Diet

in Hemodialysis

Why does my diet matter?

Diet is part of your treatment and can help you feel better. An essential part of treatment is your diet. Diet can help you feel better and avoid complications like fluid overload, bone disease, high blood potassium and weight loss.

Waste is normally removed from the body by the kidneys. Build up of these substances can occur if kidney function is impaired. Accumulation and its effects can be lessened by following a strict diet.

Key components to monitor and limit are your intake of:


  • potassium
  • phosphate
  • sodium
  • fluids

Phosphorus and Potassium

Phosphorus

Normally gotten rid of in the urine. Build up in blood can cause muscle aches, pain, and brittle bones, calcification of the heart, joint, skin, and blood vessels.

Tips and tricks to keep your phosphorus level in check


  1. limit high phosphorus foods: meats, poultry, dairy and fish (1 serving of 7-8 ounces); milk and dairy products (one 4oz serving)
  2. avoid high phosphorus foods: dark colored sodas, chocolate, most beans; dark, whole or unrefined grains, refrigerator doughs, dried fruits and vegetables
  3. take your phosphate binders with meals as prescribed by doctor to help get rid of phosphorus
  4. limit phosphorus intake to 1000mg per day



Potassium

Element necessary to keep normal water balance between the cells and body fluids. Build up of potassium can be dangerous to you heart and in high levels can cause irregular heart beat, possibly stop heart if potassium is to high. When levels of potassium are high often there are no symptoms. Typically renal diet is limited to 2000mg of potassium each day.

Few foods high in Potassium:


  • Tomatoes and tomato based products
  • Honeydew melon, cantaloupe, papaya, oranges
  • Most Beans
  • Chocolate
  • Nuts
  • Avocados
  • Prunes

Sodium and Protein

Sodium

Helps to regulate water in the body.

More sodium intake worsens ones blood pressure and also results in excessive thirst which will work against the adherence of fluid restriction.

Protein

Important in growth and body tissue maintenance. Also plays a role in fighting infection, healing wounds, and a source of energy to the body.

Fluid Intake

With dialysis often there is a decrease in urine output.

What can excess fluid do to the body?

Increased fluid in the body can increase the pressure on the heart and lungs.

Fluid allowance is based on: urine + 500mL.

500mL accounts for the amount of fluid you lose in a day through the skin and lungs.

So many restrictions, how can I go out to eat with friends or grab something on the go?

Just remember that balance is key. If you have specific food places you go to often it may help to pre-plan and go online and look up their food facts to help you chose wisely.


Fast Food

Things to watch out for:


  • Often meat is pre-salted so maybe hard for fast food places to omit salt from burgers or sandwiches.
  • Fast food often means fries. Fries are high in potassium, so order small order of unsalted fries.
  • Small beverage best to keep within fluid restrictions. Don't forget to count it in your fluid count.
  • If possible choose broiled, steamed or grilled items over deep fried.



Dining Out

Have a favorite restaurant? Ask the manager for a copy of the menu and take it to your dietitian so they can help you to make good choices.

Like Italian? if you like Italian food you can often find many items suitable for your diet. it is recommended to ask for sauce on the side. Also red sauces are high in potassium and white sauces high in phosphorus. Pesto sauce is a great alternative sauce. It is recommended to avoid soups in most restaurants. Most soups are from canned or dried stock and have high sodium and add to your fluid allowance.

Got the munchies?

Key is to choose snacks that are low in potassium and phosphorus.

When in doubt ask your dietitian!

Good Snack Options-many more then just these


  • Vanilla Wafers (10)
  • Grapes (15)
  • Dry Cereal (1 ounce)
  • Unsalted pretzels (1 cup)
  • Popcorn- plain or caramel (1 cup)
  • English muffin (1/2)
  • Apple (fresh) (1 small)
  • Blueberries (fresh) (1 cup)
  • Shortbread cookies (4)

Holiday

Holidays can be very hard to follow your diet. Ask for Holiday food list. Feel free to ask dietitian about any family recipes and ways to make them work for your diet.

We do not live to make your life miserable or to watch you fail.

We are here to help you succeed!

Quick Review

  • Moderation
  • Slow down and enjoy your food. Takes twenty minutes for brain to get signal that you are full.
  • Stop eating when full. If tempted to keep eating when full, walk away.
  • Small chocolate cake slice and eat it slow and enjoy it.
  • Eating out, enjoy that meal twice. Eat half of your meal at the restaurant and take the rest home for the next day.
  • Goal is healthy lifestyle not a temporary diet.
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Source

The Renal Diet. (n.d.). Retrieved November 28, 2015, from https://www.vcuhealth.org/transplant/docs/renal_diet.pdf