Dialysis

Dialysis

Healthy kidneys remove waste from your blood and produce hormones your body needs. If your kidneys fail, you either need a kidney transplant or dialysis. Dialysis is a procedure that uses a machine to perform many of the functions of the kidney. Dialysis can help prevent problems resulting from kidney failure and it allows people with kidney failure to live productive lives. Dialysis filters your blood, and like a health kidney, removes waste from your blood. Patients using dialysis are also required to follow a strict diet in order to stay healthy. There are two types of dialysis: hemodialysis and peritoneal dialysis. There are different advantages and disadvantages with both hemodialysis and peritoneal dialysis. Talk to your doctor about which type of dialysis would work better for you.

Recently Answered

  • 1 Answer
    A
    The following important tips can be helpful with your diet if you are on hemodialysis:
    • 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.
  • 1 Answer
    A
    If you are on hemodialysis, you have some very special dietary 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 dialysis care team will monitor your labs closely to identify changes in your blood protein levels (albumin), phosphorus, and potassium. A change in albumin can mean that you are losing body protein. High or low levels of phosphorus or potassium can be dangerous.

    In addition, some special blood tests that are done each month are called Kt/V 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.
  • 1 Answer
    A
    The following is a sample menu if you are on hemodialysis:

    Breakfast
    • Cranberry juice, 4 ounces
    • Eggs (2) or 1/2 cup egg substitute
    • Toasted white bread, 2 slices, with butter or tub margarine or fruit spread
    • Coffee, 6 ounces
    Lunch
    • Tuna salad sandwich made with 3 ounces tuna on a hard roll with lettuce and mayonnaise (Other good choices for sandwiches include egg and chicken salad, lean roast beef, low-salt ham and turkey breast.)
    • Coleslaw, 1/2 cup
    • Pretzels (Salt-free or low-salt varieties)
    • Canned and drained peaches, 1/2 cup
    • Ginger ale, 8 ounces (Cola drinks are high in phosphorus. Choose ginger ale or lemon-lime beverages instead.)
    Dinner
    • Hamburger patty, 4 ounces on a bun with 1-2 teaspoons ketchup
    • Salad (1 cup): lettuce, cucumber, radishes, peppers, with olive oil and vinegar dressing
    • Lemonade, 8 ounces
    Aim for at least 2-3 fish meals each week. Many fish are rich in heart-healthy omega-3 fats. Tuna and salmon (rinsed or canned without salt) and shellfish are excellent heart-healthy protein choices.

    Snack/Dessert
    • Milk, 4 ounces
    • Slice of apple pie
    This meal plan provides 2,150 calories, 91 grams protein, 2,300 milligrams (mg) sodium, 1,800 mg (46 mEq) potassium, 950 mg phosphorus and 38 ounces of oral fluid.
  • 1 Answer
    A
    Depending on your calorie needs, your dietitian may recommend high-calorie desserts if you are on hemodialysis. In general pies, cookies, sherbet and cakes are good choices, but limit dairy-based desserts and those made with chocolate, nuts and bananas. If you have diabetes, discuss low-carbohydrate dessert choices with your dietitian.
  • 1 Answer
    A
    All vegetables have some potassium, but certain vegetables have more than others and should be limited or totally avoided if you are on hemodialysis. Limiting potassium intake protects your heart.
     
    Limit or avoid the following vegetables:
    • Potatoes (including french fries, potato chips and sweet potatoes)
    • Tomatoes and tomato sauce
    • Winter squash
    • Pumpkin
    • Asparagus
    • Avocado
    • Beets
    • Beet greens
    • Cooked spinach
    • Parsnips and rutabaga
  • 1 Answer
    A
    All fruits have some potassium, but certain fruits have more than others and should be limited or totally avoided if you are on hemodialysis. Limiting potassium protects your heart.

    Limit or avoid the following fruits:
    • Oranges and orange juice
    • Kiwis
    • Nectarines
    • Prunes and prune juice
    • Raisins and dried fruit
    • Bananas
    • Melons (cantaloupe and honeydew)
    • Star fruit (carambola) -- always avoid this fruit.
  • 1 Answer
    A
    All vegetables have some potassium, but certain vegetables have more than others and should be limited or totally avoided if you are on hemodialysis. Limiting potassium intake protects your heart. 

    Eat 2-3 servings of low-potassium vegetables each day. One serving equals 1/2 cup.

    The following are good, low-potassium vegetables:
    • Broccoli (raw or cooked from frozen)
    • Cabbage
    • Carrots (cooked)
    • Cauliflower
    • Celery
    • Cucumber
    • Eggplant
    • Garlic
    • Green and wax beans (string beans)
    • Lettuce, all types (1 cup)
    • Onion
    • Peppers, all types and colors
    • Radishes
    • Watercress
    • Zucchini and yellow squash
  • 1 Answer
    A
    All fruits have some potassium, but certain fruits have more than others and should be limited or totally avoided if you are on hemodialysis. Limiting potassium protects your heart.

    Eat 2-3 servings of low-potassium fruits each day. One serving equals 1/2 cup of fruit, 1 small fruit or 4 ounces of juice.

    The following are good examples of low-potassium fruits and fruit drinks:
    • Apple (1)
    • Berries (1/2 cup)
    • Cherries (10)
    • Fruit cocktail, drained (1/2 cup)
    • Grapes (15)
    • Peach (1 small fresh or canned, drained)
    • Pear, fresh or canned, drained (1 half)
    • Pineapple (1/2 cup canned, drained)
    • Plums (1-2)
    • Tangerine (1)
    • Watermelon (1 small wedge)
    • Apple cider
    • Cranberry juice cocktail
    • Grape juice
    • Lemonade
  • 1 Answer
    A
    If you're starting on hemodialysis, dairy foods that are low in phosphorus include:
    • Butter and tub margarine
    • Cream cheese
    • Heavy cream
    • Ricotta cheese
    • Brie cheese
    • Non-dairy whipped topping
    • Sherbet
    Note, however, that if you have or are at risk for heart disease, some of the high-fat foods listed above may not be good choices for you.

    Certain brands of non-dairy milk (such as rice milk) and cream are low in phosphorus and potassium. Ask your dietitian for details.
  • 1 Answer
    A
    If you are on hemodialysis, limit your intake of milk, yogurt and cheese to 1/2 cup milk or 1/2 cup yogurt or 1 ounce cheese per day. Most dairy foods are very high in phosphorus.

    Please note that the phosphorus content is the same for all types of dairy milk -- skim, low fat and whole. It's also important to remember to take your phosphate binders with every meal or snack.