Kidney Health: Eat Right on Home Dialysis HF#186

 

What can I eat?

When you are on dialysis, it is vital that you control the amount of protein, sodium, fluid, phosphorus, potassium, and calories that you eat or drink.  This handout will help you with your daily meal plan, whether you are on peritoneal dialysis (PD), or home hemodialysis (HHD).

 

What does protein do?

Protein is needed for good health and to build and repair muscle.  Protein also helps you fight off infections.  Eating enough protein can help you live longer on dialysis.  People on dialysis need to eat more protein due to some protein loss during the dialysis process, especially PD.

 

How much protein can I eat?

Your dietitian will tell you how many protein choices you will need in your meal plan to meet your body’s needs.  Meat, fish, chicken, and eggs are examples of good protein sources.  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

 

Milk; ~ 1 choice daily  (Milk is limited in your diet because it is high in phosphorus and potassium.

 

Each choice has 8 grams of protein. Each of these is equal to one choice:

 

 

*Make sure a non-dairy substitute does not contain phospohorus additives.

 

 

Meat and Meat substitute* __________ choices daily

Each choice has 7 grams of protein. Each of these is equal to one choice:

 

 

*Cheese is higher in phosphorus and sodium.

 

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. Also, your PD solution will provide a lot of extra carbohydrates, so you may need to limit your starch intake because of this. Starches do not add a significant amount of protein to your diet.

 

 

Starch _______ choices daily

Each starch choice has 2 grams of protein. Each of these is equal to one choice:

 

*Potatoes contain a large amount of potassium

 

Fat Fat can help add calories if you are trying to gain weight. Some fat is necessary in your diet for your overall health.   Fat _________ choices per day (45 calories per serving)   1 teaspoon margarine, butter, shortening  2 tablespoons sour cream or liquid creamer 1 teaspoon mayonnaise 2T cream cheese 1 teaspoon cooking oil 3T non-dairy milk substitute 1 Tablespoon salad dressing 1/4 cup whipped topping 1 tablespoon powder creamer

 

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 up 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?

How much sodium you need depends on the degree of kidney function you have, the amount of urine you make, and the type of dialysis you are on. Most people on PD will need to limit high sodium foods and table salt. If on PD, limiting the sodium in your meal plan can decrease the need for higher glucose exchanges. Sodium needs for HHD ranges from 2000-3000mg per day.

 

 

AVOID foods high in sodium as listed below:

 

All salted or smoked meat or fish

 

Cheese

 

Breads and rolls with salt toppings

Convenience and processed foods

 

Seasonings with salt in them

DO NOT USE Salt substitutes that have large amounts of potassium such as: Mortons Salt Substitute®, No Salt®, Diamond Crystal®  Lite Salt.

 

 

What can i use:

 

Try these spices and herbs to cut the salt but not the flavor.

 

 

 

What about fluid?

Some  people on dialysis need to limit their fluid intake.  The amount of fluid you can safely drink is based on the amount of urine output.  If you drink too much fluid between dialyis sessions, you may feel:

 

If you are on PD, you may need bigger exchanges to help remove the extra fluid. This will add extra sugar and calories. Home hemodyalisis (HHD)often does not require extra fluid restriction. 

 

What are fluids?

 

• Fluids include all beverages, and foods that are liquid at room temperature or become liquid like broth soups, Jell-O®, ice cream, or ice.

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 about potassium?

People on PD or HHD often do not need to limit their intake of potassium. If you are told to lower the amount of potassium in your meal plan, your dietitian will talk with you about this.

 

What does phosphorus do?

Phosphorus, a mineral, is important for your bones and teeth. When your kidneys are sick, phosphorus builds up 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 phosphorous and you do need plenty of protein, your doctor may also ask you to take a medicine with meals to bind phosphorus from the food you eat. When the phosphorus is bound with the binder medicine, it will be excreted in your stool.  

 

Examples of binder medicines are: Renagel, Phoslo, Tums, Fosrenol, and Renvela.

 

What can I eat? Hopefully most of your phosphorus will come from good protein sources.  But what else can you eat?  Your dietician will let you know. 

 

Foods with a large amount of phosphorus:

 

Dairy Products

Milk	Casseroles with cheese	Yogurt
Cheese	Custard and pudding	Ice cream and ice milk

 

Protein Foods

Meat	Organ meats	Salmon and sardines
Poultry and fish	Dried beans and peas	Nuts, seeds, and peanut butter
Eggs	Lentils	Soybeans and tofu

 

Grain Products*

Whole grain breads and cornbread	Boxed cake/bread mixes
Bran products	Oatmeal
Brown rice	Wheat germ

*ok to use to help with constipation

 

Other Foods

Chocolate, cocoa	Beer	Pizza
Carbonated colas	Dried fruit	Molasses
Caramel

 

*Phosphorus content of soft drinks:

 

High Phosphorus	Low Phosphorus
Cola	Ginger ale
Diet cola	Grape soda
Dr. Pepper®	Root beer
Cherry cola	Club soda
Some bottled iced teas	Sprite®, 7-Up® , Slice®
	Orange soda (except Nehi®)

 

 *Many bottled beverages, processed meats, boxed baking items, and fast foods from restaurants contain phosphorus additives, which binders will not help much with. Also, the phosphorus in these foods is absorbed into your blood nearly 100%, whereas the phosphorus in more natural foods like meats, beans, and nuts are only absorbed 20-50%.

 

Examples of phosphorus additives include 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 (ask your kidney dietitian for a handout with more websites)

 

www.kidneyschool.com
www.Davita.com
www.ikidney.com 
www.culinarykidneycooks.com Recipes
www.kidney.org   The National Kidney Foundation
www.kidneydirections.com

 

 

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 Room L33 University Station 2880 University Avenue Madison, WI  53705 (608) 263-5012

Nutrition Clinic Room 1296 UW Health West Clinic 451 Junction Road Madison, WI  53717 (608) 265-7526

Nutrition Clinic Room 2085 UW Health East Clinic 5249 East Terrace Drive Madison, WI  53718 (608) 265-0963

 

 

 

 

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: 11/06/2012

Copyright © 11/06/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#186

Print Health Fact For You