CALCIUM-FORTIFIED FOODS have exploded in the marketplace, appearing in perishable and nonperishable foods alike. These foods can contribute a significant amount of calcium to the diet. As more information is published on the importance of calcium balance and the role of normal serum calcium levels in CKD patients, it becomes increasingly important to be aware of potential dietary sources of calcium so that we can alert our patients about them. Adequate dietary intake of calcium in patients with different stages of CKD is difficult to estimate because of the changes in calcium, phosphorus, vitamin D, parathyroid hormone (PTH), and bone metabolism. Ideal dietary calcium intake should provide enough calcium to maintain calcium balance as close as possible to that of the ageand gender-matched healthy population. It is important that patients with CKD have normal total serum calcium levels (corrected) because chronic lower levels of calcium result in secondary hyperparathyroidism and adverse effects on bone mineralization, and may be associated with increased mortality. At the same time, high calcium intake should be avoided since patients with CKD may encounter difficulties in buffering increased calcium loads, and such difficulty may result in hypercalcemia and/or soft tissue calcification. Intake of calcium in adults with advanced CKD ranged between 300 and 700 mg/day and in those treated with hemodialysis calcium intake averaged 549 mg/day. The Kidney Disease Outcomes and Quality Initiative (K/DOQI) Bone Metabolism work group stated they felt poorly equipped to establish values for adequate intake of calcium in patients with kidney disease. This was primarily due to limited data on calcium retention as a function on increased long-term calcium intake in patients with CKD. However, it is their opinion that an intake of 2.0 grams per day of calcium (dietary and supplements) is appropriate for CKD patients. Putting together a comprehensive list of these foods has proven to be quite challenging. The nutrient content information available on the Internet has been sparse, and calls to food manufacturers have been time consuming and not very rewarding. It is our intent that the information provided in Table 1 will help the Renal Dietitian and CKD patient make appropriate food choices to achieve this goal. The number of foods fortified with calcium is extensive. As such, this list is limited to beverages, breads/crackers, cereals, waffles/pancakes/muffins, margarine, and pasta. As a point of reference, a food can be labeled as a good source of calcium if it has at least 10% of the RDA, which is 1000 mg. If a food is labeled an excellent source of calcium, it will have at least 20% of the RDA. *Renal Dietitian, FMCNA-Ohio Valley Dialysis Center, Evansville, Indiana. †Clinical Dietitian, Methodist Hospital Transplant Service, Clarian Health, Inc., Indianapolis, Indiana. Address reprint requests to Julie Prinsen, RD, LD, CSR, Renal Dietitian, FMCNA-Ohio Valley Dialysis Center, 230 Bellemeade Ave, Evansville, IN 47713. E-mail: Julie.Prinsen@fmcna.com © 2004 by the National Kidney Foundation, Inc. 1532-8503/04/1403-0012$30.00/0 doi:10.1053/j.jrn.2004.04.010