Patient education: Dialysis and diet (The Basics)

Do people on dialysis need to watch their diet? — Yes. Most people on dialysis need to watch what they eat and drink. Your doctor, nurse, or dietitian (food expert) will tell you if there are foods or drinks that you should limit or avoid.

The diet that is right for you will depend on:

●The type of dialysis you have – There are 2 types of dialysis, called "hemodialysis" and "peritoneal dialysis." People who get hemodialysis at a dialysis center (in a hospital or clinic) need to watch their diet the most. They need to limit or avoid more foods than those who do peritoneal dialysis, or hemodialysis at home.

●How often you have dialysis

●Your health and other medical conditions

Why do people on dialysis need to watch their diet? — People on dialysis need to watch their diet because their kidneys aren't working as they should. Normally, the kidneys work to filter the blood. They remove excess water, salt, and other minerals and nutrients that people eat and drink.

Dialysis is a treatment that takes over the job of the kidneys. But dialysis doesn't filter the blood as well as healthy kidneys do. Plus, normal kidneys work all day, every day. People usually have hemodialysis at a center only 3 times a week. So if a person on dialysis gets too much water, salt, or other nutrients through eating and drinking, these things can build up in the body. This can make people feel sick and cause problems.

When you are careful about what you eat and drink, you can help make sure that:

●Too much fluid doesn't build up in your body between treatments – Having too much fluid can raise your blood pressure, which makes the heart work harder. Extra fluid can also cause weight gain, swelling, or trouble breathing.

●Your body has the right amount of nutrients – Some foods have high levels of certain nutrients. Eating those foods can raise the level of certain nutrients in your body between treatments. This can lead to problems.

●You stay as healthy as possible and don't gain too much weight

What changes do I need to make to my diet? — If you are on dialysis, you will need to pay attention to certain things in what you eat and drink. These include:

●Fluids – Most people on dialysis need to limit how much fluid they eat and drink. Any food that is a liquid at room temperature (such as ice cream) counts as a fluid. Some fruits and vegetables have a lot of fluid in them, including melons, peaches, cucumbers, and lettuce.

●Sodium – This is the main ingredient in table salt. Most people on dialysis need to limit the amount of sodium they eat. That's because eating a lot of sodium can raise your blood pressure. It can also make you thirsty and make you to drink more than you should. To know how much sodium is in a food, you need to look at the food's label (figure 1). Try to eat foods that are naturally low in sodium or foods that say "sodium-free" or "very low in sodium."

●Potassium – This is a nutrient that affects your heartbeat. Most people on dialysis, especially if they get hemodialysis, need to limit how much potassium they eat. If too much potassium builds up in your body, it can cause problems with your heart rhythm. Try to eat foods that are low in potassium (table 1) and avoid foods that are high in potassium (table 2).

●Phosphorus – This is a nutrient found in many foods. Foods such as milk, other dairy foods, nuts, beans, liver, and chocolate have high levels of phosphorus. Most people on dialysis need to avoid foods with high levels of phosphorus. That's because if phosphorus builds up in your body, it can cause weak bones and other problems. Your doctor might also prescribe a medicine for you to take with your meals and snacks. This medicine can help keep your phosphorus level low.

●Protein – Protein helps your muscles stay strong. Foods with a lot of protein include meat, chicken, fish, and eggs. People who do peritoneal dialysis might need extra protein, because the body loses protein with each peritoneal dialysis treatment. In some cases, your doctor or dietitian might recommend drinking a special supplement that contains extra protein and calories.

Your doctor will probably prescribe a vitamin for you to take every day. That way, your body can get the vitamins and minerals that might be missing in your diet.

What are some foods that are good to eat? — Your doctor, nurse, or dietitian can talk to you about what specific foods are good to eat, and what to limit or avoid (figure 2). They can also help you understand how much you should eat in each "serving."

Sometimes, it can be hard to figure out what to eat and what to avoid. For example, a food might be low in potassium but high in phosphorus, or low in salt but high in potassium. This is why working with a dietitian can be helpful. They can work with you to make a specific meal plan based on your needs.

What if I get thirsty? — If you get thirsty but need to limit your fluids, try these tips:

●Suck on ice instead of having a drink, because ice lasts longer. (But remember that ice is also a fluid.)

●Chew gum or suck on hard candy

●Eat low-potassium fruit that is very cold, such as frozen grapes

●Rinse your mouth out with water or mouthwash, but don't swallow

More on this topic

Patient education: Hemodialysis (The Basics)
Patient education: Peritoneal dialysis (The Basics)
Patient education: Preparing for hemodialysis (The Basics)
Patient education: Low-sodium diet (The Basics)
Patient education: Choosing between dialysis and kidney transplant (The Basics)
Patient education: Kidney transplant (The Basics)
Patient education: Planning for a kidney transplant (The Basics)
Patient education: Low-potassium diet (The Basics)

Patient education: Peritoneal dialysis (Beyond the Basics)
Patient education: Hemodialysis (Beyond the Basics)
Patient education: Dialysis or kidney transplantation — which is right for me? (Beyond the Basics)
Patient education: Low-sodium diet (Beyond the Basics)
Patient education: Low-potassium diet (Beyond the Basics)