Kidney failure (on dialysis)
Why do I need to adjust my eating habits now that I'm on dialysis?
When you have kidney failure and are on dialysis, following a kidney-friendly food and hydration regimen is critical to your health.
​
Kidney failure occurs when your kidneys are unable to remove excess waste and fluid from your body in the same way that healthy kidneys do. Dialysis helps your kidneys accomplish some of the work they did when they were healthy, but it is not a substitute for healthy kidneys and can only do 10-15% of what healthy kidneys can do.
​
In between dialysis sessions, some waste and fluid may accumulate in your body. The additional waste and fluid in your blood can lead to heart, bone, and other health issues over time.
​
You will need to alter your eating and drinking habits while on dialysis in order to feel and function at your best.
You'll need to eat extra protein while reducing liquids, sodium, potassium, and phosphorus if you have kidney failure. This can help you maintain a healthy blood pressure and avoid fluid retention (when your body retains too much fluid) in between dialysis sessions. A kidney-friendly diet and hydration plan devised by you, your doctor, and your nutritionist is an essential aspect of your treatment. Following this approach will assist you in maintaining your best health.
How can I eat healthy if I'm on dialysis and have kidney failure?
A renal (kidney) dietitian will be part of your care team once you're on dialysis. They'll explain your new kidney-friendly food and hydration plan to you, as well as any adjustments that may be necessary based on how you're feeling and your lab results.
​
You'll almost certainly need to:
-
Eat more protein
-
Limit sodium (salt), potassium and phosphorus
-
Limit fluids
​
Protein is required for muscular growth, healing, and overall health.​
Protein requirements are higher when you're on dialysis.
​
Dialysis removes some of your body's blood proteins, so you'll need to eat more protein to compensate for what you're losing throughout your treatments.
These proteins are necessary for the movement of nutrients from your veins and arteries to the rest of your body.
Get your protein from lean sources:
-
Eggs
-
Chicken
-
Fish
-
Turkey
-
Quinoa
-
Beans
-
Soy products (tofu, edamame, tempeh, soy milk, etc.)
​
Suggested serving sizes for lean protein:
-
½ cup of beans (7 grams of protein)
-
1 large egg (6 grams of protein)
-
3 oz. chicken (about the size of your palm) (27 grams of protein)
-
3 oz. fish (about the size of your palm) (20 grams of protein)
Protein
Ask your doctor and dietitian how much protein you should eat each day
​
The amount of protein you require each day is determined by your weight and level of activity. For the average person:
​
-
A man who weighs 155 pounds will easily meet his protein demands with 56 grams of protein per day.
​
-
A lady weighing 130 pounds will easily meet her protein needs with about 46 grams of protein per day.
​
​
Tips for eating more protein
​
-
Every meal should include a lean protein source.
-
Make animal or soy protein half of your daily protein intake.
​
The amount of sodium—one of two electrolytes found in salt—in foods can be found on the nutrition label. Salt serves a variety of functions in our bodies, but too much sodium can be harmful to persons who have kidney disease.
Your kidneys may be unable to eliminate excess sodium from your body if they are not functioning properly.
When your body has too much sodium, it retains (holds on to) fluid, making your heart and kidneys work harder. This can cause your blood pressure to rise and your renal illness to worsen over time.
The amount of salt present naturally in foods is sufficient to maintain a healthy level in your body, but sodium is frequently added to many processed foods, restaurant dishes, and even home-cooked meals. This can result in you ingesting too much salt and accumulating too much sodium in your body.
The amount of salt you should ingest is determined by your kidney disease stage and function. In general, a healthy amount of salt per day is 2,300 mg or less. This is approximately 1 teaspoon of salt every day. In kidney disease stages 3, 4, and 5, ask your doctor and nutritionist how much sodium you should consume each day (not on dialysis).
Sodium is typically added to these meals and drinks (unless they are labeled as low-salt or low-sodium):
​
-
Soda and sports drinks
-
Ice Cream
-
Frozen dinners and snacks
-
Fast food and food from restaurants
-
Packaged snacks (chips, pretzels, nuts, etc.)
-
Bakery items (bread, bagels, pies, cakes, etc.)
-
Condiments (ketchup, salad dressings, hot sauce, soy sauce, etc.)
-
Canned and jarred foods (tomatoes, beans, corn, pickles, etc.)
-
Seasonings and spices with salt (garlic salt, celery salt, seasoned salt, taco seasoning, seafood seasoning, etc.)
​
Tips to avoid added sodium
​
-
Avoid salt replacements labeled "NuSalt" or "No-Salt" since they contain potassium and may cause your potassium levels to rise dangerously high.
-
Choose canned and jarred products with the phrase "no salt added" on the label.
-
Choose snacks that don't include any salt (unsalted or no-salt pretzels, etc.) To control the quantity of salt in your food, prepare and cook your meals from scratch using one of our kidney-friendly recipes.
-
Instead of salt, use fresh or dried herbs and spices to enhance the flavor of your dishes.
-
Instead of sports drinks or soda, drink water.
-
If you're eating out, request that your dish be cooked without any salt.
​​​
Sodium(salt)
​
When you have renal failure, you must limit the amount of fluid you consume each day. You will feel better and stay healthier if you limit your fluid intake. It can be difficult, but there are solutions.
​
When you're on dialysis, you don't urinate (pee) nearly as much as you used to, if at all. Dialysis removes excess fluid from the body, thus drinking and eating too much fluid might cause fluid to build up in between dialysis sessions. Fluid retention (when your body retains too much fluid) can be harmful and cause a variety of issues, including:
​
-
Swelling
-
Breathing problems
-
Blood pressure that is too high
-
Infections of the lungs, such as pneumonia
-
Decreased blood proteins
-
Heart failure
Ask your doctor and dietitian how much fluid you should have each day.
​
Remember that fluid refers to more than just the water you consume. At room temperature, everything that turns to liquid counts toward your daily fluid intake.
​
Examples of fluids include:
-
Ice
-
Soups and stews
-
Pudding
-
Ice cream, sherbet, sorbet, popsicles, etc.
-
Protein drinks (Nepro, Novasource, Ensure, etc.)
-
All beverages (water, soda, tea, coffee, milk, nondairy milk, etc.)
-
Jell-O® other gelatin products and gelatin substitutes (pectin, arrowroot powder, etc.)
Fluid
​
Potassium is found in almost all foods, and your body needs it for a variety of functions. When you have renal failure and are on dialysis, it is critical to maintaining a healthy potassium level in your body.
Potassium is necessary for the expansion and contraction of your muscles. Because your heart is a muscle, maintaining a healthy potassium level aids in the proper functioning of your heart.
Too much potassium in the body is extremely dangerous, as it can cause a heart attack or even death.
Potassium
Tips to lower your potassium levels:
​
-
Instead of sports drinks or sodas, which can contain a lot of potassium, opt for water (and added sodium and calories)
-
To regulate the amount of potassium in your food, prepare and cook your meals from scratch using one of our kidney-friendly recipes.
-
To make your portion size appear larger, use a tiny plate (9-10 inches in diameter).
-
Keep track of how much potassium you intake each day.
​
Phosphates are a type of phosphorus that can be found in a variety of foods. Phosphorus is naturally present in some foods, although it is frequently added to preserve them.
​
Phosphorus aids in the formation of bones and teeth, provides energy, and is a component of DNA.
​
When you have kidney failure and are on dialysis, you must reduce your phosphorus intake. Too much phosphorus in your diet can cause brittle bones, high blood pressure, calcium deposits in your veins and organs, and painful skin sores.
​
Don't scratch if you have dry, itchy skin due to excessive phosphorus levels (it will only make the itching worse)! Every day, cleanse and moisturize your skin. To avoid dry, itchy skin, ask your doctor which moisturizers work best for you, and keep to the kidney-friendly food and hydration regimen they've prescribed.
Phosphorus
Ask your doctor and dietitian how much phosphorus you should have each day.
Foods that commonly have added phosphorus:
​​
-
Hot dogs
-
Mixtures for pancakes or biscuits
-
Fast food
-
Tortillas
-
Certain beverages, like cola and iced tea
-
Other types of packaged foods
Tips to avoid added phosphorus
​
-
Avoid foods that have "phos" ("phosphate," "phosphoric," etc.) on the ingredient label.
​
-
If you have been prescribed phosphorus binders, take them before or at the beginning of your meals as instructed. Phosphorus binders are medicines that remove excess phosphorus from the foods you eat, preventing your body from absorbing it and accumulating it.