The food you eat can have a big impact on how well you will do on dialysis. Diet management is one of your most important responsibilities, so you need to know what foods to increase and what foods to limit. It is necessary to understand balancing your diet as well as moderation.
This is your opportunity to take control over how well you do between treatments.
Though it will take some time to learn all of what you need to know about a renal-friendly diet, your renal dietitian will be there to help you every step of the way. They work with you to individualize diet recommendations to fit your needs and improve your quality of life. Proper diet management can help you feel better and avoid complications associated with kidney disease.
Some basic tips to keep in mind as you adjust to a renal-friendly diet include:
- Choose fresh foods instead of convenience food, fast food, processed food or canned foods.
- Remove the salt shaker from the table and replace it with a salt-free seasoning, such as Mrs. Dash®.
- Avoid salt substitutes, such as Morton’s Salt Substitute, Nu-Salt and Morton’s Lite Salt. These are all made with potassium.
- Choose unprocessed meats, poultry, fish or other seafood. Be sure they’re all cooked without salt.
- Pack sandwiches using fresh, unsalted ingredients.
- Select fresh or frozen vegetables instead of canned.
- Drink only when you are thirsty and stay within your prescribed fluid restriction.
- Satisfy your thirst by eating cold or frozen low potassium fruits, like grapes.
- Chew gum, hard candies and mints to moisten a dry mouth.
Maximize your health and wellness
by eating renal-friendly foods and understanding what the best physical activities are to keep you moving.
Understand guidelines for various food groups
Keep in mind that following a renal-friendly diet is a new skill that takes time to learn, so use your renal dietitian to help you. Here are some guidelines to get you started.
Eat plenty of foods high in protein.
There are two kinds of protein: high quality and low quality.
- High quality (i.e. animal) protein comes from milk, meats, chicken, fish and eggs, all of which are a good source of the amino acids the body needs to build muscle and maintain healthy cells, organs and bones.
- Low quality (i.e. plant) protein comes from vegetables, breads and cereals, and lacks some of the amino acids the body needs to grow and maintain healthy cells, organs and bones.
A renal-friendly diet requires both kinds of proteins, made up of at least 50% high-quality protein. A typical renal-friendly diet should include a daily amount of meat, chicken, fish or eggs, or vegetarian choices if you are a vegan. Your renal dietitian will work with you to determine the appropriate mixture of both based on your protein needs.
Potassium is a mineral that impacts how your muscles work, whether it’s the muscles in your legs or, perhaps the most important muscle in your body, your heart. When kidneys do not function properly, potassium builds up in the blood. This can cause dangerous changes in how the heart beats, for example, which could lead to a heart attack.
Some foods high in potassium include bananas, tomato products, oranges, orange juice and potatoes. This is not to say that you can never have a glass of orange juice again. The amount of potassium allowed for your individual renal-friendly diet will be based on the level of potassium found in your blood. Work with your nephrologist and your renal dietitian to determine the best way to incorporate your favorite foods into your meal plan.
Phosphorus is a mineral found in many foods, and having the right amount of phosphorus and calcium in the blood is needed for strong bones and healthy blood vessels. Normal working kidneys can remove extra phosphorus from your blood, but when kidney function is compromised, they can no longer remove the excess phosphorus. As a result, high phosphorus levels in your body can pull calcium out of your bones (which can make them weak), and can lead to dangerous calcium deposits in blood vessels, lungs, eyes and heart. Calcium deposits are basically the hardening of blood vessels, tissues and organs which can cause blockages in arteries and veins, decreasing the functions of the organs that are affected. This is what can increase your risk for heart attack or even amputation.
To prevent this from happening, phosphorus should be controlled through both diet and phosphate binders. The key to phosphorus control is:
- Avoid packaged foods that contain added phosphorus. Look for phosphorus, or for words with PHOS, on ingredient labels.
- Take phosphate binders with all meals and snacks, per the direction of your nephrologist.
- Attend all dialysis treatments, as prescribed.
Phosphorus is found in almost all foods, but is especially high in dairy products, cheese, dried beans, liver, nuts and chocolate. Work with your nephrologist and your renal dietitian to determine what foods you can safely incorporate into your meal plan.
The main source of sodium in the diet is salt. Limiting the amount of sodium in your diet is important because too much can cause swelling or puffiness, also known as edema. It can also increase thirst and cause fluid weight gain, difficulty breathing and high blood pressure, all of which can create more work for your heart.
Balance Fluid Intake
People on hemodialysis often make less urine than someone with healthy kidneys, so it’s critical to balance the amount of fluid you eat or drink with the amount you are urinating. This helps prevent putting unnecessary pressure on your heart and lungs.
If you drink or eat more fluid than you urinate daily, you will retain fluid and gain “fluid weight.” Your nephrologist and health care team will help you find the right amount of fluid you can safely consume each day. Remember, some foods – like Jell-O and popsicles – count as fluid.
When you’re on dialysis, exercise of any kind may seem unlikely and uncomfortable. But getting moving can sometimes be exactly what is needed. It’s important that you talk to your nephrologist and renal dietitian before you start any exercise routine. They will help you define what movements make the most sense for you.
Some types of low-impact activities that do not put a lot of stress on your joints include:
- Tai Chi
Here are some resources that offer additional information on kidney disease and treatment. Click here for a longer list of resources available to you.