The kidneys are responsible for cleansing the blood, regulating blood pressure and filtering and removing waste and excess fluid. Individuals with kidney failure depend on dialysis to perform the essential functions of the kidneys. Diet plays an important role in managing the health of patients with kidney disease. Following a special diet while on dialysis can help improve your quality of life and help you feel better between dialysis treatments.
Calories
It is important to get enough calories to support your overall health and well-being. Calories provide the body with energy, promote a healthy weight and aid the body in using protein. Depending upon whether you need to limit protein, you may find it difficult to consume enough calories. Dialysis patients typically need to gain weight or remain at their current weight. For this reason, it is recommended that you consume between 30 to 35 calories per kg of body weight each day. This recommendation is based on your dry weight, or your weight after dialysis when fluid has been removed from your body. A registered dietitian at your dialysis center can assist you in creating an individualized meal plan.
Protein
Protein is a nutrient necessary for building muscles, repairing tissues and fighting infections. Your physician may recommend a low-protein or protein-controlled diet initially. This is done to reduce the amount of waste in your blood, maximize your kidney function and slow the progression of kidney disease. Once you begin dialysis however, your protein needs will be much higher. A high-protein diet emphasizing fish, poultry, pork, eggs and beans is suggested to meet a total of 8 to 10 oz of protein-rich foods per day.
Sodium
Excess sodium in your diet can lead to increased thirst, fluid retention, weight gain and high blood pressure. Most patients on hemodialysis require a sodium restriction of 1,000 to 3,000 mg of sodium per day while individuals on peritoneal dialysis can eat 2,000 to 4,000 mg daily. Work with your dietitian to learn about low-sodium foods and how to read food labels. Avoid canned foods, frozen dinners, seasoning, processed meats, snack foods and dehydrated soups. Look for food labels that say low-sodium, reduced sodium, sodium-free or no added salt. Choose fresh foods naturally low in sodium whenever possible.
Phosphorus
Your kidneys may not be able to sufficiently remove excess phosphorus from your blood; this causes your body to pull calcium from your bones. This results in brittle bones that break easily. Therefore, you need to limit the amount of dairy products, lentils, nuts, peanut butter, soft drinks, beer, hot chocolate and other high-phosphorus containing foods. Your physician may prescribe phosphorus binders for you to take with meals and snacks.
Potassium
Potassium is a mineral found in your blood that promotes normal muscle and heart function. Potassium-restrictions depend upon the stage of your kidney disease. A low potassium diet helps minimize a buildup in the blood, known as hyperkalemia, a common problem for dialysis patients. If left untreated, hyperkalemia can result in arrhythmias and even death. Potassium is found primarily in milk, fruits and vegetables. This does not mean you have to eliminate these foods, but rather balance your intake by eating a well-rounded diet that includes each food group.
Fluid
In general, early stages of kidney failure do not require a fluid restriction. As your condition worsens, you will need to limit your fluid intake, however. Your physician will recommend a fluid restriction based on the amount of urine you produce in a 24-hour period and the amount of weight gained between dialysis treatments. A fluid restriction means limiting your consumption of beverages such as water, juice and soft drinks. Additionally, you need to reduce the amount of foods that are liquid at room temperature. These include gelatin, soups, ice pops and ice cream. Even fruits and vegetables such as melon, grapes, apples, tomatoes, lettuce and cucumber have high water content.
References
- National Kidney Foundation:Kidney Disease
- National Kidney Foundation: Nutrition and Chronic Kidney Disease
- Drugs.com; Kidney Diet -- Dialysis; Parul Petel, M.D.; November 2008
- Medline Plus; Diet -- Chronic Kidney Disease; Parul Petel, M.D.; October 2009
- National Kidney and Urologic Diseases Information Clearinghouse: Eat Right to Feel Right on Hemodialysis; August 2008
