Renal dialysis is effective when failed kidneys have been diagnosed by cleaning out harmful wastes that can build up and lead to raised blood pressure, excess fluid retention, and an inability to produce enough red blood cells.The general goals of medical nutrition therapy for patients with renal disease are to prevent deficiency and maintain good nutritional status, control edema and electrolyte balance, prevent or retard renal osteodystrophy, and create a palatable, attractive diet that fits the patient's lifestyle.
Protein
Hemodialysis treatment takes a toll on the body, and increasing a patient's protein intake helps to compensate for this strain. Additionally, hemodialysis treatment causes protein losses of about 20g to 30g per 24 hours. The protein recommendation for patients undergoing hemodialysis is 1.2g/kg body weight and at least half of the protein should be high biological value. According to the "Journal of Renal Nutrition," It has been shown that hemodialysis patients with low albumin levels have a higher mortality rate, and low albumin levels can be predictive of poor survival of end-stage renal disease.
Potassium
In renal dialysis patients, kidney function is poor and tissue destruction may occur. Because the kidneys work to regulate potassium and tissue destruction could lead to a potassium overload, renal dialysis patients must be careful with their potassium consumption, because a potassium overload can cause the heart to stop. Potassium should not exceed 3.5-5.5 mEq/l and is found in high protein foods, fruits and vegetables.
Sodium
For renal dialysis, sodium should be closely monitored and should stay at about 135-155 mEq/l. Sodium increases thirst and sodium excretion is low when urine elimination is low, which leads to a sodium build-up that can cause an increased risk of congestive heart failure, edema and high blood pressure. Renal dialysis patients should consider monitoring their sodium intake by choosing low-sodium varieties and limiting their consumption of processed and packaged foods.
Calcium
It is important for renal dialysis patients to consume 8.7-10.2 mg/dl of calcium. Calcium helps to build bones and move muscle. Active vitamin D might be needed for absorption. Calcium can be found in dairy products and some green vegetables.
Take Water-Soluble Vitamins But Avoid Fat-Soluble Vitamins
Water-soluble vitamins are lost during hemodialysis treatment and need to be supplemented for renal patients yet, this is not the case for fat-soluble vitamins. The fat-soluble vitamins to avoid are A, D, E and K. In fact, renal patients usually have higher levels of fat-soluble vitamin A and thus, a vitamin A supplement would risk toxicity. If vitamin D supplementation is given, it should only be in the active form because renal dialysis patients are unable to activate it internally. Vitamin E is generally avoided because there is little known about its effects on renal dialysis patients. Lastly, vitamin K is typically avoided because of the high prevalence of renal dialysis patients taking anticoagulants such as Coumadin that interfere with vitamin K.
Active Vitamin D
Renal patients must be administered the active form of vitamin D, known as D-3, because renal dialysis patients can not convert inactive vitamin D, which is found in foods, supplements and sunlight to its active form.
Avoid High Fat Foods
High fat foods should be monitored because lipid abnormalities, high triglycerides, and cardiovascular disease are common among patients on dialysis. Renal dialysis patients should consider replacing fried foods with baked options and deli meats with lean protein, such as steamed chicken.
