What Is a Hemodialysis Diet?
This is a special diet for people getting dialysis.
Why Should I Follow This Diet?
The kidneys help filter waste from your body, control fluid levels, and keep potassium and sodium levels in line. Dialysis can help by doing the work of the kidneys when they are not healthy enough.
Normally, the kidneys are always filtering blood. Dialysis is done about three times a week. You must follow a special diet so waste products do not build to toxic levels in between. Fluid and salt levels can become too high.
You will need to control the amount of protein, sodium, potassium, phosphorous, and fluid you take in each day. It may change as your kidney health changes. You will need to work closely with a dietitian to learn how much of each you can eat and make a meal plan that is right for you.
People on dialysis need to take in the right amount of protein. Eating too much can cause waste products to build up in your blood. Dialysis helps remove these waste products, but it can also remove healthy proteins. Not eating enough can cause muscle loss. You should also make sure it is high-quality protein, such as meat, fish, poultry, and eggs. Milk has high-quality protein but is also high in potassium and phosphorous.
Sodium is found in table salt and many other foods. Most canned and processed foods have high amounts. It is easy to eat too much of it.
Extra sodium can cause fluid build-up and high blood pressure when the kidneys are not healthy. Dialysis can help remove some but not all of it. You will need to limit it. Do not add salt to the foods you cook or eat. Use herbs and spices instead. Keep in mind that salt substitutes have potassium.
Potassium is found in many fruits and veggies. It is a mineral that helps the muscles and the heart work. But potassium can build up in the blood in people with kidney failure. It can be deadly. You need to limit the amount of potassium you take in each day. Do not eat high-potassium foods, such as potatoes, tomatoes, citrus fruits, avocados, bananas, and dried fruit. You may still be able to eat your favorite high-potassium food, but you will need to eat much less. Your dietitian can help with this.
Phosphorous will also need to be limited. It can draw calcium out of the bones when it builds up in your blood. This can cause your bones to weaken. Phosphorous is found in protein-rich foods, such as dairy products, meat, legumes, nuts and seeds, whole grains, and cola. You may need to take a phosphate-binder. It soaks up extra phosphorous and then passes it out in your stool.
Dialysis can help balance fluid levels. You will need to keep track of your fluid intake between treatments. This means limiting how much you drink, but also what you eat. Many foods are made up of mostly fluid, such as fruits, soups, and dairy products like ice cream. Taking in too much fluid can cause fluid build-up. This can lead to high blood pressure and edema. Monitor your fluid level by regularly checking your weight and comparing it to your dry weight. Your dry weight is what you weigh right after dialysis.
This diet can differ from one person to the next. Your needs may also change over time based on your health. A dietitian can help make a meal plan that is right for you. Here are some tips:
Do not eat too much salt:
- Do not use the salt shaker.
- Use herbs and spices when you cook.
- Do not use salt substitutes that have potassium.
- Eat fresh foods instead of processed foods.
- Look for foods that say low-sodium on the label.
Do not take in too much fluid:
- Many foods contain fluids.
- All foods that are liquid at room temperature are fluids, such as popsicles, ice cream, and gelatin.
- You can lower your thirst by limiting your sodium.
Keep track of how much food you are eating:
- Read food labels to learn about portion sizes.
- Use measuring cups or a scale.
Cook at home more often:
- Restaurant food is often high in sodium and fat.
- Cooking at home will give you control of what is in the foods that you eat.
Make sure you are getting enough calories:
- Most people will need to make sure they get enough calories.
- An easy way to raise your calories is to add heart-healthy oils like canola and olive to the foods you make.
Ask your dietitian about recipes for people on dialysis.
American Association of Kidney Patients
Eat Right—Academy of Nutrition and Dietetics
Dietitians of Canada
The Kidney Foundation of Canada
Kidney failure: Eat right to feel right on hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/kidney-failure-eat-feel-right-hemodialysis/Pages/facts.aspx. Updated September 2016. Accessed June 17, 2019.
Nutrition and hemodialysis. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/nutrihemo. Accessed June 17, 2019.
Patient education: dietary and fluid compliance for patients on hemodialysis. EBSCO Nursing Reference Center website. Available at:https://www.ebscohost.com/nursing/products/nursing-reference-center. Updated January 4, 2019. Accessed June 17, 2019.
Last reviewed June 2019 by EBSCO Medical Review Board Dianne Scheinberg Rishikof MS, RD, LDN Last Updated: 12/31/2019