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

Overview

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.

How can you care for yourself at home?

Each person's dialysis diet may be a little different. Work with your doctor or dietitian to create a food plan that guides your daily food choices. Here are some tips that may help you follow your plan.

• Do not 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.

• Get the right amount of protein.
  • Ask your doctor or dietitian how much protein you need 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, fish, or eggs.
  • If you are a vegetarian, your diet may require extra planning with your dietitian to make sure you're getting enough protein and nutrients.
• Limit salt.
  • Look at food labels to see 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.
  • Buy foods that are labeled "no salt added," "sodium-free," or "low-sodium." Foods labeled "reduced-sodium" and "light sodium" may still have too much sodium.
  • Limit processed foods, fast food, and restaurant foods. And avoid salted snacks, like pretzels and chips.
  • Try lemon, herbs, and spices to flavor your meals.
• Know how much fluid you can drink each day.

  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. And remember to count foods that are liquid at room temperature as fluids. These include ice, gelatin, ice pops, and ice cream.

• Limit potassium.
  • Choose low-potassium fruits and vegetables. These include things like grapes, pineapple, lettuce, green beans, and cucumber.
  • Choose low-potassium foods such as pasta, noodles, rice, tortillas, and bagels. And avoid high-potassium foods, including things like milk, bananas, oranges, spinach, tomatoes, and broccoli.
  • Do not use a salt substitute or lite salt unless your doctor says it is okay. They can be high in potassium.
• 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 and bran breads or bran cereals.
  • Take phosphate binders as directed, if prescribed by your doctor.

Always check with your doctor if you have questions about your diet. Do not take any vitamins or minerals, supplements, or herbal products without talking to your doctor first. And check with your doctor about whether it is safe for you to drink alcohol.