Leena Watts
When kidneys are no longer functioning healthily, dialysis helps to remove waste and excess fluid from the body. However, dialysis is not as efficient as healthy kidneys, and waste and fluid can still build up in the body, causing health problems. Therefore, it is important for dialysis patients to monitor their diet and fluid intake. A renal dietitian can help patients plan their meals, limiting certain nutrients and fluids, and ensuring they get the right amount of protein, calories, vitamins and minerals.
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What You'll Learn
Monitor fluid intake
For dialysis patients, diet is a crucial part of treatment. Since dialysis cannot rid the body of fluid as effectively as healthy kidneys, it is important to monitor fluid intake to avoid fluid overload, which can cause serious health issues. Fluid overload can cause shortness of breath, dizziness, headaches, and breathing difficulties, and may even lead to hospitalisation.
To prevent fluid overload, dialysis patients should carefully monitor their fluid intake and aim to stay within their recommended daily fluid intake between treatments. This includes not only beverages but also foods that contain liquid or are liquid at room temperature, such as soups, ice cream, and watermelon. Patients can use measuring tools like food scales and measuring cups to accurately measure their food and fluid intake. Keeping a daily food and fluid diary can also help patients track their intake and identify areas where they may need to cut down.
Dialysis patients should also be mindful of their sodium intake, as sodium can increase thirst and lead to excess fluid consumption. Sodium is commonly found in canned, packaged, frozen, and fast foods, as well as condiments, seasonings, and meats. By limiting sodium and salty foods, patients can help manage their fluid intake more effectively.
To support dialysis patients in monitoring their fluid intake, healthcare professionals, including renal dietitians, can provide guidance and create personalised diet plans. These plans take into account individual needs, preferences, and health status. Additionally, smartphone applications have been developed to help patients track their fluid intake, providing a convenient tool for self-monitoring and improving adherence to fluid restrictions.
By closely monitoring fluid intake and following the recommendations of their healthcare team, dialysis patients can manage their fluid levels effectively and reduce the risk of fluid overload and its associated health complications.
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Limit sodium and salt
For dialysis patients, diet is a key part of treatment. Diet can help to manage residual kidney function, and it is important to eat and drink the right things to keep well-nourished.
Sodium and salt are two different things, but they are related. Sodium is a mineral that makes up a significant part of table salt. The body needs sodium to survive—it helps nerves and muscles to work correctly, and it helps the body to control fluid levels and
Dialysis patients need to be careful about their fluid intake, so it is important to limit sodium and salt. A high-sodium diet can cause high blood pressure, discomfort during dialysis, and fluid build-up around the heart and lungs. It can also lead to water weight build-up between dialysis treatments. According to Dr. Prest, people should consume around 2300 mg of sodium to maintain healthy blood pressure. However, for individuals with kidney disease or high blood pressure, 1500 mg may be more appropriate. It is recommended that kidney patients look for products with no more than 6 to 10% of the daily value for sodium.
There are ways to limit sodium and salt in your diet without compromising on flavor. For example, look for pasta and other products without added salt or sodium, and don't salt your pasta water. Many poultry products are soaked in a saltwater solution to ensure the meat stays juicy, so it may be worth avoiding these products or seeking out alternatives. A renal dietitian will be able to help you plan your meals and limit your sodium and salt intake.
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Control blood glucose
For dialysis patients, diet is a key part of treatment. Diet can help dialysis patients control their blood glucose levels in several ways. Firstly, it is important to meet your blood glucose goals if you have diabetes, as this helps to maintain kidney function. Secondly, dialysis patients should focus on eating fresh, homemade food to better control sodium intake and subsequently, blood pressure.
Dialysis patients are encouraged to eat high-quality protein, which produces less waste for removal during dialysis. High-quality protein sources include meat, poultry, fish, and eggs. However, milk, which is also a source of protein, is high in phosphorus and potassium and should be consumed in moderation. Phosphorus and potassium levels in the blood can become too high in kidney failure, leading to serious health issues. Therefore, it is important to monitor and control phosphorus and potassium intake.
Dialysis patients should also be mindful of their fluid intake, as excess fluid can build up in the body and cause adverse effects. Fluids include not just beverages but also foods that are liquid at room temperature, such as soup. It is recommended to consult a renal dietitian to create a personalised eating plan that considers factors such as age, weight, height, sex, exercise level, and other individual considerations.
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Manage potassium levels
For dialysis patients, managing potassium levels is crucial to maintaining overall health and well-being. Potassium levels that are too high or too low can lead to serious heart problems and even death. Here are some ways dialysis patients can manage their potassium levels:
Monitor Potassium Intake:
It is important to keep track of your potassium intake throughout the day. Dialysis patients may need to limit or avoid certain foods that are high in potassium. Working with a renal dietitian can help you identify which foods are high in potassium and how much of those foods you can safely consume.
Leaching High-Potassium Vegetables:
If you wish to include high-potassium vegetables in your diet, consider leaching them first. Leaching helps remove some of the potassium from the vegetables, making them safer to consume. To leach, soak the vegetables in warm unsalted water, using ten times the amount of water as the amount of vegetable. For example, soak 1 cup of vegetables in 10 cups of water for a minimum of 2 hours.
Avoid Canned Food Liquids:
Another way to lower potassium intake is to avoid consuming the liquids from canned foods. This includes the liquids from canned fruits, canned vegetables, and juices from cooked meat. These liquids can contain high levels of potassium that can contribute to an excessive intake.
Dialysate Potassium Concentrations:
The dialysate, or cleansing fluid used during dialysis, can also be adjusted to help manage potassium levels. Using different dialysate potassium concentrations can lower the risk of mortality in dialysis patients. Additionally, a lower dialysate potassium concentration may affect blood pressure during and after dialysis, so it is important to monitor this.
Potassium Binders:
Potassium binders are medications that can help lower potassium levels in the body. They work by exchanging potassium for sodium or calcium in the gastrointestinal tract, thereby reducing potassium absorption. Potassium binders have been shown to reduce the risk of mortality in dialysis patients, especially when used in doses of 4–8 or more grams per day.
Individualized Plans:
Every dialysis patient is unique, and working with a healthcare team is crucial to developing an individualized plan for managing potassium levels. A renal dietitian can help create a healthy eating plan that ensures you get the right amount of potassium while also considering your overall nutrition and calorie needs.
Managing potassium levels is an important aspect of dialysis care, and by following these steps and working closely with healthcare professionals, dialysis patients can effectively maintain their potassium levels within a healthy range.
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Consume high-quality protein
For dialysis patients, diet is a key part of treatment. The right diet helps the body adapt to the changes brought about by dialysis while also keeping the patient well-nourished.
One important aspect of this is the consumption of high-quality protein. Protein is one of three macronutrients and is an essential building block for the human body. It helps repair and build all the muscles in the body, including the organs. It is also used to build muscle, heal, fight infection, and stay healthy.
When you are on dialysis, your daily need for albumin, a form of protein, may increase as some albumin in your blood is removed during the process. Therefore, you may need to consume more protein to help maintain albumin levels in your body. Albumin also helps retain fluid in the blood vessels, which is especially important during dialysis treatment.
High-quality protein produces less waste for removal during dialysis. It is recommended that more than half of your protein intake should come from high biological value (HBV) sources, which contain essential amino acids. Good sources of high-quality protein include meat, poultry, fish, and eggs. If you are a vegetarian, ask your dietitian about other ways to get protein. Low-fat milk is a good source of protein, but it is high in phosphorus and potassium, and it adds to your liquid intake. Plant-based proteins such as beans, lentils, nuts, peanut butter, seeds, and whole grains are also an option, but careful planning is required to ensure sufficient essential amino acids.
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Frequently asked questions
Diet is important for dialysis patients because it helps to reduce waste buildup in the blood and prevent health problems.
Dialysis patients may need to limit their intake of fluids, sodium, salt, potassium, phosphorus, and protein. They should also avoid processed foods and aim to eat high-quality protein sources such as meat, poultry, fish, and eggs.
Signs that a dialysis patient is drinking too many fluids include sudden weight gain, swelling, shortness of breath, and a rise in blood pressure.
A renal dietitian can help a dialysis patient plan their meals and create a kidney-friendly food and fluid plan that fits their individual needs and treatment plan. They can also provide recipes and education on grocery shopping and cooking techniques.
