The Importance of a Healthy Diet to the Dialysis Patient
The kidneys normally function to remove waste products from the blood, where they are then excreted from the body via urine. For those with defective kidneys who must rely on hemodialysis (or merely “dialysis” for short) to perform this essential function, waste build up in the blood is a common problem as dialysis is not as efficient a waste removal system as is a productive kidney. Due to this shortcoming, dialysis patients are highly susceptible to illness brought on by excessive waste accumulation in the blood. One way dialysis patients can minimize blood waste, while ensuring that they get essential nutrients, is to strictly adhere to an appropriate meal plan. The next section presents some tenets that dialysis patients should heed in establishing their diet, while the last section provides a typical daily meal plan for an average-sized adult who is on dialysis.
Dialysis Patient Diet Tenets
Eat 7-10 Ounces of Protein Each Day. Dialysis patients need to make sure that their daily protein intake remains consistently high because much protein is lost as a result of dialysis treatment. Adult dialysis patients should consume about 7-10 ounces of protein each day. Foods rich in protein include poultry, fish, meat, eggs, milk and nuts.
Limit Potassium Intake. Potassium is an important nutrient, but having too much potassium in the body can cause hyperkalemia, which can lead to weakness, changes in heartbeat, nausea and loss of consciousness. Because they have trouble eliminating potassium from their bodies, dialysis patients are at risk of developing hyperkalemia. Therefore, if their potassium levels are determined to be too high, these individuals should limit their intake of foods that have a high potassium content, such as bananas, tomatoes and tomato products, oranges and potatoes, for example. Further, salt substitutes, which have an elevated potassium content, should be avoided.
Limit Phosphorus Intake. Phosphorous is important for good bone maintenance. However, too much phosphorus can lead to the formation of deposits in the heart, blood vessels, skin and joints. For this reason, the phosphorus levels of dialysis patients should be regularly measured. When levels are deemed to be too high, phosphorus-rich foods such dairy products, beans and chocolate should not be eaten.
Control Fluid Intake. Depending on the nature of the dialysis being undergone, the dialysis patient may need to limit fluid intake. For these individuals, it important to drink the bulk of their daily fluids during meals (when the fluids can best aid in digestion and help the swallowing process).
Do Not Overeat. In addition to increasing the likelihood of that fluid, phosphorus and potassium levels may become elevated, overeating of course leads to weight gain. Being fit is important to obtaining maximum benefit from dialysis.
Limit Fat and Cholesterol. Everyone, including dialysis patients, must limit their fat and cholesterol intake to avoid cardiovascular problems.
Sample Meal Plan for an Average-Sized Adult Dialysis Patient
- 3 medium-sized pancakes or waffles with berries (strawberries or blueberries, for example) and reduced fat maple syrup
- 3-4 thin melon slices
- 8 ounces of skim milk (those who have a potassium or phosphorus restriction can substitute grape juice, for example, for milk)
- Tuna fish (optionally with celery mixed in) sandwich on whole wheat bread
- Carrot sticks (optionally with low fat, low salt salad dressing)
- 4-6 ounces of diet ginger ale
- Skinless grilled chicken
- Steamed broccoli and/or cauliflower
- Whole wheat dinner roll or bread slice with low fat, low salt margarine
- 4-6 ounces of unsweetened ice tea or water with lemon
This article is only meant to provide some basic information regarding how to create appropriate dialysis meal plans. You should always follow the good advice of your doctor and/or dietitian.
A. Moran, Food Choices for Home Hemodialysis, American Association of Kidney Patients: https://www.aakp.org/aakp-library/Food-Choices
Eat to Feel Right on Hemodialysis, The National Kidney and Urologic Diseases Information Clearinghouse: https://kidney.niddk.nih.gov/kudiseases/pubs/eatright/
M. Karalis, Nutrition Tips for Enhancing the Dialysis Patient’s Quality of Life, Kidney Times: https://www.kidneytimes.com/article.php?id=20070207201911
N. Scalfani, Heart Healthy Eating for Dialysis Patients, American Association of Kidney Patients: https://www.aakp.org/aakp-library/heart-healthy-eating-for-dialysis-patients/
Planning for Emergencies: A Guide for People with Chronic Kidney Disease, National Kidney Foundation: https://www.kidney.org/atoz/pdf/DisasterBrochure.pdf