What Is a Dialysis Diet?

A dialysis diet is a special diet for people who are on dialysis treatment.

Why Should I Follow a Dialysis Diet?

The kidneys help filter wastes from our bodies, control fluid levels, and regulate levels of potassium and sodium. When the kidneys are not functioning well enough, dialysis can help by performing some of these functions for the kidneys. Because dialysis is performed periodically, and your kidneys are designed to continuously filter blood, it is important that you supplement your treatment with a controlled diet. Not following this diet can cause waste products to build up to toxic levels.

Dialysis Diet Basics

The dialysis diet regulates the amount of protein, sodium, potassium, phosphorous, and fluid that you can consume each day. Because this diet is fairly regimented, and may change depending on your kidney functioning, it is important that you work closely with a dietitian while on dialysis treatment. He or she will determine how much of each of these nutrients you can eat and help you create an individualized eating plan based on your needs.

Protein

Protein is an essential part of the diet. And for people on dialysis treatment it is extra important. If you eat too much protein, it can cause waste products to build up in your blood. Dialysis treatment helps remove these waste products, but in doing so can also remove healthy proteins. Therefore, if you don’t eat enough protein, dialysis can cause protein deficiency and muscle loss.

In addition to eating the right amount of protein, you also want to make sure that most of it is high-quality protein. Good sources of high-quality protein include meat, fish, poultry, and eggs. Milk also contains high-quality proteins, but is high in potassium and phosphorous.

Sodium

Sodium is found in table salt (sodium chloride) and many other foods. Most canned and processed foods contain high amounts of sodium. Because sodium is found in so many foods, it is easy to eat too much of it. When the kidneys aren’t 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, so you will need to limit the amount of sodium in your diet.

To cut down on your sodium intake avoid high-sodium foods, don’t add salt to foods while cooking, and pass on the salt shaker. In addition, salt substitutes often contain potassium, so try seasoning with herbs and spices instead.

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 bloodstream, causing problems with heart functioning. Therefore, you will also need to limit the amount of potassium you consume each day.

To keep your potassium levels in check, avoid high potassium foods such as avocados, bananas, and dried fruit. The article on Potassium Content of Foods contains a thorough list of which foods are high and low in potassium. You may still be able to have a taste of your favorite high-potassium food every now and then if you limit it to a very small portion size.

Phosphorus

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, causing your bones to weaken. Phosphorous is found in protein-rich foods such as dairy products, meat, legumes, nuts, and seeds, as well as whole grains and cola. In addition to limiting your intake of phosphorous-containing foods, you may also need to take a medication that soaks up extra phosphorous and then passes out in your stool. These medications are known as phosphate-binders.

Fluids

Dialysis can help regulate fluid levels, but you will need to help out between treatments by watching your fluid intake. This means limiting how much you drink, but also what you eat. Many foods, particularly fruits, soups, and dairy products such as ice cream, are made up of mostly fluid. Consuming too much fluid can result in fluid retention leading to edema (an abnormal accumulation of fluid in connective tissue or body cavity) and increased blood pressure.

You can monitor your fluid status by regularly checking your weight and comparing it to your dry weight. Your dry weight is what you weigh immediately following a dialysis session.

Suggestions on Eating a Dialysis Diet

This article is meant to provide a general overview of the dialysis diet. The details of this diet can vary considerably from one person to the next. In addition, your needs may change over time, depending on your kidney functioning and overall health status. A registered dietitian who specializes in dialysis can provide you with an individualized dialysis eating plan. However, there are some suggestions that everyone on dialysis can follow:

  • Avoid eating too much salt.
    • Pass on the salt shaker.
    • Use herbs and spices in place of salt when cooking.
    • Don’t use salt substitutes that contain potassium.
    • Choose fresh foods over processed foods whenever possible.
    • Look for foods that say “low sodium” on the label.
  • Limit your fluid intake.
    • Remember that many foods contain fluids, in particular fruits and certain vegetables.
    • All foods which are liquid at room temperature are considered fluids (eg, popsicles, ice cream, Jell-O).
    • Limiting your salt intake will help cut down on your thirst.
  • Watch your portion sizes carefully.
    • Read food labels for portion size information.
    • It may help to use measuring cups when first becoming familiar with portion sizes.
  • Cook at home more often.
    • Restaurant food is generally high in sodium and fat.
    • Cooking at home will give you control of the ingredients.
    • Ask your dietitian about recipes designed especially for people on dialysis.
  • Make sure you are getting enough calories.
    • While some people on dialysis will need to limit how many calories they consume each day, most will want to make sure they are getting enough.
    • An easy way to increase calories is to add heart healthy oils, such as olive and canola, to the foods that you prepare.