Food gives you energy and helps your body repair itself. Food is broken down in your stomach and intestines. Your blood picks up nutrients from the digested food and carries it to all your cells. These cells take nutrients from your blood and put waste products back into the bloodstream. Healthy kidneys work constantly to remove wastes from blood. The wastes leave the body through urination and bowel movements.

In a patient whose kidneys have stopped working, hemodialysis removes wastes from the blood. Between sessions, wastes can build up in the blood and cause sickness. The amount of wastes can be reduced by watching food and drink intake. A good meal plan can improve dialysis and health. Your clinic has a dietitian to help you with plan meals. Dietitians specialize in food and nutrition. A dietitian with special training in care for kidney health is called a renal dietitian.

Fluids

Fluid can build up between dialysis sessions, causing swelling and weight gain. The extra fluid affects your blood pressure and can make your heart work harder. Serious heart trouble can result from overloading your system with fluid.

You need to watch how much fluid you consume through drinking and eating. Any food that is liquid at room temperature also contains water. These foods include soup, Jell-O, and ice cream. Many fruits (melons, apple sauce, etc.) and some vegetables contain lots of water, too. All these foods add to your fluid intake.

Your dry weight is your weight after a dialysis session when all of the extra fluid in your body has been removed. If you let too much fluid build up between sessions, it is harder to get down to your proper dry weight. Your dry weight may change over a period of three to six weeks. Talk to your doctor regularly about what your dry weight should be.

Sodium

Too much sodium in your diet can be harmful because it causes your blood to hold fluid. The extra fluid raises your blood pressure and puts a strain on your heart and kidneys. Sodium is found in salt and most foods. Canned foods and frozen dinners usually contain large amounts of sodium. Too much sodium makes you thirsty. But if you drink more fluid, your heart has to work harder to pump the fluid through your body. Over time, this can cause high blood pressure and congestive heart failure. To lower your sodium intake, try to eat fresh foods that are naturally low in sodium and look for products labeled low sodium. For additional information on managing your sodium intake, consult your renal dietitian.

Control Your Thirst

You can keep your fluids down by drinking from smaller cups or glasses. Freeze juice in an ice cube tray and eat it like a popsicle. (Remember to count the popsicle in your fluid allowance!) The dietitian will be able to give you other tips for managing your thirst.

Potassium

Potassium is a mineral found in many foods, especially milk, fruits, and vegetables. It affects how steadily your heart beats. Healthy kidneys keep the right amount of potassium in the blood to keep the heart beating at a steady pace. Potassium levels can rise between dialysis sessions and affect your heartbeat. Eating too much potassium can be very dangerous to your heart. It may even cause death.

To control potassium levels in your blood, avoid foods like potatoes, oranges, tomatoes, avocados, bananas, kiwis, and dried fruit which are very high in potassium. Instead, enjoy low potassium foods like apples, all the berries, grapes, broccoli, carrots and green beans.

Phosphorus

Phosphorus is a mineral found in many foods. If you have too much phosphorus in your blood, it takes calcium from your bones. Losing calcium will make your bones weak and likely to break. Also, too much phosphorus may make your skin itch. Foods like milk, cheese, dried beans, peas, colas, nuts, and peanut butter are high in phosphorus. Your renal dietitian will give you more specific information regarding phosphorus.

You will probably need to take a phosphate binder to control the phosphorus in your blood between dialysis sessions. These medications act like sponges to soak up, or bind, phosphorus while it is in the stomach. Because it is bound, the phosphorus does not get into the blood. Instead, it is passed out of the body in the stool.

Protein

Before you were on dialysis, your doctor may have told you to follow a low protein diet. Being on dialysis changes this. Most people on dialysis are encouraged to eat as much high-quality protein as they can. The better nourished you are, the healthier you will be. Protein helps you keep muscle and repair tissue. You will also have greater resistance to infection and recover from surgery more quickly.

You will know if you are eating enough protein by your monthly blood test. Your albumin level is the best indicator. It needs to be at least 3.7, preferably over 4.0. If this level drops, you will usually feel more tired and weak. This also puts you at greater risk for developing an infection.

Calories

Calories provide energy for your body. If your doctor recommends it, you may need to cut down on the calories you eat. A dietitian can help you plan ways to cut calories in the best possible way.

Some people on dialysis need to gain weight by adding calories. Vegetable oils like olive, canola, and safflower are good sources of calories. Use them generously on breads, rice, and noodles.

Butter and margarines are rich in calories, but these fatty foods can also clog your arteries. Use them less often. Soft margarine that comes in tubs is better than stick margarine. Vegetable oils are the healthiest way to add fat to your diet if you need to gain weight.

Hard candy, sugar, honey, jam, and jelly provide calories and energy without clogging arteries or adding other things that your body does not need. If you have diabetes, be very careful about eating sweets. A dietitian's guidance is very important for people with diabetes.

Should I take Vitamins and Minerals?

Vitamins and minerals may be missing from your diet because you have to avoid so many foods. Your doctor may prescribe a multi-vitamin and mineral supplement specially formulated for people with kidney disease.

Do not take vitamins that you can buy off the store shelf. They may contain vitamins or minerals that are harmful to you.

Keep Track of Test Results

Your doctor will order regular blood tests. You will find that keeping track of your test results helps you see how your treatment is working. Your dietitian will provide you copies of your lab reports and explain them to you. When you learn how to read your reports, you will see how the foods you eat affect your kidneys. Talk with your dietitian about making healthier food choices. Remember that you are the most important member of your health care team.