Diabetic nephropathy is the leading cause of end stage renal failure requiring hemodialysis, according to an article published in 2009 in "Diabetes Care." Elderly, type 2 diabetic patients undergoing maintenance hemodialysis are subject to hypoglycemia, or low blood sugar, after hemodialysis. Many are malnourished as well, and the mortality rate is high due to cardiovascular disease. Maintenance of nutrition is critical for diabetic hemodialysis patients.
Proteins
Prior to hemodialysis, most renal failure patients are told to limit their protein intake. According to DiabeticGourmet, patients on hemodialysis should eat as much high quality protein as possible. High quality proteins include egg whites, fish, meat and poultry. Diabetic hemodialysis patients should look for lean meats that are low in saturated fat in order to prevent cholesterol from rising. Lean meats are also low in phosphorous, a mineral that hemodialysis patients need to control. A built-up of too much phosphorous in the system pulls calcium from the bones and can make skin itch. Foods such as peanut butter, beans and milk can be high in phosphorous.
Fluids
Fluid intake should be carefully controlled while on dialysis. When the kidneys fail, fluid cannot be removed from the body and it's easy for a diabetic hemodialysis patient to become fluid overloaded. The Kidney Fund website states that too much fluid build-up can cause high blood pressure, peripheral edema, or swelling of the lower extremities, and congestive heart failure. Many foods, including milk, fruits, vegetables, ice cream, jello and soups, contain water. These foods need to be used in moderation so that fluid overload does not occur. High blood sugar causes thirst, and diabetics must be very careful to control their blood sugar and avoid overindulging in fluids.
Carbohydrates
Carbohydrates are foods that break down primarily into glucose when digested. Carbohydrates are the body's main energy supply. Diabetic patients must match their insulin requirements with their carbohydrate intake. It is important that diabetic hemodialysis patients take in adequate carbohydrates. Apples, plums, tangerines, grapefruit and berries are carbohydrate sources that are low in potassium and phosphorous. Starches are also carbohydrates but many of them are high in potassium and phosphorous. However, white bread, rice, noodles, pasta and unsweetened dry cereal are low in potassium and phosphorous. They also can provide adequate dietary carbohydrate calories for the diabetic hemodialysis patient.
