Diet for Kidney Disease (Dialysis Diet)

Dialysis is an artificial way of doing some of the work of the kidneys, but it cannot replace the natural function of the kidneys. If you are on dialysis you need to carefully regulate your kidney diet.

All the information about diet for patients in the early stage of kidney failure apply to dialysis and transplant patients, especially the information on potassium, phosphate, and sodium. No matter what your state of health, you can almost always improve your condition by simple measures such as not smoking, eating healthily, and exercising regularly. Such measures will help you lose weight if you are obese.

Weight loss is a problem that causes particular concern in kidney failure. This is usually because patients are not eating enough protein and energy-providing food. Malnourished people lose weight and muscle mass. Malnutrition can develop with patients on either hemodialysis or peritoneal dialysis. Dietitians monitor renal patients for any signs of malnutrition.

Obesity can cause practical problems for people on dialysis. Overweight people with fat arms can have particular problems with access for hemodialysis. Their veins can be difficult to reach, or weak, and therefore difficult to make a fistula from. Peritoneal dialysis is less likely to work for patients who have a fat or distended tummy.

Overweight patients should refer to a dietitian for advice. Reversing obesity will not cure kidney failure, but it will bring significant health benefits.

Some patients lose their appetite and you may be asked to increase your food intake to prevent malnutrition from developing.

Pay special attention to specific aspects of kidney diet and nutrition such as your intake of iron, phosphate and calcium, potassium, protein, sodium, and vitamins, all discussed in this section. Check with your dietitian if you are unsure about any aspect of your renal diet.

Many people with kidney failure suffer from anemia. One of the causes of anemia is a low level of iron in the body. If you have low iron levels you may need to take medication.

Phosphate and calcium
Phosphate and calcium affect the health of the bones. When a person has kidney failure, the calcium level in their body tends to be too low and the phosphate level too high.

Treatment for kidney patients aims to raise blood calcium levels and lower blood phosphate levels. This can be achieved by moderating the phosphate content of your diet, by adequate dialysis, and by the use of a phosphate binder taken with meals.

However, it is difficult to cut down on phosphate intake without also lowering protein intake.

If potassium levels in the blood are too high, the heart can stop beating. Low potassium levels may cause arrythmias.

The dietitian will try to find out if a patient is eating anything that might lead to a high level of potassium. Hemodialysis patients might have to avoid such high-potassium foods as chocolate, and moderate their intake of other potassium-contianing foods such as bananas.

Peritoneal dialysis patients rarely need to restrict their potassium intake.

Protein is an essential nutrient that enables the body to build muscles and repair itself. It also helps the body to fight infection. The main sources of protein in our diet are meat, fish, dairy products, eggs, and vegetables such as peas, beans, and lentils. Low levels of protein can lead to malnutrition, fluid retention and a reduction in the body's ability to fight infections. When protein is used by the body waste products are formed and enter the blood. One of these wastes is called urea. Normal healthy kidneys are good at getting rid of urea. Failing kidneys are not good at this, but kidney patients should still eat protein.

When the time for dialysis draws closer, some patients do not feel as hungry as they used to, and some food, particularly meat products, may taste 'funny'. Special dietary supplements may help such patients maintain adequate protein intake.

It is very important to follow your dietitian's advice regarding your protein intake.

Hemodialysis patients often have greater restrictions on fluid intake than peritoneal dialysis patients, and therefore need to be very careful about salt. This is because a salty diet can make a patient thirsty and may increase blood pressure.

Vitamins B and C are lost during dialysis. Your doctor may prescribe vitamin supplement tablets. You should not take any over-the-counter vitamin supplements unless your doctor has prescribed them.

May 1, 2006