Why and How

It is crucial to eat properly while undergoing dialysis. Control of your diet is often the earliest form of treatment. It will be a key part of your on-going care. A person with kidney failure cannot get rid of extra fluid and wastes made by the body. To reduce these waste products, it is important for patients to control both their food and fluids. After starting dialysis, your dietitian will give you more detailed information. 

Many patients find that diet changes take some getting use to at first, but usually adjust well. In general, patients who adjust to their diet changes early may have fewer problems later on.

There are several things in your diet you must watch carefully once you start dialysis. Your diet changes are affected by the time of treatment you chose: traditional (3 times a week) or frequent (5 to 6 times a week) hemodialysis, or peritoneal dialysis.

Sodium/salt, fluid, potassium, phosphorus, protein, and calories are the items you need to focus on in your diet.

Your doctor may want you to limit phosphorus, sodium, and protein before dialysis starts. 

Discuss this with your physician at your next appointment. Your dietician will explain the detailed reasons for these diet concerns. 

Sodium -Ordinary table salt contains mostly sodium. It is best to cook your foods without salt . Do not add it at the table.

Many other foods have sodium in them as well. Some foods that are very high in sodium are prepared/convenience foods (TV dinners, canned soups, etc.), fast foods (hamburgers, pizza, etc.) and processed meats and cheeses. Avoid these foods or limit their use to once a week. Pre-dialysis patients need to check with their doctor about limiting sodium.

Fluids -Each day you can drink 3 cups (1 cup = 8 ounces) of fluid plus the amount equal to your daily urine output.

Fluids include all drinks, as well as foods that are a liquid or become liquid at room temperature, such as Jell-O® and ice cream.

Potassium- Limit the amount of fruits, vegetables, juices, nuts, seeds, and dried beans you eat. This keeps the potassium level in your blood from getting too high.

You can have 4 to 6 servings (a half [1/2] cup in size) each day. Check with your dietitian before using a product to replace salt since some are high in potassium.

Phosphorus-Use only 1 dairy product serving each day- such as as 2 ounces of cheese, 1 cup of milk or 1 1/2 cups of ice cream.

Take "phosphate binders" with meals or snacks as your doctor directs. Check with your doctor about the need to limit phosphorus before dialysis starts.

Protein – Once on dialysis, every day you should eat about 1.2 to 1.5 grams of protein for every kilo you weigh.

A person who weighs 56 kilograms needs about 67 to 84 grams of protein each day (or 8 1/2 to 10 1/2 ounces of protein for a person weighing 125 pounds). Choose from meats, fish, poultry, or eggs.

If you are not starting dialysis right away, check with your doctor about limiting your protein.

Calories-Eat more calories if you need to gain weight.

High calorie foods include butter, margarine, cream cheese, fried foods, gravies, sauces, sour cream, whipped cream, cakes, candies, cookies, pastries, and pies.

Some convenience or "ready made" cookies, pastries, gravies, and sauces can provide calories but are very high in sodium. Home-made foods are usually much lower in sodium.

Be very careful with dairy foods such as cream and cheese because of their high phosphorus content.