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What Is a Hemodialysis Diet?
This is a special diet for people getting dialysis.
Why Should I Follow a Hemodialysis Diet?
The kidneys help filter waste from your body, control fluid levels, and regulate levels of potassium and sodium. When the kidneys are functioning poorly, dialysis can help by doing some of these functions for the kidneys.
Normally, the kidneys continuously filter blood, but dialysis is done on a schedule, usually 3 times a week. Because of this, it is important to follow a special diet between treatments. If you do not follow the diet, waste products can build up to toxic levels. Also, fluid and salt levels can become too high.
Hemodialysis Diet Basics
This diet regulates the amount of protein , sodium , potassium , phosphorous , and fluid you can consume each day. This diet is strict. It may change as your kidney functioning changes. That is why you should work closely with your dietitian. The dietitian will determine how much of each nutrient you can eat and create a meal plan that is right for you.
Protein is an essential part of the diet, but having the right amount is very important if you are on dialysis. If you eat too much protein, waste products can build up in your blood. Dialysis helps remove these waste products, but it can also remove healthy proteins. If you do not eat enough protein, dialysis can cause protein deficiency and muscle loss. It is important to eat just the right amount. You should also make sure it is high-quality protein. Good sources include meat, fish, poultry, and eggs. Milk contains high-quality protein, but is also high in potassium and phosphorous.
Sodium is found in table salt and many other foods. Most canned and processed foods contain high amounts. Because sodium is found in so many foods, it is easy to eat too much of it.
When the kidneys are not fully functioning, extra sodium can result in fluid retention and high blood pressure . Dialysis can help remove some of the extra sodium, but not all of it. Limit the amount of sodium in your diet. Do not add salt to foods while cooking or eating. If you want to season your food, use herbs and spices. Salt substitutes contain potassium.
Potassium is found in many fruits and vegetables. It is a mineral that is essential for proper muscle functioning and heart rhythm. But when you have kidney failure , potassium can build up in the blood. This causes severe and potentially fatal problems with how your heart functions. Therefore, you need to limit the amount of potassium you consume each day. Avoid high-potassium foods. Examples include potatoes, tomatoes, citrus fruits, avocados, bananas, and dried fruit. Try to choose low-potassium foods. You may still be able to eat your favorite high-potassium food if you limit it to a very small portion size. Your dietitian can help with this.
Phosphorous is another mineral that needs to be limited on this diet. If phosphorous builds up in the blood, it can draw calcium out of the bones. This can cause your bones to weaken. Phosphorous is found in protein-rich foods. Examples include: dairy products, meat, legumes, nuts, and seeds, as well as whole grains and cola. Your doctor may recommend that you take a medication called a phosphate-binder. This medication soaks up extra phosphorous and then passes it out in your stool.
Dialysis can help regulate fluid levels. Between treatments, you will need to keep track of your fluid intake. This means limiting how much you drink, but also what you eat. Many foods are made up of mostly fluid. Examples include fruits, soups, and dairy products like ice cream. Consuming too much fluid can result in fluid retention. This can lead to increased blood pressure and edema. Monitor your fluid status by regularly checking your weight and comparing it to your dry weight. Your dry weight is what you weigh right after a dialysis session.
Suggestions on Following a Hemodialysis Diet
The details of this diet can vary a lot from one person to the next. Also, your needs may change over time, depending on your kidney functioning and overall health status. A dietitian who specializes in dialysis can create a meal plan that is right for you. Here are some general suggestions you can follow:
Avoid eating too much salt:
- Do not use the salt shaker.
- When cooking, use herbs and spices instead of salt.
- Do not use salt substitutes that contain potassium.
- Eat fresh foods instead of processed foods.
- Look for foods that say low-sodium on the label.
Limit your fluid intake:
- Remember that many foods contain fluids.
- All foods that are liquid at room temperature are considered fluids. Examples include popsicles, ice cream, and Jell-O.
- If you limit your salt intake, you will reduce your thirst level.
Be aware of how much food you are eating:
- Read food labels for portion size information.
- When first becoming familiar with portion sizes, use measuring cups or a scale.
Cook at home more often:
- Restaurant food is generally high in sodium and fat.
- Cooking at home will give you control of the ingredients.
Make sure you are getting enough calories:
- Depending on your diet, you may need to limit calories. In most cases, you will need to make sure you get enough calories.
- An easy way to increase calories is to add heart healthy oils like canola or olive, to the foods you prepare.
Ask your dietitian about recipes for people on dialysis.
Eat Right—Academy of Nutrition and Dietetics
American Association of Kidney Patients
Dietitians of Canada
The Kidney Foundation of Canada
Kidney failure: Eat right to feel right on hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/kidney-failure-eat-feel-right-hemodialysis/Pages/facts.aspx. Updated March 28, 2012. Accessed February 14, 2013.
Nutrition and hemodialysis. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/nutrihemo. Acessed February 14, 2013.
- Reviewer: Dianne Scheinberg Rishikof MS, RD, LDN
- Review Date: 04/2016
- Update Date: 05/08/2014