Back to the Basics of the Renal Diet

Dialysis helps remove fluid and toxins (excess nutrients consumed in your diet) from your body. Diet becomes an essential part of maintaining your health and well-being. Each person’s dialysis diet prescription is different, but the primary nutrients limited in the renal diet are protein, potassium, phosphorus, sodium, and fluid. Your renal dietitian will review your labs, assist you with controlling these nutrients in your diet, and provide additional dietary education and assistance based on your individual needs.

Power Up with Protein: Choose fresh meats, fish, and eggs, and try to get at least 2-4 oz at each meal. Avoid enhanced and pre-cooked meats as they may contain high amounts of sodium, phosphate, and potassium additives. Albumin is the measure of protein in your blood that will be checked every month at dialysis. The goal is to achieve an albumin level of 4 or greater. You may also benefit from a protein supplement. Ask your dietitian to see which protein supplement is appropriate for you.

Potassium: Potassium is a common mineral found in fruits, vegetables, dairy, beans, nuts, and salt substitutes. Potassium is essential to help your muscles and nerves work correctly. However, when your kidneys aren’t working properly, the potassium from your diet isn’t removed and can build up too high in the blood. Your dialysis treatments and the proper diet will help keep your potassium level regular. The normal potassium range is 3.5-5.

Phosphorus: Phosphorus is a mineral found naturally in many foods, including meats, poultry, fish, beans, dairy, and nuts. However, phosphorus is mainly found in processed foods, and food manufacturers often add phosphorus to foods and beverages as a preservative. Too much phosphorus will often build up in the blood when the kidneys are not working correctly. This will cause calcium to leak out of your bones, thus making them weaker, and deposit itself in the blood vessels and other organs, leading to hardening of the arteries and causing organs to malfunction over time. Many patients also need to take a “phosphorus binder” medication with their meals and snacks to help keep phosphorus levels normal between 3.5 and 5.5.

Slash Your Sodium Intake: Sodium is a mineral found in many foods and is often added in large amounts to processed foods. Limit your sodium intake to less than 2000 mg/day. Symptoms that you might be consuming too much sodium in your diet include high blood pressure, swelling/edema, shortness of breath, and difficulty controlling your fluid weight gain daily.

Wise Up with Water: One of the most important functions of the kidneys is eliminating excess fluid to maintain proper fluid balance in the body. When the kidney is not working, this function is impaired, and while many people still urinate when they start dialysis, most often, the kidney is not able to get rid of the excess fluid. Too much fluid build-up in your body can lead to high blood pressure, difficulty breathing normally, and swelling/edema, which can cause damage to your heart, leading to heart failure. The recommended total fluid intake in 24 hours for most people on dialysis is 1,000 mL (4 8oz cups) per day, plus the amount of urine output. Your dietitian will recommend how much to limit your fluid intake each day. Your doctor, dietitian, and nurse will also regularly evaluate your fluid balance and adjust the amount of fluid allowed each day based on your needs.