099–1107. https://pubmed.ncbi.nlm.nih.gov/21992122/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 53.
  • DOPPS03: Saran R, et al. Nonadherence in hemodialysis: associations with mortality, hospitalization, and practice patterns in the DOPPS. Kidney Int 2003;64(1):254–262. https://doi.org/10.1046/j.1523-1755.2003.00064.x
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. Skipping one or more sessions a month: mortality RR 1.30, hospitalisation RR 1.13 (abstract, Europe PMC; DOI confirmed on Crossref 2026-10-06).
  • ALB18: de Roij van Zuijdewijn CLM, et al. Role of albumin assay on calcium levels and prescription of phosphate binders in chronic hemodialysis patients. Nephron 2018;140(3):211–217. https://doi.org/10.1159/000492238 Also: https://pmc.ncbi.nlm.nih.gov/articles/PMC6262677.
    Licence: Publisher copyright (free full text in PMC): cite and paraphrase only. Checked 2026-10-06. Abstract re-read on PubMed (PMID 30212837) 2026-10-06: 506 hemodialysis patients from the CONTRAST cohort, 331 at 9 centres using bromocresol purple and 175 at 16 centres using bromocresol green (different patients, not the same samples). Mean albumin 34.5 vs 40.3 g/L; measured calcium similar, corrected calcium higher in the purple group (2.45 vs 2.33 mmol/L). The earlier note's '521' was not found in the abstract.
  • BICARB20: BiCARB study group (Witham MD, et al.). Clinical and cost-effectiveness of oral sodium bicarbonate therapy for older patients with chronic kidney disease and low-grade acidosis (BiCARB): a pragmatic randomised, double-blind, placebo-controlled trial. BMC Med 2020;18:91. https://doi.org/10.1186/s12916-020-01542-9
    Licence: CC BY 4.0 (open access). Checked 2026-10-06. Abstract read on PubMed (PMID 32268897) 2026-10-06: 300 adults aged 60 or over with eGFR under 30 (G4–G5), not on dialysis, bicarbonate under 22 mmol/L; no benefit on physical function or kidney function at 12 months; higher costs, lower EQ-5D quality of life and more adverse events (457 vs 400). KDIGO 2024's text describes the population as 'CKD G3–G4'; the trial report says eGFR under 30.
  • SHERMAN09: Sherman RA, Mehta O. Phosphorus and potassium content of enhanced meat and poultry products: implications for patients who receive dialysis. Clin J Am Soc Nephrol 2009;4(8):1370–1373. doi:10.2215/CJN.02830409 https://pmc.ncbi.nlm.nih.gov/articles/PMC2723964/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. 36 uncooked meat and poultry products. Products with additives had a phosphate-to-protein ratio 28 % higher on average (up to almost 100 % higher); additive-free products had < 387 mg potassium/100 g, while 5 of 25 enhanced products had ≥ 692 mg/100 g (max 930); 8 of 25 enhanced products did not list the additives.
  • LEON13: León JB, Sullivan CM, Sehgal AR. The prevalence of phosphorus-containing food additives in top-selling foods in grocery stores. J Ren Nutr 2013;23(4):265–270.e2. doi:10.1053/j.jrn.2012.12.003 https://pmc.ncbi.nlm.nih.gov/articles/PMC3674209/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. 2,394 best-selling grocery products (northeast Ohio): 44 % had phosphorus additives (prepared frozen foods 72 %, dry mixes 70 %, packaged meat 65 %, bread and baked goods 57 %, soup 54 %, yogurt 51 %). Additive foods averaged 67 mg/100 g more phosphorus; sample meals of additive foods had 736 mg more phosphorus a day; additive-free meals cost about $2.00 more a day.
  • ABREU23: de Abreu DBV, Picard K, Klein MRST, Gadas OM, Richard C, Barreto Silva MI. Soaking to reduce potassium and phosphorus content of foods. J Ren Nutr 2023;33(1):165–171. doi:10.1053/j.jrn.2022.06.010 https://pubmed.ncbi.nlm.nih.gov/35803495/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. KDIGO 2024 reference 599. 20 Brazilian staple foods soaked 5–10 minutes in just-boiled water (5 parts water to 1 part food). Potassium fell 40–49 % in beef, leafy greens and grains; 30–39 % in chicken, fish and non-leafy vegetables; 10–20 % in tubers. Phosphorus fell 30–39 % in grains and beans, 20–29 % in non-leafy vegetables, 10–20 % in meat and fish.
  • FRIDOLFSSON25: Fridolfsson J, Sjöberg E, Thiwång M, Pettersson S. Performance evaluation of 3 large language models for nutritional content estimation from food images. Curr Dev Nutr 2025;9(10):107556. doi:10.1016/j.cdnut.2025.107556 https://pmc.ncbi.nlm.nih.gov/articles/PMC12513282/
    Licence: CC BY 4.0 (open access): cite and paraphrase. Checked 2026-10-06. 52 standardised food photos. Mean absolute percentage error: ChatGPT-4o 36 % (weight) and 36 % (energy), Claude 3.5 Sonnet 37 % and 36 %, Gemini 1.5 Pro 65 % and 64 %; large portions were systematically underestimated.
  • SULLIVAN07: Sullivan CM, Leon JB, Sehgal AR. Phosphorus-containing food additives and the accuracy of nutrient databases: implications for renal patients. J Ren Nutr 2007;17(5):350–354. doi:10.1053/j.jrn.2007.05.008 https://pubmed.ncbi.nlm.nih.gov/17720105/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-06. 35 of 38 chicken products had phosphate additives; measured phosphorus was higher than the ESHA database value in every additive category (breaded breast strips by an average of 84 mg/100 g); "Available nutrient databases do not reflect this higher phosphorus content".

Reviews

  • DG12: Kalantar-Zadeh K, et al. Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clin J Am Soc Nephrol 2010;5:519–530. https://pubmed.ncbi.nlm.nih.gov/20093346/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 12.
  • DG13a: Noori N, et al. Organic and inorganic dietary phosphorus and its management in chronic kidney disease. Iran J Kidney Dis 2010;4:89–100. https://pubmed.ncbi.nlm.nih.gov/20404416/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 13.
  • DG13b: International Society of Renal Nutrition and Metabolism commentary on the KDOQI 2020 nutrition guideline. https://pmc.ncbi.nlm.nih.gov/articles/PMC9303594
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 13.
  • DG16a: Kalantar-Zadeh K, et al. Plant-dominant low-protein diet for conservative management of chronic kidney disease (PLADO). Nutrients 2020;12:1931. https://pmc.ncbi.nlm.nih.gov/articles/PMC7400005/
    Licence: CC BY 4.0 (open access). Checked 2026-10-05. Diet-guide source 16.
  • DG18: Review of phosphate additives in the Western diet (PMC6419782). https://pmc.ncbi.nlm.nih.gov/articles/PMC6419782/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 18.
  • DG25b: Di Iorio B, et al. Nutr Diet Suppl 2012;4:55–59, reproducing measured beverage phosphorus (Murphy-Gutekunst, J Ren Nutr 2005, as tabulated by Kalantar-Zadeh 2010). https://www.dovepress.com/article/download/11303
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 25.
  • DG36: Sousa AGP, et al. Hyporeninemic hypoaldosteronism and diabetes mellitus: pathophysiology assumptions, clinical aspects and implications for management. World J Diabetes 2016;7:101–111. https://www.wjgnet.com/1948-9358/full/v7/i5/101.htm
    Licence: CC BY-NC 4.0 (open access). Checked 2026-10-05. Diet-guide source 36.
  • DG39: de Oliveira ES, Aguiar AS. Why eating star fruit is prohibited for patients with chronic kidney disease? J Bras Nefrol 2015;37:241–247. https://pubmed.ncbi.nlm.nih.gov/26154645/
    Licence: Open access: cite and paraphrase. Checked 2026-10-05. Diet-guide source 39.
  • DG45: StatPearls. Hypermagnesemia (NCBI Bookshelf NBK549811). https://www.ncbi.nlm.nih.gov/books/NBK549811/
    Licence: CC BY-NC-ND 4.0: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 45.
  • DG55a: Pecoits-Filho R, et al. Interactions between kidney disease and diabetes: dangerous liaisons. Diabetol Metab Syndr 2016;8:50. https://pmc.ncbi.nlm.nih.gov/articles/PMC4964290/
    Licence: CC BY 4.0 (open access). Checked 2026-10-05. Diet-guide source 55.

Product labels

  • KER: Bayer HealthCare. Kerendia (finerenone) tablets: US prescribing information, revised 9/2026. https://labeling.bayerhealthcare.com/html/products/pi/Kerendia_PI.pdf
    Licence: Product label: quote the label at most one sentence; never reproduce dosing. Checked 2026-10-05.
  • FARXIGA: AstraZeneca. Farxiga (dapagliflozin) tablets: US prescribing information, revised 6/2026 (DailyMed). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=72ad22ae-efe6-4cd6-a302-98aaee423d69
    Licence: Product label: quote the label at most one sentence; never reproduce dosing. Checked 2026-10-06. Limitations of use: 'not recommended for use to improve glycemic control in patients with type 1 diabetes mellitus'. 5.1: in type 1 diabetes it 'significantly increases the risk of diabetic ketoacidosis'; check for ketoacidosis whatever the glucose; ketoacidosis has been reported up to 2 weeks after stopping an SGLT2 inhibitor. The CKD indication names no diabetes type, but people with type 1 diabetes were not studied (KDIGO 2024 research recommendations).
  • OZEMPIC: Novo Nordisk. Ozempic (semaglutide) injection: US prescribing information (DailyMed version of June 2026). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
    Licence: Product label: quote the label at most one sentence; never reproduce dosing. Checked 2026-10-06. Every indication, including the kidney indication from the FLOW trial, is for adults with type 2 diabetes.
  • ALKA: Bayer HealthCare. Alka-Seltzer Original effervescent tablets: Drug Facts label (DailyMed version of December 2025). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5be36a7f-7d1f-468d-9c29-92c8cd3ef1bc
    Licence: Product label: quote at most one sentence. Checked 2026-10-06. Active ingredients include aspirin (labelled as an NSAID) and sodium bicarbonate; each tablet contains 567 mg sodium; 'ask a doctor before use' with kidney disease, high blood pressure, a diuretic or a sodium-restricted diet.
  • DECONGEST-LABELS: Kenvue. Drug Facts labels (DailyMed): Sudafed Sinus Congestion (pseudoephedrine), Sudafed PE Sinus Congestion (phenylephrine) and Sudafed PE Head Congestion + Pain (ibuprofen and phenylephrine). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c05d7e27-6821-468f-b27d-9c0b02a07b0f Also: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2ca08917-1a75-4365-8520-c083e6a4225a, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=76513fb2-7323-4f1f-8a10-92f8f603cf97.
    Licence: Product label: quote at most one sentence; never reproduce dosing. Checked 2026-10-06. Both single-ingredient labels: ask a doctor before use if you have heart disease, high blood pressure, thyroid disease, diabetes or trouble urinating. The Head Congestion + Pain product combines an NSAID (ibuprofen) with phenylephrine and adds kidney disease to the ask-a-doctor list.
  • GLUCAGON-KIT: Fresenius Kabi. Glucagon Emergency Kit for Low Blood Sugar: instructions for use and prescribing information (approved 9/2019). https://www.glucagonemergencykit.com/wp-content/uploads/2019/12/Glucagon_IFU_191122.pdf
    Licence: Product label: quote at most one sentence; never reproduce dosing. Checked 2026-10-06. After glucagon: turn the person on their side (they may vomit), call for emergency medical help right away, feed them when awake and able to swallow.
  • DG35b: Morton Salt. Morton Lite Salt product label (290 mg sodium and 350 mg potassium per 1/4 teaspoon). https://www.mortonsalt.com/shop/low-no-sodium/morton-lite-salt/
    Licence: Product label: quote at most one sentence. Checked 2026-10-05. Diet-guide source 35.
  • PROGRAF: Astellas Pharma US. Prograf (tacrolimus) US prescribing information, revised 8/2023. https://www.astellas.com/us/system/files/prograf_7.pdf
    Licence: Product label: quote the label at most one sentence; never reproduce dosing. Checked 2026-10-06. Avoid grapefruit (2.1, 7.2); St John's wort lowers tacrolimus levels (7.2); new-onset diabetes (5.4); hyperkalaemia (5.7); hypomagnesaemia (adverse reactions); avoid live vaccines (5.14); limit sun and UV light (5.2).
  • CELLCEPT: Genentech. CellCept (mycophenolate mofetil) US prescribing information, revised 7/2026. https://www.gene.com/download/pdf/cellcept_prescribing.pdf
    Licence: Product label: quote the label at most one sentence; never reproduce dosing. Checked 2026-10-06. Boxed warning on embryofetal toxicity kept after the REMS ended; contraceptive counselling and acceptable contraception during treatment and for 6 weeks after stopping (8.3); effective contraception advised for male patients (8.3).
  • EXTRANEAL: Vantive US Healthcare. Extraneal (icodextrin) peritoneal dialysis solution: US prescribing information, revised 6/2025 (DailyMed). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d5b85158-b0d6-4855-9d07-8d1b3ad9ab71
    Licence: Product label: quote the label at most one sentence; never reproduce dosing. Checked 2026-10-06. Use glucose-specific meters and strips; GDH-PQQ, GDO and some GDH-FAD methods read falsely high, up to two weeks after stopping; CGM systems 'may or may not be compatible'; false highs have led to missed lows and inappropriate insulin.
  • DEXCOM-G7: Dexcom. Dexcom G7 Continuous Glucose Monitoring System user guide (AW00078-10 Rev 005, 05/2026). https://dexcompdf.s3.us-west-2.amazonaws.com/en-us/G7-CGM-Users-Guide.pdf Also: https://www.dexcom.com/en-us/safety-information.
    Licence: Product labeling: quote at most one sentence; link and paraphrase. Checked 2026-10-06. Safety statement: don't use if you are on dialysis or critically ill; performance hasn't been evaluated in these populations and readings may be inaccurate. Use a meter when readings don't match symptoms; hydroxyurea makes readings falsely high.
  • LIBRE-ISI: Abbott. FreeStyle Libre systems: important safety information (US). https://www.freestyle.abbott/us-en/safety-information.html
    Licence: Product labeling: quote at most one sentence; link and paraphrase. Checked 2026-10-06. Libre 3 Plus / 2 Plus: don't use if you are on dialysis or critically ill (not evaluated in these groups); high-dose vitamin C can falsely raise readings; use a blood glucose meter when the reading doesn't match how you feel.
  • SALTSUB-LABELS: Product labels (retailer listings): NoSalt Original Sodium-Free Salt Alternative (potassium chloride; 640 mg potassium per 1/4 teaspoon); Nu-Salt Salt Substitute (potassium chloride; 530 mg potassium per serving). https://hannaford.com/groceries/product/no-salt-original-sodium-free-salt-alternative-11-oz-can/51918 Also: https://www.heb.com/product-detail/nu-salt-salt-substitute/140095.
    Licence: Product label facts: cite only. Checked 2026-10-06. NoSalt label: 640 mg potassium (18 % DV) and 0 mg sodium per 1/4 tsp; ingredients potassium chloride, potassium bitartrate and others; warning: "Persons with diabetes, heart or kidney disease, or persons receiving medical treatment should consult a physician before using a sodium-free salt." Nu-Salt: 530 mg potassium (15 % DV) per serving.

Government and regulators

  • NGSP: NGSP. IFCC standardization of HbA1c (NGSP–IFCC master equation). https://ngsp.org/ifccngsp.asp
    Licence: Link and paraphrase. Checked 2026-10-05.
  • MHRA: Medicines and Healthcare products Regulatory Agency. Drug Safety Update: Extraneal (icodextrin) and products that contain (or are metabolised to) maltose, xylose or galactose: false blood glucose readings. https://www.gov.uk/drug-safety-update/extraneal-and-products-that-contain-or-are-metabolised-to-maltose-xylose-or-galactose-false-blood-glucose-readings
    Licence: Open Government Licence v3.0. Checked 2026-10-06. Re-read 2026-10-06: GDH-PQQ and glucose-dye-oxidoreductase meters read falsely high; a false high 'could result in administration of more insulin than needed and subsequent hypoglycaemia, loss of consciousness, coma, neurological damage, or death'; use only glucose-specific monitors. It does not give the two-week duration: cite the Extraneal label (EXTRANEAL) for that.
  • MHRA-DAPA: Medicines and Healthcare products Regulatory Agency. Drug Safety Update: Dapagliflozin (Forxiga): no longer authorised for treatment of type 1 diabetes mellitus (10 December 2021). https://www.gov.uk/drug-safety-update/dapagliflozin-forxiga-no-longer-authorised-for-treatment-of-type-1-diabetes-mellitus
    Licence: Open Government Licence v3.0. Checked 2026-10-06. The type 1 diabetes indication was withdrawn across Europe and the UK on 25 October 2021; 'The removal of the type 1 diabetes indication is not due to any new safety concerns'. DKA is common (up to 1 in 10) in type 1 diabetes, including euglycaemic DKA. KDIGO 2022 chapter 1 says the maker withdrew it 'citing concerns about diabetic ketoacidosis'; the regulator's wording is used in the handbook.
  • FDANaP: US Food and Drug Administration. FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the-counter sodium phosphate products to treat constipation (2014). https://web.archive.org/web/20260201200911/https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-possible-harm-exceeding-recommended-dose-over-counter-sodium Also: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-possible-harm-exceeding-recommended-dose-over-counter-sodium.
    Licence: Public domain (US government work). Checked 2026-10-05. Diet-guide source 43. The fda.gov page returned 404 on 2026-10-05; the link is the Internet Archive copy of 2026-02-01. Replace it if FDA republishes the communication.
  • REMS: Mycophenolate REMS (Risk Evaluation and Mitigation Strategy) program. https://www.mycophenolaterems.com/
    Licence: Link only. Checked 2026-10-06. Changed in 2026: the site says the FDA discontinued the REMS on 2026-07-29 (approval letter FDA-MYCO26, 2026-07-31). The label (CELLCEPT, 7/2026) keeps the embryofetal-toxicity boxed warning and the contraception counselling. Pages should say 'the label requires', not 'the REMS requires'.
  • CDC-SICK: Centers for Disease Control and Prevention. Managing sick days (page last reviewed 15 May 2024). https://www.cdc.gov/diabetes/living-with/managing-sick-days.html
    Licence: Public domain (US government work). Checked 2026-10-06. Check blood sugar every 4 hours; keep taking insulin; if you can't eat meals, about 50 g carbohydrate every 4 hours; emergency care for trouble breathing, being unable to keep liquids down for more than 4 hours or food for more than 24 hours, vomiting or severe diarrhea for more than 6 hours, losing 5 lb or more, blood sugar below 60 mg/dL, or a temperature over 101 °F for 24 hours. Its 'drink plenty of water' and fruit-juice examples ignore fluid and potassium limits, so the handbook adapts them.
  • EMA-PSE: European Medicines Agency. Pseudoephedrine-containing medicinal products: referral (PRAC review; European Commission decisions of 25 and 27 March 2024). https://www.ema.europa.eu/en/medicines/human/referrals/pseudoephedrine-containing-medicinal-products
    Licence: © European Medicines Agency: reproduction authorised with acknowledgement; link and paraphrase. Checked 2026-10-06. Must not be used by people with severe or uncontrolled high blood pressure or severe acute or chronic kidney disease or kidney failure; rare risks of PRES and RCVS (reduced blood supply to the brain).
  • FDA-PE: US Food and Drug Administration. FDA proposes ending use of oral phenylephrine as OTC monograph nasal decongestant active ingredient after extensive review (press announcement, 7 November 2024). https://www.fda.gov/news-events/press-announcements/fda-proposes-ending-use-oral-phenylephrine-otc-monograph-nasal-decongestant-active-ingredient-after
    Licence: Public domain (US government work). Checked 2026-10-06. Oral phenylephrine is not effective as a nasal decongestant; the proposal is based on effectiveness, not safety; still a proposed order on 2026-10-06 (products may still be sold); nasal sprays are not affected.
  • NIDDK-CKD: National Institute of Diabetes and Digestive and Kidney Diseases. Chronic kidney disease (CKD). https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-05.
  • NIDDK-tests: NIDDK. Tests and diagnosis of chronic kidney disease. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-05.
  • NIDDK-managing: NIDDK. Managing chronic kidney disease. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/managing
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-05.
  • NIDDK-HD: NIDDK. Hemodialysis. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. Checked 2026-10-06: in-centre usually 3 times a week, about 4 hours each; fistula 'Healing may take several months'; graft can be used soon after surgery; feel the vibration over a working access; home HD training 4½–6 hours a day, 5 days a week, for 3–8 weeks.
  • NIDDK-HD-eat: NIDDK. Eating and nutrition for hemodialysis. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis/eating-nutrition
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-05.
  • NIDDK-PD: NIDDK. Peritoneal dialysis. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/peritoneal-dialysis
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. Checked 2026-10-06: catheter works better with 10–20 days to heal before a full schedule; CAPD at least 4 exchanges a day of 30–40 minutes; APD 3–5 exchanges at night; 1–2 weeks of training; supplies delivered about monthly and can be shipped to a travel destination.
  • NIDDK-Tx: NIDDK. Kidney transplant. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/kidney-transplant
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. Checked 2026-10-06: tests of heart and other organs; waits from a few months to years; living-donor kidney can be planned; go to hospital straight away when a kidney is offered; Medicare pays for the transplant and care for 3 years after it.
  • NIDDK-conservative: NIDDK. Conservative management of kidney failure. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/conservative-management
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. Checked 2026-10-06: care continues without dialysis or transplant; focus on quality of life and symptoms (nausea, poor appetite, feelings, anaemia); may suit people for whom dialysis may not prolong life or improve its quality; hospice described.
  • NIDDK-choosing: NIDDK. Choosing a treatment for kidney failure. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/choosing-treatment
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. Checked 2026-10-06: comparison of in-centre HD (fixed schedule, no partner or equipment at home, most diet limits), home HD (choose your time, partner training, storage space, travel with a machine), PD (no partner needed after training, boxes of solution, fewer fluid limits), transplant (fewest diet limits) and conservative management; you can change your mind and try another treatment.
  • NIDDK-hypo: NIDDK. Low blood glucose (hypoglycemia). https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-05.
  • NIDDK-DKD: NIDDK. Diabetic kidney disease. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-05.
  • NIDDK-copyright: NIDDK. Copyright and reuse of NIDDK health information. https://www.niddk.nih.gov/copyright
    Licence: Public domain (US government work). Checked 2026-10-05.
  • NIDDK-kidneys: NIDDK. Your kidneys and how they work (last reviewed June 2018). https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. Source of 'about a half cup of blood every minute' and the list of kidney jobs (wastes, acid, water, salts and minerals, hormones for blood pressure, red blood cells and bones).
  • NIDDK-CKDwhat: NIDDK. What is chronic kidney disease? (last reviewed February 2025). https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. More than 35 million US adults (more than 1 in 7) have CKD; most have no symptoms early; advanced, long-lasting CKD typically can't be reversed.
  • CDC-DKA: Centers for Disease Control and Prevention. Diabetic ketoacidosis (page last reviewed 15 May 2024). https://www.cdc.gov/diabetes/about/diabetic-ketoacidosis.html
    Licence: Public domain (US government work). Checked 2026-10-06. Check glucose every 4–6 hours and ketones when sick or glucose is 250 mg/dL or above; go to the emergency room or call 911 for glucose staying at 300 mg/dL or above, fruity breath, vomiting with no food or drink kept down, trouble breathing, or several DKA symptoms.
  • CDC-SEPSIS: Centers for Disease Control and Prevention. About sepsis (page last reviewed 17 August 2026). https://www.cdc.gov/sepsis/about/index.html
    Licence: Public domain (US government work). Checked 2026-10-06.
  • CDC-STROKE: Centers for Disease Control and Prevention. Signs and symptoms of stroke (page last reviewed 19 May 2026). https://www.cdc.gov/stroke/signs-symptoms/index.html
    Licence: Public domain (US government work). Checked 2026-10-06.
  • NHLBI-BPS: National Heart, Lung, and Blood Institute (US). High blood pressure: symptoms (page last updated 25 April 2024). https://www.nhlbi.nih.gov/health/high-blood-pressure/symptoms
    Licence: Public domain (US government work). Checked 2026-10-22. Checked 2026-10-22 against the page: blood pressure above 180/120 mm Hg is too high and needs medical attention, especially with symptoms. With a reading of 180/120 and no symptoms, wait 5 minutes and check again; if it is still high, call your healthcare provider. If the second reading is also high and you have a sudden, severe headache, difficulty breathing, sudden, severe pain in your abdomen, chest or back, numbness or weakness, a sudden change in vision or problems talking, call 9-1-1. Do not wait to see if your pressure comes down on its own. The page also says the provider may recommend a medicine or a dose change: the handbook does not repeat that. The handbook reads 180/120 as a top number of 180 or more or a bottom number of 120 or more (the project's cautious choice; the page and its figures are not explicit).
  • CFR-LABEL: US Code of Federal Regulations, 21 CFR 101.9(b)(5)(viii): household measures for nutrition labeling (teaspoon 5 mL, tablespoon 15 mL, cup 240 mL, 1 fl oz 30 mL, 1 oz 28 g). https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-101/subpart-A/section-101.9
    Licence: Public domain (US government work). Checked 2026-10-06.
  • MED-ESRD: Medicare.gov. End-stage renal disease (ESRD). https://www.medicare.gov/basics/end-stage-renal-disease
    Licence: Public domain (US government work). Checked 2026-10-06. Checked 2026-10-06: eligibility by work record (Social Security, RRB or government) or as spouse or dependent child; coverage usually starts the first day of the fourth month of dialysis, as early as the first month with home dialysis training in the first 3 months, or the month of a transplant admission; ends 12 months after dialysis stops or 36 months after a transplant; 30-month coordination period with employer plans; ESRD may choose Medicare Advantage; Part B-ID $121.60/month and $283 deductible in 2026.
  • MED-KDE: Medicare.gov. Kidney disease education. https://www.medicare.gov/coverage/kidney-disease-education
    Licence: Public domain (US government work). Checked 2026-10-06. Checked 2026-10-06: stage 4 CKD; up to 6 sessions; doctor referral needed; 20 % coinsurance after the Part B deductible.
  • MED-INS: Medicare.gov. Insulin. https://www.medicare.gov/coverage/insulin
    Licence: Public domain (US government work). Checked 2026-10-06. Checked 2026-10-06: no more than $35 for a one-month supply of each Part B- or Part D-covered insulin; no deductible for insulin.
  • CMS26: Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B premiums and deductibles (fact sheet). https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
    Licence: Public domain (US government work). Checked 2026-10-06. Amounts change every year; recheck each November. Checked 2026-10-06: 2026 Part B premium $202.90/month, Part B deductible $283, Part A inpatient deductible $1,736, immunosuppressive drug premium $121.60/month.
  • OPTN: Organ Procurement and Transplantation Network. OPTN Policies (Policy 8: Kidney; Policy 11: Pancreas). https://optn.transplant.hrsa.gov/policies-bylaws/policies/
    Licence: Link and paraphrase. Checked 2026-10-05. Returns 403 to automated checkers; works in a browser.
  • TSA: Transportation Security Administration. What can I bring? Medical. https://www.tsa.gov/travel/security-screening/whatcanibring/medical
    Licence: Public domain (US government work). Checked 2026-10-06. Returns 403 to automated checkers; works in a browser. Checked 2026-10-06 through a fetch: tell the officer you have diabetes; insulin must be identified; medically necessary liquids over 3.4 oz allowed after declaring them; TSA notification card.
  • EEOC: US Equal Employment Opportunity Commission. Diabetes in the workplace and the ADA. https://www.eeoc.gov/laws/guidance/diabetes-workplace-and-ada
    Licence: Public domain (US government work). Checked 2026-10-06. Checked 2026-10-06: examples of accommodations (breaks to eat, drink, take medicine or check glucose; a private place; a place to rest; schedule changes; leave for treatment); you do not have to tell an employer about diabetes, and you can ask for an accommodation at any time after you are hired; medical information is confidential; employers with 15 or more employees; 180 days (300 in some states) to file a charge.
  • FMLA: US Department of Labor, Wage and Hour Division. Family and Medical Leave Act. https://www.dol.gov/agencies/whd/fmla
    Licence: Public domain (US government work). Checked 2026-10-06. Returns 403 to automated checkers; works in a browser. Checked 2026-10-06: up to 12 workweeks of unpaid, job-protected leave in 12 months; employer with 50 or more employees within 75 miles; 12 months and 1,250 hours worked; may be taken intermittently or on a reduced schedule; covers caring for a spouse, child or parent with a serious health condition; group health cover continues.
  • SSA: Social Security Administration. Disability benefits. https://www.ssa.gov/benefits/disability/
    Licence: Public domain (US government work). Checked 2026-10-05. Returns 403 to automated checkers; works in a browser.
  • FDAmenu: US Food and Drug Administration. Menu labeling requirements. https://www.fda.gov/food/nutrition-food-labeling-and-critical-foods/menu-labeling-requirements
    Licence: Public domain (US government work). Checked 2026-10-05.
  • FOODSAFE: FoodSafety.gov. People with weakened immune systems. https://www.foodsafety.gov/people-at-risk/people-with-weakened-immune-systems
    Licence: Public domain (US government work). Checked 2026-10-05. Returns 403 to automated checkers; works in a browser.
  • AHRQ-Q: Agency for Healthcare Research and Quality. Questions are the answer. https://www.ahrq.gov/questions/index.html
    Licence: Public domain (US government work). Checked 2026-10-05. Returns 403 to automated checkers; works in a browser.
  • DG4: NIDDK. Healthy eating for adults with chronic kidney disease. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/healthy-eating-adults-chronic-kidney-disease
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-05. Diet-guide source 4.
  • DG16b: US Food and Drug Administration. Daily Value on the Nutrition and Supplement Facts labels. https://www.fda.gov/food/nutrition-facts-label/daily-value-nutrition-and-supplement-facts-labels
    Licence: Public domain (US government work). Checked 2026-10-05. Diet-guide source 16.
  • DG34: US Food and Drug Administration. Sodium in your diet. https://www.fda.gov/food/nutrition-education-resources-materials/sodium-your-diet
    Licence: Public domain (US government work). Checked 2026-10-05. Diet-guide source 34.
  • DG37a: Institute of Medicine. Front-of-package nutrition rating systems: FDA nutrient content claim definitions (NCBI Bookshelf NBK209851). https://www.ncbi.nlm.nih.gov/books/NBK209851/
    Licence: Publisher copyright: cite and paraphrase only. Checked 2026-10-05. Diet-guide source 37.
  • NIDDK-whatis: NIDDK. What is chronic kidney disease in adults? https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. Quoted: most people in the early stages have no symptoms; blood and urine tests are the only way to know; CKD can lead to kidney failure in some people.
  • CMSPREP: Centers for Medicare & Medicaid Services. Preparing for Emergencies: A Guide for People on Dialysis (version 2.3, June 2026). https://esrd.ipro.org/wp-content/uploads/2026/06/CMSPreparingforEmergencies_508-062026.pdf
    Licence: Public domain (US government work). Checked 2026-10-06. Hosted by IPRO ESRD Network. Home HD: register with water and power companies, flashlight, back-up unit; PD: 5–7 days of supplies, learn manual CAPD if on a cycler; 5–7 days of medicines and insulin; 3-day emergency diet; try to get dialysis within 3 days of the last treatment.
  • FDA-MYCO26: US Food and Drug Administration. Supplement approval letter for CellCept (NDA 050722/S-056 and related), 31 July 2026: the Mycophenolate REMS is no longer required. https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2026/050722Orig1s056,S058;050723Orig1s056,s058;050758Orig1s054,s056;050759Orig1s063,s065correctedltr.pdf
    Licence: Public domain (US government work). Checked 2026-10-06. REMS Modification Notification letter 2 June 2026; labeling approved 31 July 2026; mycophenolaterems.com says the programme was discontinued on 29 July 2026.
  • FDAgrapefruit: US Food and Drug Administration. Grapefruit juice and some drugs don't mix (consumer update, updated 2021-07-01). https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix
    Licence: Public domain (US government work). Checked 2026-10-06. Seville oranges, pomelos and tangelos might have the same effect as grapefruit juice; names organ-transplant rejection drugs.
  • FSTX: US Department of Agriculture and US Food and Drug Administration. Food Safety for Transplant Recipients: a need-to-know guide for bone marrow and solid organ transplant recipients (booklet). https://health.ucdavis.edu/transplant/PDFs/posttransplant/Food%20Safety%20For%20Transplant%20Recipients.pdf
    Licence: Public domain (US government work). Checked 2026-10-06. The FDA's own download link now returns 404; this is a transplant centre's copy of the unchanged booklet. Safe temperatures: ground beef 160 °F, poultry 165 °F, seafood 145 °F; reheat hot dogs and deli meats to 165 °F or steaming hot.
  • NIDDK-A1C: NIDDK. The A1C test and diabetes. https://www.niddk.nih.gov/health-information/diagnostic-tests/a1c-test
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos; some images are licensed. Checked 2026-10-06. Normal below 5.7 %; prediabetes 5.7–6.4 %; diabetes 6.5 % or above. Kidney failure, iron-deficiency anemia, recent blood loss or transfusion and hemoglobin variants can make A1C unreliable.
  • FSTEMPS: FoodSafety.gov (US Department of Health and Human Services). Safe minimum internal temperatures (chart). https://www.foodsafety.gov/food-safety-charts/safe-minimum-internal-temperatures Also: https://extension.umaine.edu/food-health/2024/03/01/internal-temperatures/.
    Licence: Public domain (US government work). Checked 2026-10-06. Poultry including ground 165 °F (74 °C); ground meats 160 °F; beef, pork, veal and lamb steaks, chops and roasts 145 °F with a 3-minute rest; fish 145 °F or until opaque and flaky; eggs until yolk and white are firm; leftovers and casseroles 165 °F. foodsafety.gov returns 403 to automated checkers; the University of Maine Extension page reproduces the same chart.
  • MEDLINE-PORTION: MedlinePlus (US National Library of Medicine). Portion size (patient instructions; reviewed 2024-07-24). https://medlineplus.gov/ency/patientinstructions/000337.htm
    Licence: A.D.A.M. encyclopedia content on MedlinePlus: link and paraphrase only. Checked 2026-10-06. Meat or poultry: palm of the hand or a deck of cards; 3 oz fish: a checkbook; cheese: a pair of dice; ½ cup rice, pasta or snacks: a rounded handful or a tennis ball; 1 cup chopped raw fruit or vegetables: a woman's fist or a baseball; 2 tbsp peanut butter: a ping-pong ball; ¼ cup nuts or dried fruit: a golf ball.
  • NIDDK-portions: NIDDK. Just enough for you: about food portions (last reviewed July 2021). https://www.niddk.nih.gov/health-information/weight-management/just-enough-food-portions
    Licence: Public domain (NIDDK): reuse with attribution; no NIH or NIDDK logos. Checked 2026-10-06. A portion is how much you choose to eat at one time; a serving is the amount on the Nutrition Facts label, and the two may not match.
  • FDA-label: US Food and Drug Administration. Changes to the Nutrition Facts label. https://www.fda.gov/food/nutrition-food-labeling-and-critical-foods/changes-nutrition-facts-label
    Licence: Public domain (US government work). Checked 2026-10-06. "Vitamin D and potassium are required on the label." Manufacturers must declare the actual amount as well as % DV for vitamin D, calcium, iron and potassium. Compliance: 1 January 2020 (annual food sales of $10 million or more), 1 January 2021 (smaller manufacturers). Serving sizes: "for packages that are between one and two servings, such as a 20 ounce soda or a 15-ounce can of soup, the calories and other nutrients are required to be labeled as one serving"; larger packages that could be eaten in one sitting carry dual-column labels (per serving and per package).
  • EU1169: Regulation (EU) No 1169/2011 of the European Parliament and of the Council of 25 October 2011 on the provision of food information to consumers. Annex I, point 11. https://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:32011R1169
    Licence: EU legal text: free reuse with source acknowledgement (Commission Decision 2011/833/EU). Checked 2026-10-06. Annex I point 11: "'salt' means the salt equivalent content calculated using the formula: salt = sodium × 2,5". EU (and UK) labels give salt, not sodium; potassium is optional.
  • CFR494: US Code of Federal Regulations, 42 CFR Part 494: Conditions for Coverage for End-Stage Renal Disease Facilities (§ 494.70 patients' rights, § 494.80 patient assessment, § 494.90 plan of care, § 494.140 personnel). https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-494
    Licence: Public domain (US government work). Checked 2026-10-06. Read through the eCFR API on 2026-10-06. 494.70(a): right to be told about all treatment options including transplant and home dialysis, about advance directives, to refuse or stop treatment, and about grievance routes (ESRD Network, State survey agency). 494.80: the team includes the patient, a nurse, a physician, a social worker and a dietitian; assessment covers psychosocial needs, transplant referral, physical activity and vocational rehabilitation; reassessed at least yearly. 494.90: written plan of care signed by the patient; home dialysis plan or reasons; transplant referral tracked; education for patients and family; seen by a clinician at least monthly. 494.140: each facility must have a registered dietitian and a master's-level clinical social worker. Labs fact-check 2026-10-06 (494.90 text): (a)(1) dose of dialysis to meet a hemodialysis Kt/V of at least 1.2 and a peritoneal dialysis weekly Kt/V of at least 1.7, or an alternative equivalent accepted standard; (a)(2) albumin and body weight measured at least monthly; (a)(4) hemoglobin/hematocrit measured at least monthly.
  • MED-TRAVEL: Medicare.gov. Travel outside the U.S. https://www.medicare.gov/coverage/travel-outside-the-u.s.
    Licence: Public domain (US government work). Checked 2026-10-06. Medicare usually doesn't cover health care while travelling outside the US (rare exceptions); Medicare drug plans don't cover drugs bought abroad; some Medigap policies cover foreign emergency care; US territories count as the US.
  • MED-ACP: Medicare.gov. Advance care planning. https://www.medicare.gov/coverage/advance-care-planning
    Licence: Public domain (US government work). Checked 2026-10-06. Part B covers voluntary advance care planning; no cost when it is part of the Welcome to Medicare or yearly Wellness visit (provider accepts assignment). An advance directive includes a health care proxy and a living will.
  • MED-MSP: Medicare.gov. Medicare Savings Programs. https://www.medicare.gov/basics/costs/help/medicare-savings-programs
    Licence: Public domain (US government work). Checked 2026-10-06. Run by each state (apply through the state Medicaid office); can pay Part A and B premiums and sometimes deductibles, coinsurance and copays; members also get Extra Help with drug costs.
  • SSA-6: Social Security Administration. Disability evaluation under Social Security (Blue Book), 6.00 Genitourinary disorders – adult (listings 6.03 and 6.04). https://www.ssa.gov/disability/professionals/bluebook/6.00-Genitourinary-Adult.htm
    Licence: Public domain (US government work). Checked 2026-10-06. Returns 403 to automated checkers; works in a browser. Content confirmed through search snippets on 2026-10-06: 6.03 CKD with dialysis that has lasted or is expected to last at least 12 months; 6.04 after a kidney transplant you are considered disabled for 1 year from the transplant, then reassessed.
  • JAN-DIAL: Job Accommodation Network (US Department of Labor, Office of Disability Employment Policy). Accommodation ideas for individuals on dialysis (May 2017). https://askjan.org/blogs/jan/2017/05/accommodation-ideas-for-individuals-on-dialysis.cfm Also: https://askjan.org/.
    Licence: Public domain (US government-funded service): link and paraphrase. Checked 2026-10-06. Ideas: PD at work (storage, private clean area, waste disposal, flexible schedule), flexible leave, working from home, a laptop or tablet to work from the dialysis center, rest breaks for fatigue, reassignment to a less physically demanding job. JAN gives free, confidential advice.
  • TSA-DIABETES: Transportation Security Administration. Travel tip: traveling with diabetes (TSA blog, 13 November 2020). https://www.tsa.gov/blog/2020/11/13/travel-tip-traveling-diabetes
    Licence: Public domain (US government work). Checked 2026-10-06. Tell officers where a pump or CGM is attached before screening; devices need not be removed; screening may be imaging, metal detector or pat-down; medically needed liquids over 3.4 oz allowed in reasonable amounts; TSA notification card; TSA Cares (855) 787-2227, call 72 hours before travel.
  • FDA-INSULIN: US Food and Drug Administration. Information regarding insulin storage and switching between products in an emergency. https://www.fda.gov/drugs/emergency-preparedness-drugs/information-regarding-insulin-storage-and-switching-between-products-emergency
    Licence: Public domain (US government work). Checked 2026-10-06. Unopened insulin in a refrigerator at about 36–46 °F; vials or cartridges may be kept at 59–86 °F for up to 28 days; never use insulin that has been frozen; keep away from direct heat and sunlight.
  • NIST-63B4: Temoshok D, Fenton JL, Choong YY, et al. Digital Identity Guidelines: Authentication and Authenticator Management. NIST Special Publication 800-63B-4 (August 2025), section 3.1.1.2 Password verifiers. https://pages.nist.gov/800-63-4/sp800-63b.html
    Licence: Public domain (US government work). Checked 2026-10-06. §3.1.1.2: passwords used as a single factor SHALL be at least 15 characters; verifiers SHOULD allow at least 64; no composition rules; no periodic changes; check against a blocklist of common, expected or compromised passwords.
  • GDPR: Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 (General Data Protection Regulation). Articles 2(2)(c), 9, 15, 17 and 20. https://eur-lex.europa.eu/eli/reg/2016/679/oj
    Licence: EU legal text: free reuse with source acknowledgement (Commission Decision 2011/833/EU). Checked 2026-10-06. Does not apply to a purely personal or household activity (Art. 2(2)(c)); data concerning health is a special category (Art. 9); rights of access (15), erasure (17) and portability (20).

Patient information from charities and providers

Food data

  • FDC: US Department of Agriculture, Agricultural Research Service. FoodData Central, SR Legacy (April 2018). https://fdc.nal.usda.gov/ Also: https://fdc.nal.usda.gov/download-datasets.
    Licence: Public domain (US government work). Checked 2026-10-05. Diet-guide source 51. All per-serving nutrient values in the handbook and in data/foods.json. FDC IDs per food are in docs/research/food-lists.md, Appendix 1.
  • FDC-API: US Department of Agriculture, Agricultural Research Service. FoodData Central API Guide. https://fdc.nal.usda.gov/api-guide/ Also: https://fdc.nal.usda.gov/api-key-signup.
    Licence: Public domain (CC0 1.0). Checked 2026-10-06. Default limit 1,000 requests per hour per IP address for a key; DEMO_KEY 30 requests per hour and 50 per day per IP address. FDC data are public domain under CC0 1.0.
  • OFF-API: Open Food Facts. API documentation: introduction (rate limits, User-Agent, licence). https://openfoodfacts.github.io/openfoodfacts-server/api/
    Licence: Documentation © Open Food Facts contributors: link and paraphrase. Checked 2026-10-06. Database under the Open Database License, contents under the Database Contents License; 15 product reads per minute per IP address; always send a custom User-Agent naming the app and a contact.
  • ODBL: Open Data Commons. Open Database License (ODbL) v1.0. https://opendatacommons.org/licenses/odbl/1-0/
    Licence: Licence text (Open Data Commons). Checked 2026-10-06. Attribution and share-alike for public derivative databases; the licence that covers Open Food Facts data.

Tools and standards

  • PEMAT: Agency for Healthcare Research and Quality. The Patient Education Materials Assessment Tool (PEMAT) and user's guide. https://www.ahrq.gov/health-literacy/patient-education/pemat.html
    Licence: Public domain (US government work). Checked 2026-10-05. Returns 403 to automated checkers; works in a browser.
  • CCI: Centers for Disease Control and Prevention. The CDC Clear Communication Index. https://www.cdc.gov/ccindex/index.html
    Licence: Public domain (US government work). Checked 2026-10-05.
  • APPLE-SHORTCUTS: Apple Support. Shortcuts User Guide (Health actions, Format Date, Dictionary, Get Contents of URL, personal automations). https://support.apple.com/guide/shortcuts/welcome/ios
    Licence: © Apple: link and paraphrase. Checked 2026-10-22. Named in design note 12 (P1). The articles were not re-read for this page and the steps were not tried on a phone: action names can differ between iOS versions, and handbook/REVIEW.md holds the owner's real-iPhone check.
  • MATERIAL: Material for MkDocs 9.7.7 (MIT licence). https://squidfunk.github.io/mkdocs-material/
    Licence: MIT. Checked 2026-10-05.
  • MKDOCS: MkDocs 1.6.1 (BSD-2-Clause licence). https://www.mkdocs.org/
    Licence: BSD-2-Clause. Checked 2026-10-05.
  • AHRQ-TB: Agency for Healthcare Research and Quality. TeamSTEPPS tool: Teach-Back. https://www.ahrq.gov/teamstepps-program/curriculum/communication/tools/teachback.html
    Licence: Public domain (US government work). Checked 2026-10-06. Returns 403 to automated checkers; works in a browser. Teach-back: the patient or family caregiver explains, in their own words, what they need to know or do, to confirm understanding.
  • LE-LIFETIMES: Let's Encrypt. Decreasing certificate lifetimes to 45 days (2025-12-02). https://letsencrypt.org/2025/12/02/from-90-to-45/ Also: https://letsencrypt.org/docs/cert-lifetimes/.
    Licence: CC BY-NC 4.0 (Let's Encrypt website): link and paraphrase. Checked 2026-10-06. Default (classic) profile: 64-day certificates from 2027-02-10, 45-day certificates from 2028-02-16; 90 days until then.
  • WEBKIT-26: WebKit. News from WWDC25: web technology coming this fall in Safari 26 beta (2025-06-09). https://webkit.org/blog/16993/news-from-wwdc25-web-technology-coming-this-fall-in-safari-26-beta/
    Licence: © Apple: link and paraphrase. Checked 2026-10-06. "By default, every website added to the Home Screen opens as a web app"; turning off "Open as Web App" adds a browser bookmark instead.
  • CHROME-PWA: Google. Use web apps (Google Chrome Help). https://support.google.com/chrome/answer/9658361
    Licence: © Google: link and paraphrase. Checked 2026-10-06. Computer: More (⋮) → Cast, save, and share → Install page as app, or the install icon in the address bar; separate tabs cover Android and iPhone.
  • MDN-SECURE: MDN Web Docs (Mozilla). Secure contexts. https://developer.mozilla.org/en-US/docs/Web/Security/Secure_Contexts
    Licence: CC BY-SA 2.5 (MDN prose): link and paraphrase. Checked 2026-10-06. Only secure contexts may register service workers; a page is a secure context over HTTPS or from a loopback address (localhost), not over plain HTTP on a LAN address.
  • TS-HTTPS: Tailscale. Enabling HTTPS (knowledge base 1153). https://tailscale.com/kb/1153/enabling-https
    Licence: © Tailscale: link and paraphrase. Checked 2026-10-06. Machine names are published in the public Certificate Transparency ledger; do not enable HTTPS if any machine name contains sensitive information.
  • APPLE-TRUST: Apple Support. Trust manually installed certificate profiles in iOS, iPadOS and visionOS (article 102390). https://support.apple.com/en-us/102390
    Licence: © Apple: link and paraphrase. Checked 2026-10-06. Settings → General → About → Certificate Trust Settings → Enable full trust for root certificates.
  • APPLE-TLS: Apple Support. Requirements for trusted certificates in iOS 13 and macOS 10.15 (article 103769). https://support.apple.com/en-us/103769
    Licence: © Apple: link and paraphrase. Checked 2026-10-06. RSA keys of 2048 bits or more; SHA-2 signatures; DNS name in the Subject Alternative Name; serverAuth extended key usage; validity of 825 days or fewer.
  • RFC8375: Pfister P, Lemon T. Special-Use Domain 'home.arpa.'. RFC 8375 (May 2018). https://www.rfc-editor.org/rfc/rfc8375
    Licence: IETF Trust (BCP 78): quote with attribution. Checked 2026-10-06. 'home.arpa.' is designated for non-unique use in residential home networks.
  • PODMAN-QUADLET: Podman documentation. podman-systemd.unit(5): systemd units using Podman Quadlet. https://docs.podman.io/en/latest/markdown/podman-systemd.unit.5.html
    Licence: Apache-2.0 (Podman documentation). Checked 2026-10-06. Quadlet is a systemd generator for .container and .volume files; rootless units go in ~/.config/containers/systemd/; AutoUpdate=registry needs a fully qualified image; Notify=healthy waits for the health check.
  • PODMAN-ROOTLESS: Podman project. Basic setup and use of Podman in a rootless environment (tutorial). https://github.com/containers/podman/blob/main/docs/tutorials/rootless_tutorial.md
    Licence: Apache-2.0 (Podman documentation). Checked 2026-10-06. Rootless Podman needs a range of UIDs and GIDs in /etc/subuid and /etc/subgid (for example 100000-165535, set with usermod --add-subuids/--add-subgids) and the newuidmap/newgidmap helpers.
  • DOCKER-ROOTLESS: Docker documentation. Rootless mode: troubleshooting and known limitations. https://docs.docker.com/engine/security/rootless/troubleshoot/ Also: https://docs.docker.com/engine/security/rootless/.
    Licence: Apache-2.0 (Docker documentation). Checked 2026-10-06. docker run -p does not propagate source IP addresses by default (RootlessKit 3.0+ needs userland-proxy disabled); --cpus, --memory and --pids-limit are ignored without cgroup v2; ports below 1024 need extra configuration.
  • NETBIRD-CLI: NetBird documentation. NetBird agent command line interface (CLI). https://docs.netbird.io/get-started/cli
    Licence: © NetBird: link and paraphrase. Checked 2026-10-30. netbird up --mtu: 'Set MTU (Maximum Transmission Unit) for the WireGuard interface (default 1280)'. Peer DNS names end in netbird.cloud on NetBird's own service.
  • NETBIRD-ROUTES: NetBird documentation. How routing peers work. https://docs.netbird.io/manage/networks/how-routing-peers-work
    Licence: © NetBird: link and paraphrase. Checked 2026-10-30. Forwarded packets traverse the routing peer's firewall forward chain; masquerade is on by default (traffic leaves with the routing peer's LAN address).
  • K8S-PSS: Kubernetes documentation. Pod Security Standards. https://kubernetes.io/docs/concepts/security/pod-security-standards/
    Licence: CC BY 4.0 (Kubernetes documentation). Checked 2026-10-06. Restricted: runAsNonRoot, allowPrivilegeEscalation false, capabilities drop ALL, seccomp RuntimeDefault or Localhost, limited volume types.
  • K8S-NETPOL: Kubernetes documentation. Network Policies. https://kubernetes.io/docs/concepts/services-networking/network-policies/
    Licence: CC BY 4.0 (Kubernetes documentation). Checked 2026-10-06. "Creating a NetworkPolicy resource without a controller that implements it will have no effect."
  • K8S-USERNS: Kubernetes documentation. User namespaces. https://kubernetes.io/docs/concepts/workloads/pods/user-namespaces/
    Licence: CC BY 4.0 (Kubernetes documentation). Checked 2026-10-06. Stable since Kubernetes v1.36; needs Linux 6.3 or later, idmap-capable filesystems (btrfs, ext4, xfs, fat, tmpfs, overlayfs), containerd 2.0+ or CRI-O 1.25+.
  • TALOS-FLANNEL: Sidero Labs. Talos Linux documentation: Flannel CNI. https://docs.siderolabs.com/kubernetes-guides/cni/flannel
    Licence: © Sidero Labs (MPL-2.0 project): link and paraphrase. Checked 2026-10-06. From Talos 1.13 Flannel can enforce NetworkPolicy with kubeNetworkPoliciesEnabled: true (KubeFlannelCNIConfig from 1.14); without it NetworkPolicy resources are accepted but not enforced.
  • SQLITE-BACKUP: SQLite. SQLite Backup API. https://www.sqlite.org/backup.html
    Licence: Public domain (SQLite documentation). Checked 2026-10-06. The online backup API copies a database while it is in use and leaves a consistent, up-to-date snapshot.
  • OPENAI-DATA: OpenAI. Data controls in the OpenAI platform (API documentation: your data). https://developers.openai.com/api/docs/guides/your-data
    Licence: © OpenAI: link and paraphrase. Checked 2026-10-06. API data is not used to train or improve OpenAI models unless you opt in; abuse-monitoring logs are kept for up to 30 days unless the law requires longer.
  • OPENROUTER-ROUTING: OpenRouter. Provider routing (documentation): the data_collection preference. https://openrouter.ai/docs/features/provider-routing
    Licence: © OpenRouter: link and paraphrase. Checked 2026-10-06. data_collection "deny": use only providers which do not collect user data (the default "allow" permits providers that store data and may train on it).
  • OLLAMA-OAI: Ollama documentation. OpenAI compatibility. https://docs.ollama.com/openai
    Licence: MIT (Ollama project). Checked 2026-10-06. Ollama serves a subset of the OpenAI API at /v1 (http://localhost:11434/v1/ by default), so the app's OpenAI-compatible client can use a local model.
  • HERMES-API: Nous Research. Hermes Agent documentation: API server. https://hermes-agent.nousresearch.com/docs/user-guide/features/api-server
    Licence: © Nous Research (MIT project): link and paraphrase. Checked 2026-10-06. Binds 127.0.0.1:8642 by default; API_SERVER_KEY is required for every deployment; "The API server gives full access to hermes-agent's toolset, including terminal commands."
  • SIGSTORE-VERIFY: Sigstore. Verifying signatures (cosign documentation). https://docs.sigstore.dev/cosign/verifying/verify/
    Licence: Apache-2.0 (Sigstore documentation). Checked 2026-10-06. Keyless verification checks the signer's identity with --certificate-identity and --certificate-oidc-issuer.

This project

Not yet reviewed by a clinician. Facts and sources last checked 2026-10-05.