Food and fluids for people on haemodialysis

Do I need a special diet when I am on dialysis?

You will need to make changes to the food that you eat. For example, you need to eat more calories and protein than before. This is because the dialysis process uses up calories. A small amount of protein is also lost from the body in the dialysis fluid. Your dietitian will help you to decide on ways to meet your dietary needs.

Other changes may be needed. The kidneys work 24 hours a day filtering waste products from the blood, turning it into urine. When they fail, these waste products build up in your bloodstream. This build up can be dangerous. The following paragraphs will give you an introductory guide to the elements of your food and drink that you may have to control.

potassium and your diet

Potassium is a type of salt that is present in many of the foods that we eat. Some foods have particularly high levels of potassium in them, for example, fruit, vegetables, chocolate and coffee. High potassium levels in the bloodstream can affect your heart beat and, in extreme cases, be life threatening. If your blood potassium levels are high, you will need to follow a low potassium diet.

Your dietitian will advise you if you need to be on a low potassium diet. The diet will be tailored to your blood levels. There are different levels of restriction and not everyone on dialysis needs to be on this diet.

fluids

As kidney function deteriorates, many patients pass less urine over time. Fluid intake needs to be matched to the amount of fluid you can pass as urine. Drinking more than you can pass will lead to fluid overload. Fluid overload can cause shortness of breath, chest infections and generalised swelling. It can put a strain on your heart. The doctor or nurse on your dialysis unit will be able to tell you how much to drink to avoid these problems. Your dietitian can advise you on what to drink and suggest ways to manage your fluid restriction.

sodium (salt)

The more salt you have in food, the more thirsty you will feel. This can make it difficult to comply to your fluid restriction. A high salt intake can contribute to high blood pressure. It is therefore sensible to keep the salt in your food to a minimum. Your dietitian can help you to do this.

phosphate

Phosphate is a chemical element which is found in many foods.

Phosphate and calcium work together in the body to keep bones healthy and strong. In renal failure the kidneys are unable to remove excess phosphate from the body. If phosphate levels rise too much, calcium levels may fall and renal bone disease can occur as a result. This causes bones to become more brittle and even fracture.

Phosphate levels can be controlled taking tablets. The foods that are high in phosphate are also high in protein. If you reduce your intake of phosphate containing foods, you will reduce your intake of protein. Adequate protein is essential to health and strength, so do not reduce you intake without discussion with the dietitian. It is especially important that you are taking the binders at the right time with the right foods. A separate leaflet exists to help you understand phosphate and the methods of controlling it.

What should I eat on dialysis days?

It is important to try to eat the same on dialysis days as on any other day. If you feel nauseous on dialysis, try snacking little and often

Is it safe to eat foods that are normally restricted during dialysis?

We do not know if it is safe to eat high potassium foods such as chocolate, bananas and other fruit, crisps or drink coffee during dialysis. Different foods take different times to digest and people digest their food at different rates to one another. For this reason, we cannot measure the risks involved. As we cannot guarantee that the practice is risk free we ask you to bear it in mind if you choose to eat high potassium foods on dialysis.

Can I eat out?

Yes, all dialysis patients should feel free to eat out whether on a special diet or not. If you are on a low potassium diet, please discuss it first with your dietitian who can advise you accordingly.

Can I drink alcohol?

Yes, you can drink alcohol. All alcohol needs to be counted as part of your fluid allowance. However, if you are on a low potassium diet, vodka, whisky & gin are the only suitable alcoholic drinks.


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