End-stage renal disease means that kidney function has declined so much that dialysis or transplant is necessary. While it varies from person to person, this occurs when renal function is between 10 and 15 percent. Diet is very important at this stage because you can't count on your kidneys to remove toxins from the blood any more.
Protein
Patients on hemodialysis often find that their diets are less restrictive than during the years before dialysis. This is particularly true with respect to protein. Whereas before dialysis, your nephrologist may have recommended a low-protein diet, the opposite is true now. Extra protein is needed because hemodialysis removes certain amino acids from the blood. Just be careful that you are eating low-cholesterol, low-phosphorus foods like chicken and fish.
Potassium
As you approached end-stage, you were probably told to eat a low-potassium diet. This diet will continue when you hit end stage disease. However, many patients find they are able to consume slightly more potassium. Keep an eye on your serum potassium numbers. If you notice a change, ask your renal dietitian if you can include more potassium in your diet.
Phosphorus
Most dialysis patients continue to monitor serum phosphorus levels. Preventing phosphorus levels from getting too high is important for your long-term health because phosphorus can pull calcium out of bone. In addition to permanently weakening the bone, the calcium can create painful deposits in the joints and on blood vessels. Closely monitoring phosphorus levels helps prevent this problem.
Supplements
Specially-formulated vitamins prevent dialysis patients from becoming malnourished. These vitamins have no vitamin A, phosphorus or potassium. They include B vitamins, a small amount of vitamin C and biologically active vitamin D. The biologically active vitamin D is necessary because the kidneys can no longer use the type of vitamin D that is provided by food or sunlight.
