Eat Right to Feel Right on
Hemodialysis
On this page:
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
for that section 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 ___________________
[Top]
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.
Now that your kidneys have
stopped working, hemodialysis
removes wastes from your blood. But
between dialysis 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.
Talk with a
dietitian to learn how to eat right
on hemodialysis.
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.
[Top]
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 have serious heart trouble
from overloading your system with
fluid.
Control Your Thirst
The best way to reduce fluid
intake is to reduce thirst
caused by the salt you eat.
Avoid salty foods like chips and
pretzels. Choose low-sodium
products.
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 with your doctor
regularly about what your dry weight
should be.
My dry weight should be
_____________.
Many foods
contain water.
Talk With 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 with 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)
Be careful to
keep track of your fluids and other
foods.
[Top]
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
the vegetables before cooking
them. Your dietitian will give
you more specific information
about the potassium content of
foods.
Talk With 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:
apricots
avocados
bananas
beets
Brussels 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 |
Others:______________________________________
Changes:
Talk with 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 _________.
[Top]
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.
Taking a
phosphate binder helps control
phosphorus in your blood.
[Top]
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. Protein helps you keep muscle
and repair tissue. The better
nourished you are, the healthier you
will be. You will also have greater
resistance to infection and recover
from surgery more quickly.
Your body breaks protein down
into a waste product called urea. If
urea builds up in your blood, it’s a
sign you have become very sick.
Eating mostly high-quality proteins
is important because they produce
less waste than others. High-quality
proteins come from meat, fish,
poultry, and eggs (especially egg
whites).
Poultry and fish, like broiled
flounder, are good sources of
high-quality protein.
Talk With a Dietitian
Meat, fish, and chicken are
good sources of protein. Talk
with 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 with 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.
[Top]
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
with a dietitian about spices you
can use to flavor your food. The
dietitian can help you find spice
blends without sodium or potassium.
Find new ways
to spice up your food.
Talk With a Dietitian
Talk with 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:
_____________________________
[Top]
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.
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 a tub 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.
If you need to get extra calories,
vegetable oils like these are a good
choice.
[Top]
Should I take
vitamins and minerals?
Take only the vitamins your doctor
prescribes.
Vitamins and minerals may be
missing from your diet because you
have to avoid so many foods. Your
doctor may prescribe a vitamin and
mineral supplement like Nephrocaps.
Warning: Do not
take vitamin supplements that you
can buy off the store shelf. They
may contain vitamins or minerals
that are harmful to you. |
