Nutrition and Hemodialysis

Now that you are beginning hemodialysis, there may be many changes in your daily life. Your doctor has probably told you that you may need to make some changes in your diet. The renal dietitian at your dialysis center will help you plan a diet for your special needs.

Why do I need to be on a special diet?

Because your kidneys are not able to get rid of enough waste products and fluids from your blood and your body now has special needs, you will need to limit fluids and change your intake of certain foods in your diet. How well you feel will depend on:

• eating the right kind and amounts of food from your diet
• having the hemodialysis treatments your doctor orders for you
• taking the medications your doctor orders for you.

Your diet is very important to your care. It is important that you have the right amount of protein, calories, fluids, vitamins and minerals each day. Your dietitian will help you plan your meals to make sure you get the proper balance.

How will I know if I am eating right to keep me healthy?

Because you are on dialysis, you have some very special needs. Eating well helps you stay healthy. Eating poorly can increase your risk of illness. Your dietitian will talk with you about how well you are eating.
Some questions you might be asked:

• Have you noticed a change in the kind or amount of food you eat each day?
• Have you had any problems eating your usual or recommended diet?
• Have you lost weight without trying?
• Have you noticed any changes in your strength or ability to take care of yourself?

Your dietitian or nurse might look at the fat and muscle stores in your face, hands, arms, shoulders, and legs. Your dialysis care team will look for changes in your blood level of proteins, and especially one called albumin. A change in this protein can mean that you are losing body protein.
Some special blood tests that are done each month are called Kt/V (pronounced kay tee over vee) or urea reduction ratio (URR). These tests help your doctor decide if you are getting enough dialysis. Getting the right amount of dialysis is important to help you feel your best.
A change in your fat and muscle stores or any of these blood tests could be a sign that you are not getting enough dialysis. Along with the Kt/V, these tests provide information about your intake of protein or your protein equivalent of nitrogen appearance (PNA). Using the PNA, your albumin and any changes in your appetite, your dietitian will determine if you are eating enough of the right foods. The right amount of dialysis is needed to make sure you are able to enjoy your food while keeping you healthy.

What if I have high cholesterol

Changing your diet may help lower the cholesterol level in your blood. Your dietitian will talk with you about the kinds of fat and animal foods you eat. Also, your doctor may decide you need a special medication to reduce the cholesterol in your blood.

What if I have diabetes

In some cases, you may need to make only a few changes in your diet to fit your needs as a kidney patient. For example, some of the free foods you have been using may need to be limited on your kidney diet. Your dietitian will help develop a meal plan especially for you.

Is there anything else I should know

The following important tips can be helpful with your diet:

• Fresh or plain frozen vegetables contain no added salt. Drain all the cooking fluid before serving.
• Canned fruits usually contain less potassium than fresh fruits. Drain all the fluid before serving.
• Non-dairy creamers are low in phosphorus and can be used in place of milk.
• Labels on food packages will give you information about some of the ingredients that may not be allowed in your diet. Learn to read these labels.
• To help you avoid salt, many herbs and spices can be used to make your diet more interesting. Check with your dietitian for a list of these.