Milly Gaines
When a person is on dialysis, their kidneys are unable to remove waste and excess fluid from their body efficiently. As a result, their diet must be carefully planned to help their body adapt to this change while ensuring they remain well-nourished. Typically, a renal dietitian will be involved in creating a personalised diet plan that fits the needs of the patient. This plan will include a balance of nutrients to help keep the body healthy and strong, while limiting the intake of certain minerals such as potassium, phosphorus, and sodium to prevent a harmful buildup in the body. In addition to these restrictions, the diet may also involve monitoring calorie and protein intake, depending on the patient's body size, activity level, and health.
Diet followed by a person on dialysis
| Characteristics | Values |
|---|---|
| Purpose | To help the body adapt to the change while keeping it well-nourished |
| Dietary restrictions | Fluids, certain foods, condiments, sodium, potassium, phosphorus |
| Protein | High-quality protein is encouraged as it produces less waste for removal during dialysis. |
| Vitamins and minerals | Needs are specific to each person. A healthcare professional may order special vitamin and mineral supplements. |
| Weight | Maintaining a healthy dry weight is important. |
| Blood levels | Healthy blood levels of a protein called albumin are important. |
| Blood pressure | It is important to meet blood pressure goals. |
| Blood sugar | Meeting blood glucose goals is important for those with diabetes. |
| Individualization | The diet is tailored to each person's needs, treatment schedule, and nutrition status. |
| Meal planning | A renal dietitian helps plan meals and create an eating plan. |
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What You'll Learn
Limit fluids and certain foods
When you're on dialysis, your kidneys cannot remove enough waste and fluid from your body. Therefore, your diet must help your body adapt to this change while keeping you well-nourished.
Dialysis patients are encouraged to eat high-quality protein because it produces less waste for removal during dialysis. High-quality protein comes from meat, poultry, fish, and eggs. However, milk, a good source of protein, is high in phosphorus and potassium and should be consumed in limited quantities.
Your diet should also include a balance of nutrients to help keep your body healthy and strong while allowing the amount of potassium, phosphorus, and sodium your body can safely handle. For instance, potassium is easily removed by dialysis, but when it builds up in the blood between treatments, it can cause muscle weakness and heart problems. Similarly, phosphorus is difficult for dialysis to filter from the blood, so it's important to limit foods that contain this mineral.
Sodium is another important component to monitor in your diet. Sodium causes your body to retain more fluid and raises your blood pressure. Eating less sodium and drinking less fluid can help you feel comfortable before and after your dialysis sessions. Too much fluid gain between dialysis sessions can cause discomfort, including swelling, shortness of breath, or high blood pressure. It's important to note that sodium is not only found in salt but also in many canned, packaged, frozen, and fast foods, as well as condiments, seasonings, and meats. Therefore, it's crucial to read nutrition labels and be mindful of your overall fluid intake, including foods that contain water, such as gelatin, ice, sherbet, watermelon, sauces, and gravies.
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Monitor daily intake of nutrients
Monitoring your daily intake of nutrients is crucial when on dialysis. This involves keeping track of your fluid intake and certain nutrients, such as potassium, phosphorus, and sodium. The goal is to prevent the buildup of waste and fluid in the body, which can lead to serious health issues. Here are some detailed instructions to help you monitor your daily intake of nutrients effectively:
Keep a Food and Fluid Journal:
Record everything you eat and drink throughout the day. Include not only the types of food and beverages but also the quantities. This will help you become more aware of your intake and identify areas where adjustments are needed.
Limit Fluids:
Dialysis may not be able to remove large amounts of fluid at once, so it's important to monitor your fluid intake. This includes not only beverages but also foods with high water content, such as watermelon, gelatin, ice, sauces, and gravies. Work with your dietitian to determine your fluid allowance and stick to it.
Manage Potassium Intake:
High levels of potassium in the blood can lead to muscle weakness and heart problems. Dialysis can remove potassium, but it builds up between treatments. Limit potassium-rich foods, especially if you have fewer frequent dialysis sessions. Work with your dietitian to determine which fruits, vegetables, and dairy products to restrict.
Control Phosphorus Consumption:
Dialysis has difficulty filtering phosphorus from the blood, so it's crucial to limit foods containing this mineral. High phosphorus levels can lead to weak bones, heart issues, joint pain, and skin ulcers. Processed meats, like hot dogs and canned chili, are high in phosphorus and should be avoided. Discuss phosphorus-rich foods with your dietitian and find alternatives or ways to reduce their presence in your diet.
Reduce Sodium Intake:
Sodium causes your body to retain fluid, leading to discomfort and health issues like high blood pressure. Limit your sodium intake to less than 2300 milligrams per day, which is equivalent to one teaspoon of salt. Avoid high-sodium foods like deli meats, canned foods, packaged foods, and condiments. Read nutrition labels carefully, as sodium can be hidden in unexpected places.
Monitor Protein Intake:
Protein is essential for energy and body functions, but too much can overwork your kidneys. Choose lean, low-fat proteins like chicken, fish, eggs, and roast beef. If you're a vegetarian, consult your dietitian for alternative protein sources. Adjust your protein intake based on your body size, activity level, and overall health.
Remember, everyone's needs are unique, so work closely with your healthcare team, including a renal dietitian, to create a personalised diet plan that fits your specific requirements and preferences. Regular tests will also help monitor your progress and make any necessary adjustments to your diet.
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Eat high-quality protein
People on dialysis need to eat more protein to help build and repair muscles and fight infection. This is because dialysis can also remove some of the albumin in the blood, which is a type of protein that helps fluid stay in the blood vessels. A renal dietitian will help you plan your meals and advise on the best sources of protein for your body's needs.
High-quality protein produces less waste for removal during dialysis. It is important to eat high-quality protein with every meal and sometimes with snacks. This can come from animal sources such as meat, poultry, fish, and eggs, or plant sources like beans, grains, and nuts.
It is recommended to eat lean, low-fat meats that are low in phosphorus, such as chicken, fish, or roast beef. If you are a vegetarian, ask your dietitian about other ways to get protein. While milk is a good source of protein, it is high in phosphorus and potassium, and it also adds to your liquid intake.
Some foods that are high in protein are also high in phosphorus. As a dialysis patient, you will need to understand which foods are high in protein and how much phosphorus they contain. Your dietitian will help you make the best choices and advise you on taking phosphate binders with meals that are high in protein.
It is important to remember that everyone's calorie needs are different. You might need to cut down on calories if you are overweight, or you might need to find ways to add calories to your diet if you are losing weight without trying.
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Limit salt and sodium
For people on dialysis, limiting salt and sodium in one's diet is important to prevent discomfort and health complications. Dialysis removes extra fluid from the body, but only a certain amount can be removed at a time. If there is too much fluid gain between dialysis sessions, it can cause swelling, shortness of breath, or high blood pressure.
Sodium intake is strongly related to extracellular fluid volume, blood pressure, appetite, nutritional status, and mortality. Sodium causes the body to retain more fluid, which can lead to an increase in blood pressure. Therefore, limiting sodium intake can help manage blood pressure and prevent fluid buildup between dialysis treatments. The recommended sodium intake for most individuals, including those on dialysis, is less than 2300 milligrams per day, equivalent to one teaspoon of salt. This requires limiting high-sodium foods like deli meats, chips, canned foods, processed meats, and condiments.
Dialysis patients are at risk of zinc deficiency, which can decrease the sensation of taste, including the taste of salt. This may lead to a reduced appetite and subsequent weight gain. Therefore, it is important to monitor zinc levels and consider supplementation if necessary.
It is important to work with a renal dietitian to create a personalized eating plan that considers your specific needs and preferences. They can provide guidance on limiting sodium and salt intake while ensuring adequate nutrition and fluid intake.
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Track carbs and blood sugar
For people on dialysis, diet is a key part of treatment. The diet helps to manage the buildup of waste and fluid in the body, which can make you sick if left untreated. As such, it is important to track your intake of certain food groups, including carbohydrates.
Carbohydrates are a nutrient found in many foods and drinks that are turned into sugar (glucose) when digested. When you have diabetes, it is crucial to learn about the carbohydrates found in food and keep track of your intake. This is because carbohydrates directly affect your blood sugar levels.
There are two types of carbohydrates: complex carbohydrates or starches, and simple carbohydrates or sugars. Complex carbohydrates usually raise blood sugar more slowly as they take longer to digest and absorb, whereas simple carbohydrates usually raise blood sugar more quickly. To keep blood sugars stable throughout the day, it is important to eat at the same time every day and eat the same amounts of carbohydrates at each meal and snack. Eating a meal or snack every 3-4 hours and not skipping meals is also recommended. The amount of carbohydrates you need will depend on your weight and activity level. In general, 3 to 6 servings of carbohydrates are recommended at meals, and 1 to 3 servings are recommended at each snack.
If you are on dialysis, it is important to consult your dietitian for individual weight or diabetes management plans. Your dietitian will help you determine how many servings of carbohydrates are best for you and which high-fibre foods may be included in your diet. Fibre is a type of carbohydrate that can be found in certain foods and plays a vital role in protecting your heart, blood vessels, and colon. High-fibre diets can help lower cholesterol levels, reducing your risk of cardiovascular conditions and heart disease, which is the leading cause of death in dialysis patients.
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Frequently asked questions
The hemodialysis diet is a balanced diet that includes nutrients to keep your body healthy and strong while limiting the intake of potassium, phosphorus, and sodium to the amount your body can handle.
The hemodialysis diet is tailored to each individual and their treatment plan and health concerns. However, some general guidelines include limiting fluid intake and certain foods and condiments. Sodium intake should be less than 2300 milligrams per day, and it is recommended to eat high-quality protein from meat, poultry, fish, and eggs as it produces less waste for removal during dialysis.
One potential issue is that the diet may limit some food groups that normally provide important vitamins and minerals. It is important to consult a healthcare professional before taking any supplements, as certain vitamins and minerals can be harmful during dialysis. Additionally, the hemodialysis diet may need to be adjusted over time as an individual's health and treatment plan evolve.
