Diet for Dialysis Patients

Once you’re on dialysis, your protein needs are usually much higher than they were before you started treatment. That’s because both HD and 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.

It's important for dialysis patients to limit their daily sodium intake to 2,000 mg or less. When you have 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; it can also make you thirstier. To make sure you’re not eating too much salt, it's best to stay away from packaged, processed foods; canned or frozen foods; and restaurant and fast foods. Healthy, home-cooked meals flavored with spices and herbs are a great alternative that puts you in control of how much salt goes into your body.

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, flavored beverages, milk, yogurt, cheese, processed meats, chocolate and nuts. Intake of these foods and drinks should be avoided if you want to stay within your recommended daily phosphorus intake of 800 to 1,000 mg.

Whether you're on PD or 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.

Getting enough fiber from the foods you eat is an important part of maintaining your overall health. Fiber 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 fiber 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 dietitian 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.

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 treatments. This is because dialysis fluid contains dextrose, which is a form of sugar. The dextrose in your dialysis fluid 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 PD patients are recommended to eat fewer calorie-rich carbohydrates than HD patients.

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

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

Because patients on PD or HHD treat less often and for shorter periods of time, they may experience less of the negative effects of fluid imbalance than patients on ICHD.

If you are treating with PD or HHD, you may not have the same fluid restrictions as someone on ICHD. However, it’s still recommended that you stick within a fluid allowance of about 4 cups (1 Liter) of fluid per day, which includes the fluid that is in foods like green peas, celery and watermelon.

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