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Friday, January 23, 2009

Dialysis Diet (Renal Diet)

(Renal Diet)

What Is a Dialysis Diet?

A dialysis diet is a special diet if you are on dialysis treatment.

Why Should I Follow a Dialysis Diet?

The kidneys help filter waste from your body, 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.

Normally, the kidneys continuously filter blood. But, dialysis is done on a schedule (eg, three times a week). Because of this, it is important to follow a special diet between treatments. If you do not follow the diet, waste products can 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, work closely with a dietitian while on dialysis treatment.

The dietician will determine how much of each nutrient you can eat and create an eating plan based on your needs.

Protein

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

In addition to eating the right amount of protein, make sure it is high-quality protein. Good sources include meat, fish, poultry, and eggs. Milk also contains high-quality proteins, but is also 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. 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, 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. This causes problems with heart functioning. Therefore, limit the amount of potassium you consume each day.

To keep your potassium levels in check, avoid high potassium foods such as potatoes, tomatoes, citrus fruits, avocados, bananas, and dried fruit. The article Potassium Content of Foods contains a list of foods high and low in potassium. You may still be able to eat your favorite high-potassium food if you limit it to a very small portion size. Your dietitian can help with this.

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, you may need to take a medication called a phosphate-binder. Phosphate-binders soak up extra phosphorous and then passes it out in your stool.

Fluids

Dialysis can help regulate fluid levels. But, in between treatments, you will need to watch 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, which can lead to increased blood pressure and edema (when fluid accumulates in the connective tissue or body cavity).

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 provides a general overview. 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 kidneyhealth 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:
functioning and overall

  • 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 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.
    • Read food labels for portion size information.
    • When first becoming familiar with portion sizes, use measuring cups.
  • 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.
    • Depending on your particular diet, you may need to limit calories. But, in most cases, you will need to make sure you get enough calories.
    • An easy way to increase calories is to add heart healthy oils, such as olive and canola, to the foods that you prepare.

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