Adopting a Kidney-friendly Diet

A kidney-friendly diet will help keep your body in balance and make sure that you get the nutrition you need to stay healthy.

Understanding what you should and should not eat while on dialysis is an important part of treating your chronic kidney disease (CKD). Maintaining a balanced diet – including carbohydrates, fats, proteins, minerals and liquids – will provide you with a good foundation for staying healthy while on dialysis. Listening to your clinician or dietician’s advice about what your body needs is essential, particularly if it means changing some of your current habits.

Grandmother, daughter, and granddaughter standing in a kitchen, talking and laughing at the sink

Adjusting Your Diet for Dialysis

As a patient starting dialysis treatments, you need to make many adjustments to your daily life. As your clinician may have told you, this can include changing what you eat and drink. Because your kidneys are not able to filter waste and extra fluid out of your body the way they should, your diet needs to exclude certain types of foods for your body to stay healthy and balanced throughout treatment.

Adopting a more kidney-friendly diet does not need to be a challenge. Being mindful of your dietary needs throughout your treatment journey can help you feel and do your best.

Patient and their spouse preparing a kidney-friendly salad together

General Diet Guidelines on Dialysis

Specific dietary restrictions for dialysis differ from person to person. However, there are some general guidelines all patients should follow, whether on haemodialysis (HD) - including home haemodialysis (Home HD) - or peritoneal dialysis (PD).

Protein

Once you’re on dialysis, your protein needs are usually much higher than they were before you started treatment. That’s because both haemodialysis (HD) and peritoneal dialysis (PD) treatments cause your body to lose protein. There are a variety of different healthy protein sources – including chicken, beans, beef, eggs, fish, turkey, tofu and many others. Choosing fresh, high-quality protein is the healthiest option. You should avoid cured and deli meats in order to limit the amount of salt you’re putting into your body.

Sodium

It is important for dialysis patients to limit their daily sodium intake to 2,000 mg or less. If you have chronic kidney disease (CKD), your kidneys have a hard time keeping the sodium and water in your body in balance. This can give you high blood pressure, shortness of breath, and swelling and make you thirstier. To make sure you’re not eating too much salt, it is best to stay away from packaged, processed foods, canned or frozen foods, and restaurant and fast foods. Healthy, home-cooked meals flavoured with spices and herbs are a great alternative that puts you in control of how much salt goes into your body.

Phosphorus

Phosphorus is essential for building and maintaining strong bones. When your kidneys are not functioning as well as they should though, phosphorus build-up can occur. This puts you at risk for severe bone and heart problems, like cardiovascular disease and hip fractures. There is a lot of phosphorus in fast foods and flavoured beverages, as well as milk, yogurt, cheese, processed meats, chocolate, and nuts. Notice how many healthy foods are high in phosphorus! these foods and drinks should be avoided if you want to stay within your recommended daily phosphorus intake of 800 to 1,000 mg.

Calcium

Whether you are on peritoneal dialysis (PD) or haemodialysis (HD), the amount of calcium you get from your diet should not be greater than the recommended daily allowance of 2,000 mg. Too much calcium in your body can put you at risk of vascular calcification, which are mineral deposits in your veins and arteries, and other harmful conditions.

Fibre

Getting enough fibre from the foods you eat is an important part of maintaining your overall bodily health. Fibre helps your body control its blood sugar levels, keep cholesterol in check, and maintain gut health. You should consume about 20 to 25 grams of fibre each day. This is easy if you eat a diet rich in fruits and vegetables and low-phosphorus grains.

Keep in mind that every person on dialysis has specific dietary needs. You should talk to your clinician or dietician about what specific foods you should and should not eat while you’re on dialysis to make sure that you’re on the kidney-friendly diet that’s right for you.

Therapy-Dependent Diet Guidelines

Your optimal dialysis diet is determined by your age, weight, level of kidney function, and what type of dialysis you are on, as well as whether you have other health conditions – such as hypertension, high cholesterol, or diabetes. Dietary requirements are the same for people being treated with peritoneal dialysis (PD) and haemodialysis (HD), including home haemodialysis (Home HD). However, there are a few key differences to keep in mind.

Calories

If you’re on PD, some of the calories your body takes in will come from your dialysis solution, the fluid that is used to clean your blood during your treatments. This is because dialysis fluid contains dextrose, which is a form of sugar. While you’re treating, the dextrose in your dialysis fluids provides your body some of its daily recommended calorie intake, which decreases your body’s need to take in calories from food. As a result, most peritoneal dialysis (PD) patients are recommended to eat fewer calorie-rich carbohydrates than haemodialysis patients (HD).

Potassium

Peritoneal dialysis (PD) generally removes excess potassium from the body more efficiently than haemodialysis (HD). If you’re on peritoneal dialysis (PD), you are typically able to consume between 3,000 and 4,000 mg of potassium per day. But if you’re being treated with haemodialysis (HD), you should limit your potassium intake to about 2,000 mg per day to maintain balance. If you are a home haemodialysis (Home HD) patient, it is best to speak with your care team or dietician about the level of potassium that is recommended for you.

Fluid Balance

One of the most important functions of your kidneys is keeping the fluid in your body in balance. When you have chronic kidney disease (CKD), your kidneys are not able to remove this fluid as effectively as they should be. This can lead to a build-up of excess fluid, which is both uncomfortable and unhealthy for your body.

Because they treat less often and for shorter periods of time, patients on in-centre haemodialysis (In-Centre HD) may feel more of the negative effects of fluid imbalance than patients on peritoneal dialysis (PD) or home haemodialysis (Home HD).

If you are treating with peritoneal dialysis (PD) or home haemodialysis (Home HD), you may not have the same fluid restrictions as someone on in-centre haemodialysis (In-Centre HD). However, it’s still recommended that you stick within a fluid allowance of about 4 cups (32 ounces) of fluid per day, which includes the fluid that is in foods like green peas, celery and watermelon.

Minimising your sodium intake and planning the liquid you drink and eat ahead of time can help you keep your water gains to a minimum.

Where to go next?

Exercising on dialysis

Exercising regularly while you’re on dialysis can help you feel physically and mentally strong. Learn more about ways you can stay active throughout your treatment journey.

Traveling on Dialysis

It may be possible for you to continue traveling after your diagnosis. Learn more about traveling with chronic kidney disease (CKD).

Intimacy

It is possible for you to maintain intimate relationships while you’re on dialysis. Learn more about intimacy and dialysis.

Treatment options

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