Does what I eat and drink affect my hemodialysis?
If you are on dialysis you need to be aware of your diet.
Between dialysis treatment sessions, wastes can build up in your blood and make you sick. You can reduce waste buildup by controlling what you eat and drink. You can match what you eat and drink with what your kidney treatments remove.
Some foods cause wastes to build up quickly between your dialysis sessions. If your blood contains too much waste, your kidney treatment session may not remove them all.
How can you find out about your diet plan?
Almost all dialysis centers will have a dietician who can plan your meals. A renal dietitian has special training in caring for the food and nutrition needs of people with kidney disease.
Keep a copy of this information handy to remind yourself of the foods you can eat and foods to avoid.
Do I need to watch what I eat and drink?
Yes. You will need to carefully plan your meals and keep track of the number of liquids you eat and drink. It helps to limit or avoid foods and beverages that have lots of
Sodium—for example, vegetable juice and sports drinks
Why you should keep track of the amount of liquid I eat or drink?
You may feel better if you keep track of and limit how much liquid you eat and drink. Excess fluid can build up in your body and may cause
- swelling and weight gain between dialysis sessions
- changes in your blood pressure
- your heart to work harder, which can lead to serious heart trouble
- a buildup of fluid in your lungs, making it hard for you to breathe
Hemodialysis removes extra fluid from your body. However, hemodialysis can remove only so much fluid at a time safely. If you come to your hemodialysis with too much fluid in your body, your treatment may make you feel ill. You may get muscle cramps or have a sudden drop in blood pressure that causes you to feel dizzy or sick to your stomach.
Your health care provider can help you figure out how much liquid is right for you.
One way to limit how much liquid you have is to limit the salt in the foods you eat. Salt makes you thirsty, so you drink more. Avoid salty foods such as chips and pretzels.
Your renal dietitian will give you other tips to help you limit how much liquid you consume while making sure you don’t feel too thirsty.
What is liquid food?
Foods that are liquid at room temperature, such as soup, contain water. Gelatin, pudding, ice cream, and other foods that include a lot of liquid in the recipe also count. Most fruits and vegetables contain water, such as melons, grapes, apples, oranges, tomatoes, lettuce, and celery. When you count up how much liquid you have in a day, be sure to count these foods
What is my dry weight?
Your dry weight is your weight after a hemodialysis session has removed all extra fluid from your body. Controlling your liquid intake helps you stay at your proper dry weight. If you let too much fluid buildup between sessions, it is harder to achieve your dry weight. Your doctor can help you figure out what dry weight is right for you.
Potassium is the most important electrolyte to keep an eye on?
Potassium levels can rise between hemodialysis sessions and affect your heartbeat. Eating too much potassium can be dangerous to your heart and may even cause death.
To control potassium levels, limit potassium-rich foods such as avocados, bananas, kiwis, and dried fruit. Choose fruits and vegetables that are lower in potassium. Have very small portions of foods that are higher in potassium, such as one or two cherry tomatoes on a salad or a few raisins in your oatmeal.
You can remove some of the potassium from potatoes by dicing or shredding them and then boiling them in a full pot of water.
What do I need to know about phosphorus?
Too much phosphorus in your blood pulls calcium from your bones. Losing calcium may make your bones weak and likely to break. Also, too much phosphorus may make your skin itch. Limiting phosphorus can be hard because foods that contain phosphorus, such as meat and milk, also contain the protein you need. You should be careful to eat enough protein; however, not so much that you get too much phosphorus. Processed and packaged foods contain especially high levels of phosphorus. You can also find phosphorus naturally in foods such as poultry, fish, nuts, peanut butter, beans, cola, tea, and dairy products. Usually, people on hemodialysis should only have a 1/2 cup of milk per day. Your renal dietitian will give you more specific information about phosphorus.
You may need to take a phosphate binder or calcium carbonate to control the phosphorus in your blood between hemodialysis sessions..
What do I need to know about sodium?
Sodium is a part of salt. Sodium is found in many canned, packaged, frozen, and fast foods. Sodium is also found in many condiments, seasonings, and meats. Too much sodium makes you thirsty, which makes you drink more liquid.
Try to eat fresh, naturally low-sodium foods.
How do I decide about calories?
All foods contain calories, and you need calories for energy. Many people on hemodialysis do not have a good appetite and do not get enough calories. If you find you do not feel like eating, talk with your renal dietitian to find healthy ways to add calories to your diet. Vegetable oils—such as olive oil, canola oil, and safflower oil—are good sources of calories and are the healthiest way to add fat to your diet if you need to gain weight. Use them generously on breads, rice, and noodles only if your renal dietitian tells you to add calories to your diet.
Butter and margarine are rich in calories; however, they are mainly saturated fat. Saturated fats and trans fats can clog your arteries. Use them less often. Soft margarine that comes in a tub is better than stick margarine. Choose soft margarine with less saturated and trans fats.
Talk with your renal dietitian about the types and amounts of fat you need in your diet. Everyone will have different needs that a renal dietitian can help address.
Hard candy, sugar, honey, jam, and jelly provide calories and energy without fat or adding other things that your body does not need.
Should I take vitamin and mineral supplements?
You may not get enough vitamins and minerals in your diet because you have to avoid so many foods. Hemodialysis also removes some vitamins from your body. Your health care provider may prescribe a vitamin and mineral supplement designed specifically for people with kidney failure.
Dr. Rakesh Rai, MS, FRCS, MD, CCST, ASTS Fellow.