(Disclaimer: This diet chart contains only general guidelines on the renal diet. Please contact your nephrologist or dietician for specific advice. Each individual is different and what works for one may not work for another.)
Our kidneys regulate the salt and water content in our body.Some of the minerals in our body like potassium and phosphate are also excreted by the kidney.
When our kidneys don’t work well ,Salt and water and other toxins including minerals like potassium and phosphate accumulate in our body. Most of these can be removed by dialysis to certain extent. So it is very important to restrict these elements in our diet. Here is the complete overview of Diet and Nutrition for Hemodialysis Patients.
There are 4 main things you need to remember about your diet when you are on dialysis:
1. Liquids for Hemodialysis Patients
Excess fluid intake in your diet will cause swelling of legs,High Blood pressure,and also can cause breathlessness because of fluid in your lungs. So it is very important to restrict your liquid intake to a certain quantity. Liquids include water, tea, coffee, curd, juices, milk, etc.
Ask your nephrologist how much liquid you can have in one day.If you are not passing any urine it should normally be 1.0 litre per day. If you are passing urine your allowance will be 1 litre plus the amount of urine you pass in a day(24 hrs). Keep a check on the urine output every month, as your urine output reduces, your fluid allowance also will reduce
Measure out that amount of water you can drink in a bottle every morning and only drink from this bottle. If you drink other liquids, then pour out an equal amount of water from this bottle.
Diet and Nutrition for Hemodialysis – Tips to reduce thirst in dialysis patients
Here are some tips we’ve gathered from dialysis patients:
- Use small glasses at meals. Take sips ,not gulps .If you use larger glasses, don’t fill them up completely.
- Limit the amount of salt in your diet. Salt makes you thirsty ,so limiting salt will control thirst
- Keep a supply of hard candy, like mints, lemon drops, or mango bites. They lubricate your mouth and help decrease thirst.
Divide your fluid allowance into manageable parts. For example, if you can have 1 litre per day, you could drink 250ml at 4 different times of the day, at 10 a.m., 2 pm, 6 p.m. and 10 p.m.
- If you plan to attend a social event in the evening, you can decrease your intake earlier in the day so you can enjoy a beverage at the event.
- Be sure to brush your tongue, since good oral hygiene habits also help get rid of that “dry mouth” feeling.
Keep busy. This is the best option. This totally takes your mind away from thirst and is the most effective way to reduce your water intake!
Facts about Potassium
Potassium is a vital nutrient everyone needs to keep their heart, nerves and muscles working properly. For kidney disease patients – especially those on dialysis – having too much or too little potassium in the body can be a serious problem. , Very high Potassium can cause changes in the heart rhythm and can even kill us! So, it is very important that we control the amount of Potassium we take in our food.
Hemodialysis patients are at particular risk of having excess potassium. As the kidneys fail, they lose the ability to expel potassium. Although dialysis removes potassium from the body, it can build up during longer periods between treatment sessions. Peritoneal dialysis patients are at less risk than hemodialysis patients because they dialyze daily. However, they still need to monitor their potassium levels regularly.
What is the potassium safety zone?
Typically, Diet and Nutrition for Hemodialysis patients should include 2,000-3,000 milligrams (mg) of potassium per day. A peritoneal dialysis patient, on the other hand, can typically have 3,000-4,000 mg of potassium per day.
When your blood is tested for potassium, the safety zone is generally in the range of 3.5-5.5 milliEquivalents per liter (mEq/L) of blood, although each person has his or her own individual potassium safety zone. With hemodialysis patients, potassium levels are tested before the dialysis treatment, when levels are highest. In fact, it is not uncommon for the potassium level to go up to 6.0 mEq/L in these tests, as it will immediately start coming down when treatment begins. Less than 3.5 or more than 6.0 mEq/L is definitely outside the potassium safety zone.
How can you keep your potassium level from getting too high?
First, meet with your doctor or the renal dietitian to determine your individual potassium allowance. The dietitian can work with you to set up a reasonable diet plan that will keep you within normal limits.
Be sure to avoid or limit high-potassium foods such as:
- Coconut water
- Dry fruits like sultanas
- Orange juice
- Salt substitutes containing potassium
- Vegetable juices
It is important to track your potassium levels on a monthly basis. Don’t hesitate to discuss your individual potassium levels and dietary preferences with your physician
Low Potassium Fruits
Follow these tips to keep your Potassium under check
Leach all vegetables before using in your food. Leaching can be done by cutting the vegetables into small pieces, washing thoroughly under flowing water, boiling them in water for 15 minutes and then throwing the water away. Use these vegetables in all your food normally.
3. Diet and Nutrition for Hemodialysis – Salt
You absolutely must reduce your intake of salt. Generally speaking for dialysis patients salt allowance is 2gm/day i.e 1 tea spoon.
To do this, follow these tips:
- Cook your food without salt and then add a little just before eating.
- Avoid processed food, pickles and papad
- Never have low sodium salts as these contain potassium which is even more dangerous
- Try adding some lime and other seasonings to make the food tasty
- Reduce the quantity of salt gradually. It will be easier and more effective than cutting salt all at once.
High phosphorus can cause itchy skin,bony pains and also cause calcification of blood vessels. To cut down on your Phosphorus:
- Avoid red meat
- Take your Phosphate Binders prescribed by your Nephrologist with every meal. Ask your doctor which of your medicines is a Phosphate binder!
- Avoid things like Chocolate, Cola drinks,cheese or reduce your intake of these foods