Like immunocompromised individuals, CKD patients are especially vulnerable to foodborne illnesses.

Foodborne illness affects 76 million people annually in the United States, resulting in approximately 5,000 deaths, according to estimates by the Department of Health and Human Services and the CDC.

CKD patients are especially vulnerable, along with older adults and individuals with compromised immune function. Although recent media attention has focused on an outbreak of salmonellosis caused by contaminated peanut butter, there are more than 250 identified types of foodborne illness.

Educating patients regarding potential sources of foodborne illness as well as food safety strategies is important to improving outcomes. However, as circumstances of the latest Salmonella outbreaks reveal, there is no substitute for good manufacturing practices and oversight to ensure a safe food supply.


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The Salmonella genus comprises a number of gram-negative anaerobic species. The bacteria are noted to be “widespread in the intestines of birds, reptiles, and mammals” and acknowledged as “the leading cause of foodborne illness in the United States, causing about 1.4 million infections annually”(Curr Gastroenterol Rep. 2008;10:424-431).

Foods are almost universally at risk for Salmonella contamination, especially unpasteurized milk and juice, uncooked meat and eggs, and fruits and vegetables that are eaten raw. Bulk processing of foods from different sources (i.e., ground meats, eggs) can increase the likelihood of contamination.

The recent extensive occurrence of salmonellosis related to peanut products prompted the FDA to set up a Web site of recalled products (www.accessdata.fda.gov/scripts/peanutbutterrecall/index.cfm, accessed February 2, 2009). Possible mechanisms of Salmonella infection are thought to include inadequate heat during peanut roasting or contamination after processing.