Diet With Renal Failure

How to approach a kidney diet

There are two things to know about the dialysis diet: First, it’s different from the food choices you may already be making and second, try not to make too many changes at once. Some people with kidney failure who are on the dialysis diet (also known as a kidney diet) start out focusing on what they “can’t” eat. While there are certainly foods and beverages to avoid, remember that following dialysis nutrition guidelines is a way to take control of your health and have a better quality of life.

Think of the dialysis diet as an opportunity to try new things. Exploring delicious kidney-friendly recipes and sharing them with your family can be fun and enjoyable.

Know the kidney diet differences

A diet prescribed in chronic renal failure and designed to control intake of protein, potassium, sodium, phosphorus, and fluids, depending on individual conditions. Carbohydrates and fats are the principal sources of energy.

Sodium

Sodium is a mineral found in salt (sodium chloride), and it is widely used in food preparation. Salt is one of the most commonly used seasonings, and it takes time to get used to reducing the salt in your diet. However, reducing salt/sodium is an important tool in controlling your kidney disease.

  • Do not use salt when cooking food.
  • Do not put salt on food when you eat.
  • Learn to read food labels. Avoid foods that have more than 300mg sodium per serving (or 600mg for a complete frozen dinner). Avoid foods that have salt in the first 4 or 5 items in the ingredient list.
  • Do not eat ham, bacon, sausage, hot dogs, lunch meats, chicken tenders or nuggets, or regular canned soup. Only eat soups that have labels saying the sodium level is reduced – and only eat 1 cup – not the whole can.
  • Canned vegetables should say “no salt added”.
  • Do not use flavored salts such as garlic salt, onion salt or “seasoned” salt. Also, avoid kosher or sea salt.
  • Be sure to look for lower salt or “no salt added” options for your favorite foods such as peanut butter or box mixes.
  • Do not purchase refrigerated or frozen meats that are packaged “in a solution”; or pre-seasoned/flavored. These items are usually chicken breasts, pork chops, pork tenderloin, steaks, or burgers.

Potassium

Potassium is a mineral involved in how muscles work. When kidneys do not function properly, potassium builds up in the blood. This can cause changes in how the heart beats, possibly even leading to a heart attack. Potassium is found mainly in fruits and vegetables; plus milk and meats. You will need to avoid certain ones and limit the amount of others.

Potassium-rich foods to avoid:

  • Melons such as cantaloupe and honeydew (watermelon is okay)
  • Bananas
  • Oranges and orange juice
  • Grapefruit juice
  • Prune juice
  • Tomatoes, tomato sauce, tomato juice
  • Dried beans – all kinds
  • Pumpkin
  • Winter squash
  • Cooked greens, spinach, kale, collards, Swiss Chard

Other foods to avoid include bran cereals, granola, “salt substitute” or “lite” salt, molasses. Potatoes and sweet potatoes need special handling to allow you to eat them in SMALL amounts. Peel them, cut them in small slices or cubes and soak them for several hours in a large amount of water. When you are ready to cook them, pour the soaking water off and use a large amount of water in the pan. Drain this water before you prepare them to eat.

Be sure to eat a wide variety of fruits and vegetables every day to avoid getting too much potassium.

Phosphorus

Phosphorus is another mineral that can build up in your blood when your kidneys don’t work properly. When this happens, calcium can be pulled from your bones and can collect in your skin or blood vessels. Bone disease can then become a problem, making you more likely to have a bone break.

  • Dairy foods are the major source of phosphorus in the diet, so limit milk to 1 cup per day. If you use yogurt or cheese instead of liquid milk – only one container OR 1 ounce a day!
  • Some vegetables also contain phosphorus. Limit these to 1 cup per WEEK: dried beans, greens, broccoli, mushrooms, and Brussels sprouts.
  • Certain cereals need to be limited to 1 serving a week: bran, wheat cereals, oatmeal, and granola.
  • White bread is better than whole grain breads or crackers.
  • Soft drinks contain phosphorus so only drink clear ones. Do not drink Mountain Dew® (any kind), colas, root beers, Dr. Pepper® (any kind). Also, avoid Hawaiian Punch®, Fruitworks®, Cool® iced tea, and Aquafina® tangerine pineapple.
  • Beer also has phosphorus – avoid all kinds.
Pre-Dialysis Diet Dialysis Diet Diet Tip
Fluid Fluid, which can be found in everything from beverages to fruit and vegetables, is usually not restricted at this point. Most people on dialysis need to limit fluid intake to 4-8 cups a day. Frozen grapes, lemon wedges, mouthwash rinses and ice help decrease thirst.
Potassium You likely won’t be on a restricted potassium diet unless your blood levels are high. Your type of treatment and personal lab results will determine if a low-potassium diet is needed. Limit common potassium sources such as bananas, oranges, potatoes, tomato products, avocado, yogurt and nuts.
Phosphorus If labs show you have high phosphorus levels, you may be eating less dairy, nuts, legumes, meat and soy. People on dialysis generally continue to limit foods high in phosphorus and often take phosphate binders to keep levels in a healthy range. Read food labels closely and look for phosphate additives that can add a significant amount to your daily intake.
Sodium You’re probably limiting your sodium intake to around 1,500 mg a day—choosing fresh foods over processed, picking low-sodium products and eating fewer fast foods. Your new daily target could be from 1,000 mg to 3,000 mg depending on your treatment type. You’ll still want to continue eating fresh, low-sodium, home-cooked meals. Discover a whole new world of low-sodium flavors with herbs, spices, vinegar and flavored oils.
Protein As kidney function declines, you may be eating less protein to minimize protein-related waste buildup in your blood. A low-protein diet is no longer needed. In fact, people on dialysis need to eat extra protein to replace some lost during dialysis. Choose at least half of your protein from high-quality sources, such as meat, seafood, poultry and eggs.

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