Patients with diabetes who are on hemodialysis have to be very careful about the foods that are included in their diets. These patients have to follow guidelines related to their diabetic disease to maintain appropriate blood glucose levels; however, the guidelines for end-stage kidney disease have to be incorporated into the diet plan as well. The patient has to eat fewer foods that are high in phosphorus, potassium and sodium; the amount of fluids and carbohydrates consumed need to be monitored too. While patients with kidney disease who are not on dialysis need to restrict protein consumption, patients on dialysis should make sure to eat sufficient protein levels each day. Patients with diabetes on hemodialysis have to keep all of these rules in mind while selecting food.
Fewer Foods Containing Phosphorus
Patients on hemodialysis have to eat fewer foods that contain the mineral phosphorus, according to the DaVita website. Dialysis does not remove phosphorus very well; high levels can lead to weakening of the bones. Examples of foods containing large amounts of phosphorus include dairy product like milk, cheese and yogurt; peanut butter; dried peas and beans; and dark cola drinks, according to the National Kidney Foundation.
Fewer Potassium-Rich Foods
Potassium levels that are too high or too low can cause muscle problems or heart failure, according to DaVita. Patients with diabetes who are on hemodialysis must reduce the intake of potassium-rich foods to help keep potassium levels in control. High-levels of potassium are present in bananas, oranges, melons, tomatoes and potatoes, according to the National Kidney Foundation. A dietitian will give the patient a diet that supplies the correct amount of this mineral.
Eating Less Sodium
Sodium causes fluid retention in the body. According to DaVita, dialysis treatments are not performed every day so the excess fluid in the body can cause high blood pressure and make the patient short of breath. Eating too much sodium can also increase thirst which can also lead to an increase in fluids in the body. Patients on hemodialysis should limit or avoid intake of soy sauce, processed meats, canned foods, and chips and crackers, according to the National Kidney Foundation.
Fluid Restriction
Besides having to monitor sodium intake, diabetic patients on hemodialysis must watch their fluid intake as well. These patients should follow the dietitian's recommendations for fluid consumption each day. This does not just refer to beverages; any food that is in a liquid form at room temperature like ice cream, sherbet or soup also contributes to the total amount of fluid per day, according to the National Kidney Foundation.
Foods Containing Protein
Patients who are on hemodialysis need more protein in their diets than people who have less severe kidney disease, according to the University of Maryland Medical Center. Since protein is important for fighting infections and building muscles, diabetic patients on hemodialysis must be sure to eat the right amount of protein. However, some protein sources contain other substances like phosphorus that these patients need to monitor. Fresh meat, eggs, fish and poultry are good sources of protein; dairy products--while good sources of protein--also contain significant levels of phosphorus and should be limited.
Managing Carbohydrates
Patients with diabetes who are on hemodialysis have to watch their blood glucose levels while following the other guidelines. These patients have to monitor the amount of carbohydrates eaten each day, according to the American Association of Kidney Patients. Carbohydrates like cakes, cookies, breads, starches and fruits are converted into sugars and can increase glucose levels in the blood. While the patients are watching carbohydrates, they also have to keep in mind the sodium, phosphorus and potassium levels of the carbohydrates that they do eat. Small servings of low-potassium and low-phosphorus fruits like apples, strawberries, pineapples and grapefruit are appropriate. Starches that are low in sodium as well as potassium and phosphorus include white bread, unsalted crackers, cream of wheat and rice. These patients should discuss carbohydrate consumption with their dietitian.
