How to Eat Healthy While on Dialysis

It is crucial to understand the role diet plays during dialysis to better cope with the implications of this treatment. A dietitian assists patients in making dietary changes based on their individual medical histories, blood test results, weight, and type and course of dialysis. Examining foods and adjusting daily diet helps limit waste buildup in the blood between dialysis sessions and promotes an active life. Apart from a clinically prescribed diet, a few standard dietary recommendations can improve overall health over the course of dialysis.

The Importance of a Healthy Dialysis Diet

Dialysis replicates the kidney’s blood-filtering function when they can no longer do their job efficiently. As kidney function decreases, dangerous muscle and food waste accumulates in the blood. While physicians intervene to drain out waste with dialysis, the treatment also breaks down vital nutrients that are needed to stay healthy. Added to this is the fact that some substances such as potassium aren’t processed properly, leading to further health complications.

To deal with the repercussions of dialysis, each patient’s nutritional needs, and the body’s inability to process some minerals, dietitians and physicians recommend a personalized dialysis menu. Most dialysis diets involve dietary and fluid restrictions, with diet specifics varying slightly depending on whether the patient is having peritoneal dialysis or the more common hemodialysis.

Dietary Changes While on Hemodialysis

healthy salad

Image courtesy Luca Sbardella | Flickr

Hemodialysis involves inserting a specialized plastic tube between the patient’s artery and vein in either the arm or leg. Blood is diverted through a dialysis membrane that filters out waste and cleanses the blood flowing back to the patient. Because there is typically a longer period between each session of hemodialysis than peritoneal dialysis, greater care needs to be taken in the interim to limit the accumulation of waste in the blood. While on hemodialysis, dietary restrictions involve limiting phosphorous, potassium, sodium, and excessive fluids. Increased protein and calorie intake is important, especially if patients experience weight loss.

Dietary Changes While on Peritoneal Dialysis

Peritoneal dialysis involves inserting a special membrane that filters out waste into the patient’s stomach. Fluids periodically fill the abdominal cavity and flush out waste through a plastic tube leading out of the abdomen. Because there’s frequent waste removal from the body, dietary restrictions while on peritoneal dialysis aren’t as rigid as while on hemodialysis. Patients are still required to limit sodium, phosphorous, and liquids and increase proteins in their diet. Potassium intake, however, depends on periodically monitored blood levels. Dietitians may also put patients on low-calorie diets to control weight gain because the dialysis liquid used during treatment contains sugar.

Implementing a Personal Dialysis Diet Plan

Changes to a patient’s diet may be made even before dialysis begins and before a dietitian prepares a personalized meal plan. The basic diet code for dialysis patients is to limit fluids and foods rich in salt, potassium, and phosphorus while increasing protein-rich foods. The following sample menu is a reference for the recommended dietary balance and included foods during dialysis. This plan includes approximately 2150 calories, 2300 milligrams of sodium, 91 grams of protein, 950 milligrams of phosphorus, 1800 milligrams of potassium, and 38 ounces of fluids.

Breakfast

2 eggs or half a cup of egg substitute
Toasted white bread with fruit spread, tub margarine, or butter
4 ounces of cranberry juice
6 ounces of coffee

Snack

4 ounces of milk
A slice of apple pie

Lunch

Half a cup of canned and drained peaches
Half a cup of coleslaw
Low salt pretzels
A chicken salad, egg, lean meat, or tuna sandwich
8 ounces of ginger ale

Dinner

A cup of salad with cucumber, radishes, lettuce, and peppers splashed with vinegar and olive oil dressing
A 4-ounce hamburger patty with a teaspoon or two of ketchup. A fish meal twice or thrice a week is heart-healthy and high in protein.

Dialysis Dietary Guidelines

Dietitians and physicians routinely monitor the patient’s health to determine whether vitamin and mineral supplements are needed. Over-the-counter supplements aren’t recommended while on dialysis as they may have harmful interactions.

Patients should maintain daily diet charts and include foods that contain liquid in the amount of liquid they are permitted to have each day. This includes soup, gravy, ice cream, popsicles, and gelatin. Dialysis patients shouldn’t use salt substitutes because they contain potassium, which can cause blood potassium levels to spike. It’s important for all dialysis patients to keep to the diet and restrictions prescribed by their health care providers and check with their doctors before making any changes on their own.

Living a meaningful and active life with dialysis is possible with the right nutritional balance to compensate what’s lost during treatment. Regulating diet and fluid intake helps patients get the best out of their dialysis routines and stay healthy. Customized diet plans conforming to each patient’s needs, combined with standard dialysis diet guidelines, prevents possible harmful complications and helps patients cope better with dialysis.