Kidney Health: Eat Right on Hemodialysis
What can I eat?
Healthy kidneys help clear wastes out of your body through your urine. Wastes come from the body processing foods we eat and drink. Sick kidneys cannot keep up. As a result, waste and fluid can build up in your blood. This can make you feel sick. Hemodialysis can clear most waste and fluid. Eating right can help make less waste build up in your blood. The less waste build up in your blood, the better you will feel.
What does protein do?
Protein is needed to build and repair muscle. Protein also helps you fight off infections. Eating enough protein can help you live longer on HD. People on HD need to eat more protein because some protein is lost during the dialysis process.
How much protein can I eat?
Your dietitian will decide the amount of protein that you should have each day to meet your body’s needs. A larger amount of protein can be found in meat, eggs and fish. Bread, cereal and vegetables have small amounts of protein.
Below is the number of protein choices you should eat each day.
Your daily protein prescription is _______________________ grams.
Meat/Meat Substitute* ____________ choices daily
1 ounce beef, chicken, lamb, pork, fish ¼ cup salmon, tuna, crab, lobster, clams ¼ cup cottage cheese 1 ounce or 5 medium shrimp 1 egg ¼ cup egg substitute 4 ounces tofu *2 tablespoons peanut butter *½ cup cooked beans, peas or lentils 1 ounce natural cheese (Swiss, Cheddar, etc)
*Choices higher in phosphorus and /or potassium |
Milk, ______________choices daily (Milk is limited in your diet because it is high in potassium and phosphorus.)
1 cup milk 1 cup yogurt ¾ cup custard 1 cup (milk based) soup ½ cup ice cream 1 cup milk-based pudding *2½ cups non-dairy substitute
*Make sure a non-dairy substitute does not contain phosphorus additives. |
Starches
Starches help provide energy and have fiber to help with constipation. You may need to limit starches if you are diabetic or are trying to lose weight. Starches do not add a significant amount of protein to your diet.
Starch ________________choices daily
1 slice of bread, muffin, 2 inch biscuit, or dinner roll ½ cup double-cooked potatoes* ½ cup cooked rice or pasta ½ cup cooked cereal ½ hamburger bun, English muffin, bagel ¾ cup dry cereal ¼ cup Grapenuts® 2-4 inch pancakes 3 graham crackers (2 1/2 inch square) 6 saltines 2 ½ tablespoons flour 3 cups popcorn ½ of a 6 inch pita 1-7 inch flour tortilla 2-4 by ½ inch breadsticks
*See potassium section for how to double-cook potatoes
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Fat
Fat can help add calories if you are trying to gain weight. Soem fat is necessary in your diet for your overall health.
Fat________choices per day (45 calories per serving)
1 teaspoon margarine, butter, shortening 1 teaspoon mayonnaise 1 teaspoon cooking oil 1 Tablespoon salad dressing 1 Tablespoon powder creamer 2 Tablespoons sour cream or liquid creamer 2 Tablespoons cream cheese 3 Tablespoons non-dairy milk substitute 1/4 cup whipped topping
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What does sodium or salt do?
Salt is a mix of sodium and chloride. Sodium, a mineral, helps the body balance fluids. It exits the body through the urine. When your kidneys are sick, sodium can build in your blood. This can make you thirsty. The more fluid you drink, the more your heart works to pump the fluid through your body. Over time, this can cause high blood pressure and congestive heart failure.
How much sodium can I eat?
• Do not use salt at the table.
• Use only half the amount of salt (or less) called for in recipes and in cooking.
• Limit sodium to less than 2000 mg per day.
Avoid foods high in sodium as listed below.
All salted or smoked meat/fish
Breads and rolls with salt toppings
Cheeses
Convenience and processed foods
DO NOT USE Salt substitutes that have large amounts of potassium such as: Morton’s Salt Substitute®, No Salt®, and Diamond Crystal®, Lite Salt.
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What can I use?
Try these spices and herbs to cut the salt but not the flavor.
Durkee Smart Seasons®
Dried horseradish
Flavored pan sprays
Fresh garlic
Fresh dried herbs
Herbal Bouquet®
Lawry’s Seasoned Pepper®
Mrs. Dash® (all types)
Pepper: black, red, or white
Powder: onion or garlic
Scallions, onions, shallots
Spike® salt-free
Tabasco®sauce
Veg-it®
Pleasoning® Mini Salt
What about fluid?
Most people on hemodialysis need to limit their fluid intake. The amount of fluid you can drink safely is based on the amount of urine output. If you drink too much fluid between hemodialysis sessions, you may feel:
• Short of breath
• Weight gain
• Your heart works harder
• Swelling or edema
• Increased blood pressure
What are fluids?
Any food that you drink or food you eat that becomes liquid at room temperature.
| Food | Amount | Ounces |
| Jell-o® (plain) | 1/2 cup | 4 |
| Jell-o® (with fruit or veggies | 1/2 cup | 2 |
| Popsicle® | 1 twin bar | 2 |
| Yogurt | 4 ounces | 3 |
| Ice Cream or Sherbet | 1/2 cup | 3 |
Many fruits and vegetable also have a lot of water in them.
• Melons, apples, oranges, grapes, tomatoes, lettuce, and celery
• Ice is a fluid
How much fluid can I eat?
• You want to limit yourself to ____cups per day or ____ounces per day.
• You will want to avoid gaining more than 1-2 pounds per day.
How can I control my thirst?
• Drink from smaller cups, glasses, or cans
• Freeze juice and eat it like a popsicle
• Limit sodium intake
What does potassium do?
Potassium is found in your muscles. Your biggest muscle is your heart. Too much or too little potassium in your blood can cause muscle cramps or stop your heartbeat.
How much potassium can I eat?
Hemodialysis helps to clear potassium out of your blood. Potassium can build in your blood between hemodialysis sessions.
Below is a listing of fruits and vegetables that contain low, medium and high amounts of potassium. Your nutritionist will let you know how many choices from each group you may have.
Low Potassium Group _______________ choices per day.
*See below for how to double-cook potatoes |
Medium Potassium Group _____________ choices per day.
Fruit
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Vegetables
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High Potassium Group ________________ choices per day.
Fruit
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Vegetables
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How to double-cook potatoes (to lower the potassium) * This does not make the potatoes a low-potassium food, but it can decrease the potassium content by about half.
**Avoid Yukon gold potatoes as they will still be high in potassium after double cooking. |
What does phosphorus do?
Phosphorus, a mineral, is important for your bones and teeth. When your kidneys are sick, phosphorus builds in your blood. This pulls calcium from your bones. Your bones can become weak and prone to break. Calcium and phosphorus can settle in your soft tissues, your blood vessels and your heart, causing damage to them also.
How much phosphorus can I eat?
To keep your bones healthy, limit your phosphorus intake. But because protein foods contain phosphorus and you do need plenty of protein, your doctor may also ask you to take a medication with meals to bind phosphorus from the food you eat. When the phosphorus is bound with the binder medication, it will be excreted in the stool.
Examples of binder medications include: Renagel, Renvela, Phoslo, Tums®, or Fosrenol.
What can I eat: Hopefully most of your phosphorus will come from good protein sources. But what else can you eat? Your dietitian will let you know.
Foods with a large amount of phosphorus:
Dairy products
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Protein foods
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Grain Products*
*OK to use to help with constipation
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Other Foods
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Phosphorus content of soft drinks:
High phosphorus
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Low phosphorus
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*Many bottled beverages, processed meats, and boxed baking items contain phosphorus additives, which binders will not help much with. Examples are phosphoric acid, hexametaphosphate, or tricalcium phosphate. Always read the ingredients list of packaged foods for 'phos' foods.
Resources
There are several cookbooks designed especially for people with kidney failure. These may help add variety to your diet.
The Gourmet Renal Nutrition Cookbook by Sharon Stau, RD, MPH, Sol Goldman Renal Therapy Center, Lenox Hill Hospital Dialysis Unit, 100 E. 77th St., New York, NY 10021.
Cooking the Renal Way by Council on Renal Nutrition of Oregon; (revised 1993), Oregon CRN, P.O. Box 29133, Portland, OR 97210-9133.
The Renal Gourmet by Mardy Peters, a kidney patient; Emenar Inc., 320 Charmille Lane, Woodale, IL 60191.
Living Well on Dialysis A Cookbook for Patients and Their Families. National Kidney Foundation, New York, NY. Council of Renal Nutrition.
Websites
www.culinarykidneycooks.com Recipes
www.kidney.org The National Kidney Foundation
If you are a patient of UW Health and have more questions or wish to make an appointment, please contact UW Health at one of the phone numbers listed below.
Nutrition Clinic University Station 2880 University Avenue Madison, WI 53705 (608) 263-5012 |
UW Health West Clinic Diabetes Nutrtition 451 Junction Road Madison, WI 53717 (608) 263-7741 appts (608) 265-7506 |
UW Health East Clinic Diabetes Nutrition 5249 East Terrace Drive Madison, WI 53718 (608) 265-7405 appts (608) 265-0963 |
The Spanish version of this NCFY is PI #372
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 07/10/2012
Copyright © 03/15/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#185
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