We read with great interest the study by Zhang et al. in Journal of Renal Nutrition and commend the authors for examining carbohydrate sources, added sugars, and subjective sleep quality in 713 Chinese maintenance hemodialysis patients.1 The most visible finding was that the highest tertiles of carbohydrates from pickled products, sweet foods, and added sugars were associated with poor sleep quality after multivariable adjustment.1 Because this conclusion could influence dietary advice in patients already balancing protein-energy wasting, sodium, potassium, phosphorus, and fluid restrictions, several interpretive issues warrant discussion.