Diet for dialysis patients

Protein

Once you’re on dialysis, your protein needs are usually much higher than they were before you started treatment. That’s because both HD and PD treatments cause your body to lose protein. There are a variety of different healthy protein sources – including chicken, beans, beef, eggs, fish, turkey and tofu. Choosing fresh, high-quality protein is the healthiest option. You should avoid cured and deli meats in order to limit the amount of salt you’re putting into your body.

Sodium

If you have chronic kidney disease, your kidneys don’t get rid of as much sodium. This can make you thirsty and want to drink more. If you get fluid overloaded (too much water) it can give you high blood pressure, shortness of breath, and swelling. To make sure you’re not eating too much salt, it is best to stay away from packaged, processed foods, canned or frozen foods, and restaurant and fast foods. Healthy, home-cooked meals flavoured with spices and herbs are a great alternative that puts you in control of how much salt goes into your body.

Phosphate

Phosphorus is essential for building and maintaining strong bones. However, when your kidneys are not functioning as well as they should, phosphorus build-up can occur. This puts you at risk for severe bone and heart problems, like heart disease and hip fractures. There is a lot of phosphorus in fast foods and flavoured beverages, as well as milk, yoghurt, cheese, processed meats, chocolate, and nuts. Many healthy foods are high in phosphate, however these foods and drinks should be limited to enable you to stay within an appropriate daily phosphorus.

Calcium

Too much calcium in your body can put you at risk of calcium deposits in your blood vessels and heart valves. This can lead to heart and vascular problems.

Fibre

Getting enough fibre from the foods you eat is an important part of maintaining your overall bodily health. Fibre helps your body control its blood sugar levels, keep cholesterol in check, and maintain gut health. You should consume about 20 to 25 grams of fibre each day. This is easy if you eat a diet rich in fruits and vegetables and low-phosphorus grains.

Keep in mind that every person on dialysis has specific dietary needs. You should talk to your clinician or dietitian about what specific foods you should and should not eat while you’re on dialysis to make sure that you’re on the kidney-friendly diet that’s right for you.

Calories

If you’re on PD, some of the calories your body takes in will come from your dialysis solution, the fluid that is used to clean your blood during your treatments. This is because dialysis fluid contains dextrose, which is a form of sugar. The dextrose in your dialysis fluids provides your body some of its daily recommended calorie intake, which decreases your body’s need to take in calories from food. As a result, most peritoneal dialysis patients are recommended to eat fewer calorie-rich carbohydrates than haemodialysis patients.

Potassium

PD generally removes excess potassium from the body more efficiently than HD. If you’re on PD, you are typically able to consume between 3,000 and 4,000 mg of potassium per day. But if you’re being treated with HD, you should limit your potassium intake to about 2,000 mg per day to maintain balance. If you are a home haemodialysis patient, it is best to speak with your care team or dietitian about the level of potassium that is recommended for you.

Fluid balance

One of the most important functions of your kidneys is keeping the fluid in your body in balance. When you have chronic kidney disease, your kidneys are not able to remove this fluid as effectively as they should be. This can lead to a build-up of excess fluid, which is both uncomfortable and unhealthy for your body.

Because they treat less often and for shorter periods of time, patients on in-centre haemodialysis may feel more of the negative effects of fluid imbalance than patients on peritoneal dialysis or home haemodialysis.

If you are treating with peritoneal dialysis or home haemodialysis, you may not have the same fluid restrictions as someone on in-centre haemodialysis. However, it’s still recommended that you stick within a fluid allowance of about 1 litre of fluid per day, which includes the fluid that is in foods like green peas, celery and watermelon.

Minimising your sodium intake and planning the liquid you drink and eat ahead of time can help you keep your water gains to a minimum.