Diet for End-Stage Renal Disease (Dialysis): Care Instructions

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Your Care Instructions

You need to change your diet when you are on dialysis for end-stage renal disease (kidney failure). You will need more protein than you did before you started dialysis. You may need to limit salt and fluids. You also may need to limit minerals such as potassium and phosphorus. A diet for end-stage renal disease takes planning. A dietitian who specializes in kidney disease can help you plan meals that meet your needs.

Your nutrition needs depend on the type of dialysis you get. Talk with your doctor or dietitian to make sure your diet is right for your condition. Do not change your diet without talking to your doctor or dietitian.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Work with your doctor or dietitian to create a food plan that guides your daily food choices.
  • Do not skip meals or go for many hours without eating. If you do not feel very hungry, try to eat 4 or 5 small meals instead of 1 or 2 big meals.
  • If you have a hard time eating enough, talk to your doctor or dietitian about ways you can add calories to your diet.
  • Do not take any natural health products without talking to your doctor first.
  • Check with your doctor about whether it is safe for you to drink alcohol.
  • Check with your doctor about how much fluid you can drink each day. Drinking a lot of fluid can cause you to gain too much water weight between dialysis sessions.

To get the right amount of protein

  • Ask your doctor or dietitian how much protein you can have each day. You will probably need more protein while you are on dialysis than you did before you started dialysis.
  • Choose high-quality protein sources, such as lean meat, poultry, and fish.

To limit salt

  • Read food labels on cans and food packages. The labels tell you how much sodium is in each serving. Make sure that you look at the serving size. If you eat more than the serving size, you will get more sodium than what is listed on the label.
  • Do not add salt to your food. Avoid foods that list salt, sodium, or monosodium glutamate (MSG) as an ingredient.
  • Buy foods that are labelled "no salt added," "sodium-free," or "low sodium." Foods labelled "reduced sodium" and "lightly salted" may still have too much sodium.
  • Limit processed foods, fast food, and restaurant foods. These types of food are very high in sodium.
  • Avoid salted pretzels, chips, popcorn, and other salted snacks.
  • Avoid smoked, cured, salted, and canned meat, fish, and poultry. This includes ham, bacon, hot dogs, and luncheon meats.
  • Use lemon, herbs, and spices to flavour your meals.

To limit fluids

  • Know how much fluid you can drink. Every day fill a pitcher with that amount of water. If you drink another fluid (such as coffee) that day, pour an equal amount out of the pitcher.
  • Count foods that are liquid at room temperature, such as gelatin dessert and ice cream, as fluids.

To limit potassium

  • Choose low-potassium fruits such as blueberries and raspberries.
  • Choose low-potassium vegetables such as cucumbers and radishes.
  • Do not use a salt substitute or lite salt unless your doctor says it is okay. Most salt substitutes and lite salts are high in potassium.

To limit phosphorus

  • Follow your food plan to know how much milk and milk products you can have.
  • Avoid nuts, peanut butter, seeds, lentils, beans, organ meats, and sardines.
  • Avoid cola drinks.
  • Avoid bran breads or bran cereals.
  • Take phosphate binders as directed, if prescribed by your doctor.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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