Eat Right to Feel Right on
Hemodialysis
On this page:
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How to Use This Publication
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How does food affect my hemodialysis?
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What do I need to know about fluids?
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What do I need to know about potassium?
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What do I need to know about phosphorus?
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What do I need to know about protein?
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What do I need to know about sodium?
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What do I need to know about calories?
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Should I take vitamins and minerals?
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Resources
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Acknowledgments
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About the Kidney Failure Series
How to Use This Publication
When you start
hemodialysis, you must make many changes
in your life. Watching the foods you eat
will make you healthier. This
publication will help you choose the
right foods.
Print this
publication and use it with a dietitian
to help you learn how to eat right to
feel right on hemodialysis. Read one
section at a time. Then go through the
exercise with your dietitian.
Once you have
completed every exercise, keep a copy of
this publication to remind yourself of
foods you can eat and foods you need to
avoid.
My dietitian's
name is _____________________________
Phone ___________________
How does food affect my
hemodialysis?
Food gives you
energy and helps your body repair
itself. Food is broken down in your
stomach and intestines. Your blood picks
up nutrients from the digested food and
carries them to all your body cells.
These cells take nutrients from your
blood and put waste products back into
the bloodstream. When your kidneys were
healthy, they worked around the clock to
remove wastes from your blood. The
wastes left your body when you urinated.
Other wastes are removed in bowel
movements.
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Talk to a dietitian to learn how to eat right on
hemodialysis. |
Now your kidneys
have stopped working. Hemodialysis
removes wastes from your blood. But
between sessions, wastes can build up in
your blood and make you sick. You can
reduce the amount of wastes by watching
what you eat and drink. A good meal plan
can improve your dialysis and your
health.
Your clinic has a
dietitian to help you plan meals. A
dietitian specializes in food and
nutrition. A dietitian with special
training in care for kidney health is
called a renal dietitian.
What do I need to know about fluids?
You already know
you need to watch how much you drink.
Any food that is liquid at room
temperature also contains water. These
foods include soup, Jell-O, and ice
cream. Many fruits and vegetables
contain lots of water, too. They include
melons, grapes, apples, oranges,
tomatoes, lettuce, and celery. All these
foods add to your fluid intake.
Fluid can build up
between dialysis sessions, causing
swelling and weight gain. The extra
fluid affects your blood pressure and
can make your heart work harder. You
could get serious heart trouble from
overloading your system with fluid.
Control Your Thirst
You
can keep your fluids down by
drinking from smaller cups
or glasses. Freeze juice in
an ice cube tray and eat it
like a popsicle. (Remember
to count the popsicle in
your fluid allowance!) The
dietitian will be able to
give you other tips for
managing your thirst. |
Your dry weight is
your weight after a dialysis session
when all of the extra fluid in your body
has been removed. If you let too much
fluid build up between sessions, it is
harder to get down to your proper dry
weight. Your dry weight may change over
a period of 3 to 6 weeks. Talk to your
doctor regularly about what your dry
weight should be.
My dry weight
should be _____________.
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Many foods contain water. |
Talk to a
Dietitian
Even
though you are on
hemodialysis, your kidneys
may still be able to remove
some fluid. Or your kidneys
may not remove any fluid at
all. That is why every
patient has a different
daily allowance for fluid.
Talk to your dietitian about
how much fluid you can have
each day.
I can
have _____ ounces of fluid
each day.
Plan 1
day of fluid servings:
I can
have _____ ounce(s) of
______________ with
breakfast.
I can
have _____ ounce(s) of
______________ in the
morning.
I can
have _____ ounce(s) of
______________ with lunch.
I can
have _____ ounce(s) of
______________ in the
afternoon.
I can
have _____ ounce(s) of
______________ with supper.
I can
have _____ ounce(s) of
______________ in the
evening.
TOTAL
_______ ounces (should equal
the allowance written above) |
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Be careful to keep track of your fluids and other foods. |
What do I need to know about
potassium?
Potassium is a
mineral found in many foods, especially
milk, fruits, and vegetables. It affects
how steadily your heart beats. Healthy
kidneys keep the right amount of
potassium in the blood to keep the heart
beating at a steady pace. Potassium
levels can rise between dialysis
sessions and affect your heartbeat.
Eating too much potassium can be very
dangerous to your heart. It may even
cause death.
You can
remove some potassium from potatoes by
soaking them in water.
To control
potassium levels in your blood, avoid
foods like avocados, bananas, kiwis, and
dried fruit, which are very high in
potassium. Also, eat smaller portions of
other high-potassium foods. For example,
eat half a pear instead of a whole pear.
Eat only very small portions of oranges
and melons.
Dialyzing
Potatoes and Other Vegetables
You can remove
some of the potassium from potatoes and
other vegetables by peeling them, then
soaking them in a large amount of water
for several hours. Drain and rinse
before cooking. Your dietitian will give
you more specific information about the
potassium content of foods.
Talk to a Dietitian
Make a food plan
that reduces the
potassium in your
diet. Start by
noting the
high-potassium foods
(below) that you now
eat. A dietitian can
help you add other
foods to the list.
High-Potassium
Foods: |
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apricots
avocados
bananas
beets
brussel
sprouts
cantaloupe
clams
dates
figs
|
kiwi fruit
lima beans
melons
milk
nectarines
orange juice
oranges
peanuts
pears
(fresh) |
potatoes
prune juice
prunes
raisins
sardines
spinach
tomatoes
winter
squash
yogurt
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Others:______________________________________
Changes:
Talk to a dietitian
about foods you can
eat instead of
high-potassium
foods.
Instead of
_________, I will
eat _________.
Instead of
_________, I will
eat _________.
Instead of
_________, I will
eat _________.
Instead of
_________, I will
eat _________. |
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What do I need to know about
phosphorus?
Phosphorus is a
mineral found in many foods. If you have
too much phosphorus in your blood, it
pulls calcium from your bones. Losing
calcium will make your bones weak and
likely to break. Also, too much
phosphorus may make your skin itch.
Foods like milk and cheese, dried beans,
peas, colas, nuts, and peanut butter are
high in phosphorus. Usually, people on
dialysis are limited to 1/2 cup of milk
per day. The renal dietitian will give
you more specific information regarding
phosphorus.
You probably will
need to take a phosphate binder like
Renagel, PhosLo, Tums, or calcium
carbonate to control the phosphorus in
your blood between dialysis sessions.
These medications act like sponges to
soak up, or bind, phosphorus while it is
in the stomach. Because it is bound, the
phosphorus does not get into the blood.
Instead, it is passed out of the body in
the stool.
What do I need to know about
protein?
Before you were on
dialysis, your doctor may have told you
to follow a low-protein diet. Being on
dialysis changes this. Most people on
dialysis are encouraged to eat as much
high-quality protein as they can. The
better nourished you are, the healthier
you will be. You will also have greater
resistance to infection and recover from
surgery more quickly.
Protein helps you
keep muscle and repair tissue. In your
body, protein breaks down into a waste
product called urea. If urea builds up
in your blood, you can become very sick.
Some sources of protein produce less
waste than others. These are called
high-quality proteins. High-quality
proteins come from meat, fish, poultry,
and eggs (especially egg whites).
Getting most of your protein from these
sources can reduce the amount of urea in
your blood.
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Poultry and fish, like broiled flounder, are a good source
of high-quality protein. |
Talk to a
Dietitian
Meat,
fish, and chicken are good
sources of protein. Talk to
a dietitian about the meats
you eat.
I will
eat ______ servings of meat
each day. A regular serving
size is 3 ounces. This is
about the size of the palm
of your hand or a deck of
cards.
Try to
choose lean (low-fat) meats
that are also low in
phosphorus. If you are a
vegetarian, ask about other
ways to get your protein.
Low-fat milk is a good
source of protein. But milk
is high in phosphorus and
potassium. And milk adds to
your fluid intake. Talk to a
dietitian to see if milk
fits into your food plan.
I
(will) (will not) drink
milk. I will drink ______
cup(s) of milk a day. |
What do I need to know about sodium?
Sodium is found in
salt and other foods. Most canned foods
and frozen dinners contain large amounts
of sodium. Too much sodium makes you
thirsty. But if you drink more fluid,
your heart has to work harder to pump
the fluid through your body. Over time,
this can cause high blood pressure and
congestive heart failure.
Try to eat fresh
foods that are naturally low in sodium.
Look for products labeled low sodium.
Do not use salt
substitutes because they contain
potassium. Talk to a dietitian about
spices you can use to flavor your food.
The dietitian can help you find spice
blends without sodium or potassium.
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Find new ways to spice up your food. |
Talk to a
Dietitian
Talk
to a dietitian about spices
and other healthy foods you
can use to flavor your diet.
List them on the lines
below.
Spice:
_____________________________
Spice:
_____________________________
Spice:
_____________________________
Food:
_____________________________
Food:
_____________________________ |
What do I need to know about
calories?
Calories provide
energy for your body. If your doctor
recommends it, you may need to cut down
on the calories you eat. A dietitian can
help you plan ways to cut calories in
the best possible way.
But some people on
dialysis need to gain weight. You may
need to find ways to add calories to
your diet. Vegetable oils?like olive
oil, canola oil, and safflower oil?are
good sources of calories. Use them
generously on breads, rice, and noodles.
Butter and
margarines are rich in calories. But
these fatty foods can also clog your
arteries. Use them less often. Soft
margarine that comes in tubs is better
than stick margarine. Vegetable oils are
the healthiest way to add fat to your
diet if you need to gain weight.
Hard candy, sugar,
honey, jam, and jelly provide calories
and energy without clogging arteries or
adding other things that your body does
not need. If you have diabetes, be
very careful about eating sweets. A
dietitian's guidance is very important
for people with diabetes.
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If you need to get extra calories, vegetable oils like
these are a good choice. |
Should I take vitamins and minerals?
