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Pistachios are among the worst nuts for kidney patients — extremely high in potassium (~1,025 mg/100g) and phosphorus (~490 mg/100g). Even 10 nuts carry a meaningful load; avoid in stage 3-5 and dialysis.
Pistachios sit at the top of the potassium and phosphorus tables for nuts — a handful can consume a large share of a stage 4-5 potassium budget.
For early CKD, a strictly counted few nuts occasionally is the ceiling; for stage 3-5 and dialysis, avoid them and choose lower-mineral options.
Macadamias are the lighter nut, and fruits like apple and grapes are the safest swaps.
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This content is a general reference, not medical advice, a diagnosis, or a treatment plan. Do not change your diet, fluids, medicines, or dialysis plan without your nephrologist or renal dietitian. Individual recommendations depend on your labs, medications, conditions, and care plan.