Dialysis and Your Diet

When you first learned that you had chronic kidney disease, you probably made some changes in your diet. Now that you’re on dialysis, your diet needs have changed again. Knowing which foods to eat and which foods to limit can help you feel better at this stage of kidney disease.

What is a dialysis diet?

Dialysis filters out wastes and extra water from your blood. In the process, it also removes proteins. You need to eat plenty of protein to make up for what’s lost. A dialysis diet is also designed to help you:

• Limit phosphorus and sodium

• Get the correct amount of potassium

• Limit how much fluid you have, as needed

Your diet may be a little stricter if you get hemodialysis 3 times a week. In this type of dialysis, your blood is run through a filter outside your body. When your blood is cleaned this way only 3 times in a week, wastes and water can build up in your blood between treatments. That means you need to be very careful about the foods and drinks you take in.

You may need a slightly less strict diet if you do hemodialysis at home every day. The same is true if you get peritoneal dialysis. This uses the lining of your belly to filter blood inside your body. But whatever form of dialysis you get, it’s vital to pay attention to what you eat. A dietitian who specializes in kidney disease can help you create a personal eating plan.

How can this diet help you?

Dialysis takes over some of the work that healthy kidneys would normally do. But dialysis can’t do the job as well as kidneys. Some waste and extra water may still build up in your blood. Over time, that could lead to problems with your heart and bones. You can help reduce this buildup—and the health problems it causes—by limiting how much fluid you have and how much of certain minerals you get.

Does this diet have any risks?

Your diet needs may change over time. At one point, you might have a low protein level. Later on, your protein level might be fine, but your potassium level might be too high. It’s important to change your diet as needed. Regular lab tests can help you keep tabs on your nutrition. Ask your dietitian to explain how you can use this information to guide your daily food choices.

Which foods should you eat?

Include a source of lean protein at every meal. Good options include lean cuts of beef and pork, chicken, fish, eggs, and garbanzo beans.

The amount of protein that’s needed varies from person to person. As an example, a 155-pound man on dialysis might aim to get 12 to 13 ounces of lean protein per day. A 130-pound woman on dialysis might aim for 10 to 11 ounces. Ask your dietitian what’s right for you.

Along with protein foods, include plenty of vegetables, fruits, and grains. Most people on dialysis should focus on foods that are lower in phosphorus and potassium. Examples of foods low in both include green beans, lettuce, mango, pineapple, cornflakes, pasta, and white bread.

Which foods should you pass up?

Many people on dialysis need to limit foods high in phosphorus, potassium, and sodium.

High-phosphorus foods include beef liver, refried beans, sardines, tuna canned in oil, and bran cereal. Dairy foods such as milk, cheese, and yogurt are also high in this mineral.

Limit high-potassium foods in many cases. Examples are bananas, raisins, avocados, cooked spinach, potatoes, tomato paste, and bran cereal. Several kinds of beans, including great northern, navy, and refried beans, also contain a lot of this mineral.

Foods high in sodium include salty snacks such as chips and crackers, high-sodium sauces such as steak and soy sauce, and cured meats such as bacon and ham. High levels are also found in many processed foods, including canned soups, hot dogs, and frozen meals.

You will also often need to limit fluids. A fluid is anything that is liquid or melts at room temperature. That includes any type of drink, such as water, tea, juice, milk, or almond milk. But it also includes ice, soup, pudding, gelatin, and ice cream.

Tips for following this diet

Choose whole, unprocessed foods when possible. Many processed foods and bottled or canned drinks contain phosphorus additives. They are often high in potassium and sodium, too.

Spice up meals without adding salt. Salt is the main source of sodium in the diet. Use herbs, lemon juice, or spices instead. But don't use salt-free seasoning blends that contain potassium.

Suggestions for planning meals

• For breakfast, have scrambled eggs, toast, and a bowl of strawberries.

• For lunch, have a chicken salad or lean roast beef sandwich and a tangerine.

• For dinner, have a lean hamburger with lettuce and onion. Add a side of coleslaw.