Meal Planning
In-center hemodialysis replaces some—but not nearly all—of your kidney function. In addition to your dialysis treatments, a key part of staying healthy is following the meal plan you and your dietitian set up. Most people on nocturnal in-center hemodialysis have few limits and a normal or near-normal diet as long as they stay for the full treatment. If you choose standard in-center hemodialysis, you will need to be more careful about food choices.
Your dietitian will work with you to help you make a meal plan that meets your health needs and includes as many as possible of your favorite foods. Kidney friendly cookbooks and recipes, as well as shopping tips, will be provided to keep your meals pleasant and interesting. The exact details will depend on whether you are still making some urine and on the results of your blood tests. Here are some parts of your diet that you’ll be learning about:
- Fluid – Dialysis treatments will remove some fluid. If your treatments remove all your excess fluid (most likely with nocturnal hemodialysis), you may not need much of a fluid limit. If you do standard treatments, you will have strict fluid limits to protect your health and your heart. “Fluids” include foods that are liquid at room temperature, such as ice cream and popsicles. Your dietitian can give you tips to control your fluid intake. You can also get information at Controlling Fluids.
- Calories – Most people on hemodialysis have a hard time gaining “real” weight. If you’re underweight or overweight, your dietitian can help. Healthy food choices and a good meal plan can help you have the energy and be the weight that is best for you. Whether you need to gain or lose weight, getting more exercise can help your appetite and firm your muscles.
- Protein – Foods with protein (such as beef, pork, chicken, fish, soy, or eggs) help your body build and repair tissues, and fight infection. On hemodialysis, you lose a little protein with each treatment, which makes it important that you eat enough protein in your diet. You’ll get a blood test each month for serum albumin, a form of protein. If your level is not 4.0g/dL or higher, your dietitian may suggest that you eat more protein, or even add a tasteless protein powder to your food.
- Potassium – Potassium maintains nerve and muscle function in your body, including your heart. It is very critical that the levels of potassium in your blood stay in your healthy range. If they are too high or too low, it can stop your heart or cause muscle weakness, numbness, hallucinations, and other problems. When you do hemodialysis, you will have days off between dialysis treatments, so extra potassium can build up in your body. You’ll have a blood test each month to check your potassium level. If it’s too low or high, your dietitian may suggest that you eat more or less of foods that are high in potassium. For more information on controlling potassium in your diet, click here.
- Phosphorus – A mineral needed for healthy bones and energy. It is present in nearly all foods. You’ll have a blood test each month to check your phosphorus level. Healthy kidneys remove extra phosphorus but dialysis doesn’t remove as much, so with kidney failure, your phosphorus levels may be too high. If this happens, in the short run you might notice severe itching. In the long run, your bones can become weak and your blood vessels become stiff. In most cases, people on standard hemodialysis will need to take pills called “phosphate binders.” People on nocturnal hemodialysis may need them, too. These pills, taken with meals and snacks, bind with phosphorus and remove it in your stool. You can get more information in the Managing Your Diet section.
- Sodium – Salt contains sodium, which helps to control fluid levels in your body. If you eat too much salt, you’ll be thirsty and may drink too much fluid. This can lead to swelling and high blood pressure. For tips on controlling sodium, click here.
When you eat well, you are helping yourself stay healthy. Not eating well will cause you to become weak, break down your muscles for protein, and become malnourished. Malnutrition is linked to a higher risk of infection, hospitalization and even death. If changes occur in your taste or appetite, teeth or gums, or health in general, talk with your dietitian to make changes to your meal plan. Your dietitian will be happy to work with you to make a meal plan you can follow and enjoy.
