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Dialysis Diet

WHAT YOU NEED TO KNOW:

What is a dialysis diet?

Dialysis is a treatment that removes waste from your blood when your kidneys can no longer do this. A dialysis diet also helps to decrease the amount of waste that builds up in your blood. Your dietitian will help you create a meal plan with the right amount of nutrients. Your diet may change over time based on your weight, blood test results, and other reasons. You may also need to make changes if you have other health problems, such as diabetes.

What changes do I need to make if I receive hemodialysis?

You will need to limit potassium, phosphorus, sodium, and liquid in your diet. You may be able to have more protein than you did before you started dialysis. It may be hard to eat enough food. Your dietitian may suggest that you add extra calories if you lose weight. You can get extra calories by adding sugar, jelly, jam, honey, or syrup to foods. You can also add healthy fats, such as canola oil, olive oil, or soft margarine. If you have diabetes, ask your dietitian how to add calories.

What changes do I need to make if I receive peritoneal dialysis?

You will need to limit phosphorus and sodium . You may also need to limit liquid if your body is retaining fluid. You may need to decrease or increase potassium, depending on your blood levels. You will also need extra protein because protein is lost through your treatments.

What foods can I include?

Your dietitian will tell you how many servings you can have from each of the food groups below. The approximate amount of these nutrients is listed next to each food group. Read the food label to find the exact amount.

  • Bread, cereal, and grains: These foods contain about 80 calories, 2 grams (g) of protein, 150 milligrams (mg) of sodium, 50 mg of potassium, and 30 mg of phosphorus.
    • 1 slice (1 ounce) of bread (French, Italian, raisin, light rye, or sourdough white), small dinner roll, or 6-inch tortilla
    • ½ of a hamburger bun, hot dog bun, or English muffin or ¼ of a bagel
    • 1 cup of unsweetened cereal or ½ cup of cooked cereal, such as cream of wheat
    • ⅓ cup of cooked pasta (noodles, macaroni, or spaghetti) or rice
    • 4 (2-inch) unsalted crackers or 3 squares of graham crackers
    • 3 cups of air-popped, unsalted popcorn
    • ¾ ounce of unsalted pretzels
  • Vegetables: A serving of these foods contains about 30 calories, 2 g of protein, 50 mg of sodium, and 50 mg of phosphorus.
    • Low potassium (less than 150 mg):
      • ½ cup cooked green beans, cabbage, cauliflower, beets, or corn
      • 1 cup raw cucumber, endive, alfalfa sprouts, cabbage, cauliflower, or watercress
      • 1 cup of all types of lettuce
      • ¼ cup cooked or ½ cup raw mushrooms or onions
      • 1 cup cooked eggplant
    • Medium potassium (150 to 250 mg):
      • 1 cup raw broccoli, celery, or zucchini
      • ½ cup cooked broccoli, celery, green peas, summer squash, zucchini, or peppers
      • 1 cup cooked kale or turnips
  • Fruits: A serving of these foods contains about 60 calories, 0 g protein, 0 mg sodium, and 150 mg of phosphorus. Each serving is ½ cup, unless another amount is given.
    • Low potassium (less than 150 mg):
      • Apple juice, applesauce, or 1 small apple
      • Blueberries
      • Cranberries or cranberry juice cocktail
      • Fresh or canned pears (light syrup or packed in water)
      • Grapes or grape juice
      • Canned peaches (light syrup or packed in water)
      • Pineapple or strawberries
      • 1 tangerine
      • Watermelon
    • Medium potassium (150 to 250 mg):
      • Fresh peaches or pears
      • Cherries
      • Cantaloupe, mango, or papaya
      • Grapefruit or grapefruit juice
  • Meat, poultry, and fish: These foods have about 75 calories, 7 g of protein, an average of 65 mg of sodium, 115 mg of potassium, and 70 mg of phosphorus. Do not use salt to prepare these foods.
    • 1 ounce of cooked beef, pork, or poultry
    • 1 ounce of any fresh or frozen fish, lobster, shrimp, crab, clams, tuna, unsalted canned salmon, or unsalted sardines
  • Other protein foods: These foods have about 90 calories, 7 g of protein, an average of 100 mg of sodium, 100 mg of potassium, and 120 mg of phosphorus.
    • 1 large whole egg or ¼ cup of low-cholesterol egg substitute
    • 1 ounce of cheese
    • ¼ cup of cottage cheese or tofu
    • 1 ounce of unsalted nuts or 2 tablespoons of peanut butter
  • Fats: These foods have very little protein and about 45 calories, 55 mg of sodium, 10 mg of potassium, and 5 mg of phosphorus. Include healthy fats, such as unsaturated fats, which are listed below.
    • 1 teaspoon margarine or mayonnaise
    • 1 teaspoon oil (safflower, sunflower, corn, soybean, olive, peanut, canola)
    • 1 tablespoon oil-based salad dressing (such as Italian) or 2 tablespoons mayonnaise-based salad dressing (such as ranch)
  • Liquids:
    • Non-cola sodas (ginger ale, lemon-lime sodas)
    • Lemonade or limeade
    • Water or mineral water

What foods should I limit or avoid?

The foods you need to limit depend on whether you are on hemodialysis or peritoneal dialysis. Ask your healthcare provider which of the following foods you should limit.

  • Starches: The following foods have higher amounts of sodium, potassium, or phosphorus.
    • Biscuits, muffins, pancakes, and waffles
    • Cake and cornbread from boxed mixes
    • Whole-grain foods such as oatmeal and whole-wheat cereals
    • Salted pretzel sticks or rings and sandwich cookies
  • Meat and protein foods: The following are high in sodium and phosphorus.
    • Deli-style meat, such as roast beef, ham, and turkey
    • Canned salmon and sardines
    • Processed cheese, such as American cheese and cheese spreads
    • Smoked or cured meat, such as corned beef, bacon, ham, hot dogs, and sausage
  • Legumes: These foods have about 90 calories, 6 g of protein, less than 10 mg of sodium, 250 mg of potassium, and 100 mg of phosphorus.
    • ⅓ cup of black beans, red kidney beans, black-eye peas, garbanzos, and lentils
    • ¼ cup of green or mature soybeans
  • Dairy: The following foods have about 8 g of protein, an average of 120 mg of sodium, 350 mg of potassium, and 220 mg of phosphorus.
    • 1 cup of milk (fat-free, low-fat, whole, buttermilk, or chocolate milk)
    • 1 cup of low-fat plain or sugar-free yogurt or ice cream
    • ½ cup of pudding or custard
    • Nondairy milk substitutes: These foods have 75 calories, 1 gram of protein, and an average of 40 mg of sodium, 60 mg of potassium, and 60 mg of phosphorus. A serving is ½ cup of almond, rice, or soy milk, or nondairy creamer.
  • Vegetables: The following vegetables are high in potassium. Each serving has more than 250 mg of potassium. A serving is ½ cup, unless another amount is given.
    • Artichoke or ¼ of a medium avocado
    • Brussels sprouts, beets, chard, collard or mustard greens
    • Potatoes, sweet potatoes, pumpkin, and yams
    • ¾ cup of okra
    • Raw tomatoes and low-sodium tomato juice, or tomato sauce
    • Winter squash, cooked asparagus, and cooked spinach
  • Fruit: The following fruits are high in potassium. Each serving has more than 250 mg of potassium.
    • 3 fresh apricots
    • 1 small nectarine (2 inches across)
    • 1 small orange or ½ cup of orange juice
    • ¼ cup of dates
    • ⅛ of a small honeydew melon
    • 1 six-inch banana
    • ½ cup of prune juice or prunes and kiwifruit
  • Fats: Limit unhealthy fats, such as saturated fats, which are listed below.
    • Butter, lard, cream cheese, whipped cream, and sour cream
    • Powdered coffee creamer
  • Other: The following foods are high in sodium.
    • Frozen dinners, soups, and fast foods, such as hamburgers and pizza (see the food label for serving sizes)
    • Table salt and seasoned salts, such as onion or garlic salt
    • Barbecue sauce, ketchup, mustard, soy sauce, steak sauce, and teriyaki sauce
  • Liquids: These liquids have some potassium or phosphorus in them. Avoid these liquids, or drink only small amounts.
    • Colas and pepper-type sodas
    • Beer
    • Hot chocolate and tea
    • Sports drinks
    • These liquids are very high in sodium or potassium and should be avoided.
      • Broth or bouillon
      • Consomme
      • Salt-free broth or bouillon made with salt substitute (potassium chloride)

What other guidelines should I follow?

  • Count foods that contain liquid. Foods that contain liquid must be included in the amount you are allowed to have each day. This includes foods such as soup or gravy. Any food that is liquid at room temperature must also be counted. These foods include gelatin, ice cream, and popsicles.
  • You may need to take a vitamin and mineral supplement. Your dietitian will recommend a vitamin and mineral supplement for you if you need one. Talk with your healthcare provider or dietitian before you take any vitamins, minerals, or herbal supplements. Some types may be harmful.
  • Do not use salt substitutes because they contain potassium. They may cause the potassium levels in your blood to become too high.

When should I contact my healthcare provider?

  • You gain or lose weight very quickly.
  • You have shortness of breath.
  • You feel very weak and tired.
  • You have questions or concerns about the dialysis diet.

Care Agreement

You have the right to help plan your care. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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