Kidney diet - dialysis patients

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Kidney anatomy

End stage renal disease - diet; Hemodialysis - diet; Peritoneal dialysis - diet

The following are some general dietary recommendations for dialysis patients.

PROTEIN

Pre-dialysis patients are often asked to limit protein intake to slow the progression of kidney disease. This changes with the start of dialysis: the patient now needs much more protein. Patients on peritoneal dialysis need even higher protein, because a large amount of protein can be lost in the peritoneal fluid which is discarded.

However, dialysis patients still need to limit salt, potassium and phosphorous, which makes it a little challenging to get enough protein. Moreover, many dialysis patients have poor appetites, especially early after start of dialysis. Every dialysis center has a dietician who can explain the dietary modifications required, suggest food selection, and prescribe supplements as required.

SODIUM

Most patients need to control the sodium (salt) content in their diet. This helps maintain fluid balance in the body to avoid fluid retention and elevated blood pressure.

POTASSIUM

The daily intake of potassium is also controlled. This helps prevent hyperkalemia (a high level of potassium), a common problem for people on dialysis.

PHOSPHORUS

The mineral phosphorus is also controlled by this diet. Phosphorus is not effectively removed by dialysis treatments. Patients need to reduce their intake of dairy products and other foods high in phosphorus.

They are usually prescribed calcium supplements, which bind the phosphorus in food. It is important to take these calcium tablets with meals. Some patients may be given a non-calcium phosphorus binder, such as Renagel. The amount of binders that need to be taken by each patient is determined by their blood levels of phosphorus and their intake of phosphorus-containing foods in the diet.

FLUIDS

During kidney failure, the amount of urine produced drops. The urine output usually stops completely once patients have been on dialysis for more than 6 months. Patients on peritoneal dialysis usually retain their urine output for a longer time and have less restriction on fluid intake.