Milly Gaines
When on dialysis, it is important to follow a strict diet to maintain kidney health and ensure effective treatment. This involves limiting fluid intake and certain foods to reduce waste buildup in the blood, which can make you sick. A renal dietitian can help you plan your meals, incorporating foods you enjoy while adhering to guidelines. This typically includes reducing sodium, salt, potassium, and phosphorus, and increasing high-quality protein from sources like meat, poultry, fish, and eggs. Dining out can be challenging, but careful planning and choosing freshly cooked options without added salt can help. Regular laboratory tests monitor your health, and your healthcare team can adjust the dialysate to lower potassium and phosphorus levels if needed.
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What You'll Learn
Limiting fluids and sodium
Dialysis removes extra fluid from your body, but only so much fluid can be removed at a time. If you arrive at your dialysis session with too much fluid in your body, the treatment may make you feel unwell. You may experience muscle cramps, dizziness, or nausea.
To limit fluid intake, it is recommended to keep track of how much liquid you consume. This includes not only drinks but also foods that are liquid at room temperature, such as soup or gelatin. It is also important to limit sodium intake, as sodium causes your body to retain more fluid and raises your blood pressure. Eating less sodium will help you feel more comfortable before and after dialysis.
Your dietitian will give you guidelines to help you monitor your fluid and sodium intake. They will also work with you to create a meal plan that meets your unique needs and incorporates foods you enjoy.
In addition to limiting fluids and sodium, a hemodialysis diet will typically include a balance of nutrients, including protein, potassium, and phosphorus. It is important to control your intake of these nutrients to keep your body healthy and strong while allowing your body to safely process them.
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Eating high-quality protein
When on dialysis, it is important to eat high-quality protein as it helps to reduce waste buildup in your blood, which can make you feel unwell. High-quality protein sources include meat, poultry, fish, and eggs. However, it is important to choose lean, low-fat meats that are low in phosphorus, such as chicken, fish, or roast beef. If you follow a vegetarian or vegan diet, ask your renal dietitian about other ways to get protein.
While protein is essential for building muscle, repairing tissue, and fighting infection, some high-protein foods also contain high levels of phosphorus. Phosphorus levels in the blood can become too high in kidney failure, and hemodialysis does not effectively remove it. This can lead to weak bones and other health issues. Therefore, it is important to limit phosphorus in your diet, especially from processed and packaged foods, which contain high levels of phosphorus additives.
To ensure you are getting enough protein without consuming too much phosphorus, it is important to work with your renal dietitian to understand which foods are high in protein and their phosphorus content. They will help you make the best choices and determine the right serving size for your needs. A general guide is that a serving size of protein is around three ounces, or the size of the palm of your hand.
It is also important to take phosphate binders when consuming high-protein foods, as these can help reduce the absorption of phosphorus in your body. Additionally, eating more plant-based foods instead of processed foods will decrease your overall phosphorus load, as plant-based sources of phosphorus are absorbed less by the body.
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Reducing salt and phosphorus
While on dialysis, it is important to control your diet to reduce waste buildup in your blood and make you feel better. This includes reducing your salt and phosphorus intake.
Reducing Salt Intake
Dialysis removes extra fluid from your body, but only to a certain extent. If you arrive at your dialysis appointment with too much fluid, the treatment may make you feel unwell. You may experience muscle cramps, dizziness, or nausea. To limit fluid intake, you should reduce your salt intake. Salt makes you thirsty, leading to increased fluid consumption. Avoid salty foods such as chips and pretzels, and opt for low-sodium alternatives. Your renal dietitian can provide tips to help you reduce salt and manage thirst.
Reducing Phosphorus Intake
Phosphorus levels in the blood can become dangerously high in individuals with kidney failure. Dialysis is not effective at removing phosphorus, which can lead to weak bones as it binds with calcium. To prevent this, you may need to limit phosphorus in your diet. Processed foods often contain added phosphorus, so it is best to opt for plant-based, whole foods. Check food labels for additives with "PHOS", such as disodium phosphate. Phosphate additives are inorganic and easily absorbed by the body. In contrast, your body absorbs less phosphorus from plant-based sources like nuts and seeds. Animal-based foods, including meat and dairy, contain inorganic phosphates that are more readily absorbed.
Your diet while on dialysis should be carefully planned with the guidance of a renal dietitian. They will help you navigate the complexities of a kidney-friendly diet, ensuring you receive proper nutrition while managing waste buildup.
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Monitoring calories and weight
Monitoring your calorie and weight is crucial when on dialysis. Your dietitian will work with you to determine the appropriate calorie intake for you, taking into account factors such as your age, weight, height, sex, and exercise level. It is important to focus on consuming nutrient-dense foods that provide a high number of healthy nutrients relative to the number of calories consumed. For instance, a piece of fruit will provide more nutrients and fewer calories than a candy bar, which is likely to contain more sugar and fat.
Dialysis patients are advised to follow a diet that balances nutrients while limiting the intake of certain minerals like potassium, phosphorus, and sodium. This is because dialysis is unable to effectively remove these minerals from the blood, which can lead to health complications. For example, high levels of phosphorus in the blood can cause weak bones, while potassium buildup can cause muscle weakness and heart problems.
To ensure you are getting adequate nutrition, regular weight checks are essential. You will be weighed before and after each dialysis treatment to monitor your progress toward your target weight, also known as your "dry" weight. This is the weight your doctor estimates you would be if all excess fluid were removed from your body. Gaining some water weight between treatments is normal, but too much fluid buildup can cause discomfort, including swelling, shortness of breath, or high blood pressure.
To manage fluid levels effectively, it is recommended to limit salt and sodium intake, as these increase thirst and fluid retention. Your dietitian can provide guidance on reducing fluid intake and choosing foods that fit within your allowed fluid limits. They may also advise you to monitor your weight at home to ensure you are gaining the appropriate amount of water weight between treatments.
In addition to weight monitoring, monthly laboratory tests are conducted to evaluate your mineral balance, protein nutrition, and overall adequacy of dialysis. These tests, along with your weight checks, will help your healthcare team adjust your diet and treatment plan as needed to ensure optimal health and nutrition.
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Planning meals and snacks
Firstly, it is important to understand that your diet while on dialysis aims to help your body manage waste buildup and maintain adequate nutrition. Dialysis removes extra fluid and waste from your body, but it can only handle a certain amount at a time. Therefore, limiting fluids and certain foods that contribute to waste buildup is crucial.
When planning meals, consider the following:
- Protein: Animal-based proteins like meat, poultry, fish, and eggs are recommended. Choose lean, low-fat options such as chicken, fish, or roast beef, and avoid processed meats high in sodium and phosphorus. If you are a vegetarian, consult your dietitian for alternative protein sources.
- Phosphorus: Dialysis does not effectively remove phosphorus, which can lead to weak bones and other health issues. Limit phosphorus intake by avoiding processed foods and checking labels for additives with "PHOS". Opt for plant-based foods with organic phosphates like nuts and seeds, which are absorbed less easily.
- Potassium: While dialysis can remove potassium, it can build up in the blood between treatments, affecting your heart and muscles. Certain fruits, vegetables, and dairy products high in potassium may need to be restricted.
- Sodium and Salt: Sodium causes your body to retain fluid, leading to discomfort and health issues. Reduce sodium and salt intake, especially by limiting processed and packaged foods.
- Calories: Aim for nutrient-dense foods that provide a high amount of healthy nutrients relative to their calorie content. Choose fruits over sugary snacks to get more nutrients and avoid excessive sugar and fat intake.
- Fluid Intake: Limiting fluids is essential to prevent "fluid overload," which can cause swelling, high blood pressure, and other issues. This includes not only beverages but also foods with high water content, such as watermelon, soups, sauces, gelatin, ice cream, and certain fruits. Your dietitian will guide you in monitoring your fluid intake.
Remember, your dietitian will work closely with you to develop a meal plan that considers your individual needs, preferences, and treatment schedule. They will also provide guidance on portion sizes and creative ways to reduce fluid intake while ensuring adequate hydration. It is important to follow their recommendations and make adjustments as needed to ensure your dialysis treatments are effective and to help you feel your best.
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Frequently asked questions
A hemodialysis diet is a carefully planned meal regimen that aims to maintain a balance of nutrients while restricting certain substances like potassium, phosphorus, sodium, and fluids.
Following a hemodialysis diet helps to minimize waste and fluid buildup in the body, reducing the risk of associated health complications and helping you feel your best.
One of the main restrictions is limiting fluid intake, including beverages and foods with high water content. Additionally, sodium (salt) intake should be reduced to prevent excess fluid retention and high blood pressure. Phosphorus and potassium levels should also be monitored and restricted if necessary, as hemodialysis does not effectively remove these minerals.
High-quality protein sources such as meat, poultry, fish, and eggs are recommended. Lean meats like skinless chicken and turkey breasts are ideal. Beans, lentils, tofu, and plant-based proteins are also good choices. Freshly cooked foods are preferable to processed options, as they contain less phosphorus.
Dining out on dialysis can be challenging, but planning ahead is key. Choose restaurants that offer freshly cooked meals without added salt. Opt for smaller portions and consider putting half of your meal in a to-go box before you start eating. Consult your dietitian for specific recommendations and guidelines.
