Madeleine Hull
A dialysis diet is a key part of hemodialysis treatment, which helps to remove waste and extra fluid from the blood. The diet is designed to help the body adapt to the treatment while keeping the patient well-nourished. It involves limiting fluids and certain foods and condiments, such as sodium, potassium, phosphorus, and sugar. A renal dietitian can help create a personalised eating plan that takes into account the patient's treatment plan, nutrition status, and other health concerns.
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What You'll Learn
Limit sodium, salt, and fluid intake
When on dialysis, it is important to limit sodium, salt, and fluid intake. Dialysis helps to filter out wastes and extra water from the blood, but it cannot work as efficiently as healthy kidneys. As a result, some waste and fluid can still build up in the body, especially between dialysis treatments, which can lead to health problems.
A diet that is high in sodium can lead to a build-up of fluid between dialysis treatments and increase thirst. It is recommended that sodium intake be limited to less than 2300 milligrams per day, which is equivalent to about one teaspoon of salt. This means limiting the use of a saltshaker, but also being mindful of other sources of sodium. Many canned, packaged, frozen, and fast foods contain high levels of sodium, as do condiments, seasonings, and meats. For example, deli meats, salty snacks such as chips, and cured meats like bacon and ham are high in sodium. It is important to check nutrition labels, as some foods that do not taste salty may still contain high levels of sodium.
Limiting fluid intake is also important, as it can help reduce stress on the heart and prevent a build-up of fluid in the body. This may mean carefully planning meals and keeping track of the amount of liquid consumed, including liquids from foods such as milk.
In addition to limiting sodium and fluid intake, it is also crucial to monitor potassium and phosphorus levels when on dialysis. High levels of potassium in the blood can cause heart problems and even death, so it is important to keep track of potassium levels and adjust the diet as needed. Potassium is found in many foods, including meat, dairy, fruits, vegetables, legumes, nuts, and seeds. Phosphorus levels can also become too high in people with kidney failure, leading to weak bones. Limiting phosphorus in the diet can help improve bone health, and this can be done by avoiding processed foods and checking labels for additives with PHOS.
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Monitor blood potassium levels
Monitoring your blood potassium levels is crucial if you have kidney disease or are on dialysis. Potassium is a mineral that plays a vital role in maintaining healthy nerve and muscle function, including a regular heartbeat. However, when potassium levels in the blood are too high or too low, it can lead to serious heart problems and even death. Therefore, keeping track of your potassium levels and adjusting your diet accordingly is essential for your health.
The amount of potassium in your blood can be affected by the food you eat. Potassium is found in many foods, including fruits, vegetables, legumes, nuts, and seeds, as well as meat and dairy products. While potassium from plant-based sources like fruits and vegetables is absorbed more slowly by the body, the potassium from animal-based sources like meat and dairy is absorbed more easily. This is important to consider when planning your meals.
If you are on dialysis, your kidneys are unable to effectively remove excess potassium from your blood, so it is crucial to monitor your blood potassium levels and adjust your diet accordingly. People on hemodialysis, especially those who receive treatments less frequently, may need to limit their potassium intake. However, those who perform frequent hemodialysis at home may not need to restrict their potassium as much. It is important to discuss your specific needs with a renal dietitian or your healthcare team, as they can help you create a personalized eating plan based on your blood potassium levels and overall health.
Regular lab tests can help you keep track of your potassium levels and make informed decisions about your diet. Your healthcare team may also prescribe potassium binders, medications that can lower your potassium levels, allowing you to potentially expand your food choices. Additionally, they can adjust the dialysate (the cleansing fluid used during dialysis) to help reduce your potassium levels. By closely monitoring your blood potassium levels and working with your healthcare team, you can ensure that your diet supports your overall health while on dialysis.
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Limit phosphorus for bone health
Phosphorus is a mineral found in bones and is necessary for building strong, healthy bones. However, when you have chronic kidney disease, your kidneys cannot remove phosphorus effectively, leading to high phosphorus levels in the blood. This, in turn, pulls calcium out of your bones, weakening them.
High phosphorus levels can also lead to dangerous calcium deposits in the blood vessels, lungs, eyes, and heart, increasing the risk of heart attack, stroke, or even death. Therefore, limiting phosphorus in your diet is crucial for maintaining bone health and overall well-being.
To decrease your phosphorus load, it is advisable to avoid processed foods and carefully read labels to identify additives with "PHOS," such as disodium phosphate. Organic phosphorus is found in many unprocessed protein-rich foods, including meats, poultry, fish, nuts, beans, and dairy products. However, it is important to note that the phosphorus in animal foods is absorbed more readily than that in plant-based sources. As a result, opting for plant-based proteins like soy may be a better choice for reducing phosphorus intake.
It is also recommended to consult with a renal dietitian, who can provide guidance on limiting phosphorus in your diet while ensuring you receive adequate protein. They can assist in creating a personalised food and fluid plan that considers your specific health needs and treatment regimen.
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Eat high-quality protein
When you're on dialysis, it's important to eat high-quality protein because it produces less waste for removal during dialysis. This is because dialysis filters out wastes and extra water from your blood, and in the process, it also removes proteins. To make up for this loss, you need to eat plenty of protein.
High-quality protein comes from animal sources such as meat, poultry, fish, and eggs. If you're a non-vegetarian, you should try to include a source of lean protein at every meal. Good options include lean cuts of beef and pork, chicken, fish, and eggs. These foods provide your body with the necessary protein while producing less waste for removal during dialysis.
The amount of protein that is needed varies from person to person. For example, a 155-pound man on dialysis might aim to consume 12 to 13 ounces of lean protein per day, while a 130-pound woman on dialysis might aim for 10 to 11 ounces. It's important to consult with your renal dietitian or healthcare provider to determine the appropriate amount of protein for your specific needs.
If you are a vegetarian, it is important to consult with your renal dietitian about alternative sources of high-quality protein. While meat, poultry, and fish are common sources of complete protein, there are vegetarian-friendly options available. For instance, eggs and dairy products like milk can provide a good amount of protein. However, it is important to note that milk is also high in phosphorus and potassium, and it contributes to your overall liquid intake.
In addition to protein, it is important to include plenty of vegetables, fruits, and grains in your diet. Most people on dialysis should focus on consuming foods that are lower in phosphorus and potassium. By incorporating these dietary recommendations, you can help ensure that you are receiving adequate nutrition while managing the waste and fluid buildup associated with dialysis.
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Consult a renal dietitian
A renal dietitian is a specialist in the dietary requirements of those with kidney disease. They can help you plan your meals and advise on foods to eat and those to avoid. They can also help you create a personal eating plan that will work for you and your treatment.
Renal dietitians can provide guidance on the right amount of protein to consume, which is essential as dialysis removes protein from the blood. They will recommend high-quality protein sources that produce less waste for removal during dialysis, such as meat, poultry, fish, and eggs. If you are vegetarian, vegan, or have other dietary restrictions, a renal dietitian can advise on alternative sources of protein. They can also advise on the right serving sizes for your body and health needs.
It is important to monitor your daily intake of fluids and nutrients when on dialysis. A renal dietitian can help you keep track of the amount of liquid you consume and advise on limiting certain fluids, such as those with high levels of sodium. They can also advise on the right amount of calories for your body and health needs.
Renal dietitians can also help you understand lab results and how these can guide your food choices. For example, they can explain how to manage your potassium levels through diet. They can also advise on how to reduce your phosphorus load by avoiding processed foods and checking labels for additives.
Your diet needs may change over time, and a renal dietitian can help you adjust your diet as needed. They can also advise on any dietary supplements that may be beneficial.
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Frequently asked questions
A dialysis diet is a diet for people with kidney disease that involves limiting certain foods and fluids to help reduce waste and fluid buildup in the blood.
People on a dialysis diet are often advised to limit or avoid foods high in phosphorus, potassium, and sodium. Phosphorus-rich foods include beef liver, refried beans, sardines, tuna canned in oil, and bran cereal. Dairy products like milk, cheese, and yogurt are also high in phosphorus. Potassium-rich foods include bananas, raisins, avocados, cooked spinach, potatoes, tomato paste, and beans. High-sodium foods include salty snacks, cured meats, sauces, and processed foods.
A dialysis diet should include high-quality protein sources such as lean meats, poultry, fish, and eggs. These foods provide essential protein that may be lost during dialysis. It is also important to include plenty of vegetables, fruits, and grains in your diet while focusing on foods lower in phosphorus and potassium.
