WHAT YOU NEED TO KNOW: What is a dialysis diet? Dialysis removes waste from your blood. A dialysis diet also helps to decrease the amount of waste that builds up in your blood. You will need to follow a dialysis diet if you are receiving dialysis treatments. Your dietitian will help you plan a diet with the right amount of nutrients. Your diet may need to 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 the amount of waste that builds up in your blood between treatments. This means you will have to limit potassium, phosphorus, sodium, and liquid in your diet. You will need 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 are losing 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? Your diet will not be as limited as a person who needs hemodialysis, because waste is removed more often with this treatment. You will have 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. The dialysate (dialysis liquid) you receive during treatment contains sugar, which may cause you to gain weight. Your dietitian may want you to decrease the amount of calories you have each day if you gain weight. What foods can I include? Ask your dietitian how much potassium, phosphorus, sodium, liquid, and protein you should have each day. 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. - Starches: These foods have about 2 grams of protein, 90 calories, 80 mg of sodium, 35 mg of potassium, and 35 mg of phosphorus.
- 1 slice 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, English muffin, or small bagel
- ¾ cup of cereal
- ½ cup of cream of rice, cream of wheat, farina, or cooked grits
- ½ cup of cooked pasta (noodles, macaroni, or spaghetti) or cooked rice
- 4 (2-inch) unsalted crackers
- 1½ cups of plain popped popcorn
- 10 unsalted pretzel sticks or 9 tortilla chips
- 10 vanilla wafers or 4 sugar wafers, shortbread cookies, or sugar cookies
- Vegetables: A serving of these foods contains about 1 gram of protein, 25 calories, 15 mg of sodium, and 20 mg of phosphorus. The amount of sodium listed is for vegetables that are canned or prepared with no added salt. One serving is ½ cup, unless another amount is given.
- Low potassium (less than 150 mg):
- Green beans or bean sprouts
- Raw cabbage, cauliflower, eggplant
- Cucumber, onions, or canned corn
- All varieties of lettuce (1 cup)
- 1 small raw carrot or 1 stalk of raw celery
- Fresh and canned mushrooms (Mushrooms have 40 mg of phosphorus or more per serving.)
- Medium potassium (150-250 mg):
- 5 spears of asparagus
- Broccoli or celery
- Mixed vegetables
- Green or snow peas (Peas have 40 mg of phosphorus or more per serving.)
- Summer squash or zucchini
- Fruits: A serving of these foods contains about ½ gram of protein, 70 calories, and 15 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
- Canned pears
- Grapes or grape juice
- Canned peaches or pears
- Pineapple or strawberries
- 1 tangerine
- Watermelon
- Medium potassium (150-250 mg):
- Fresh peaches or pears
- Cherries
- Mango or papaya
- Small grapefruit or grapefruit juice
- Dairy: The following foods have about 4 grams of protein, 120 calories, 80 mg of sodium, 185 mg of potassium, and 110 mg of phosphorus.
- ½ cup of milk (fat free, low-fat, whole, buttermilk, or chocolate milk)
- ½ cup of plain or fruit-flavored yogurt, ice milk, or ice cream
- 1 slice of cheese
- Nondairy milk substitutes: These foods have ½ gram of protein, 140 calories, 40 mg of sodium, 80 mg of potassium, and 30 mg of phosphorus. A serving is ½ cup of nondairy frozen dessert, nondairy frozen dessert topping, or nondairy creamer.
- Meat and other protein foods: These foods have about 7 grams of protein, 65 calories, 25 mg of sodium, 100 mg of potassium, and 65 mg of phosphorus. Do not use salt when you prepare these foods.
- 1 ounce of cooked beef, pork, or poultry
- 1 ounce of any fresh or frozen fish, lobster, shrimp, clams, tuna, unsalted canned salmon, or unsalted sardines
- 1½ ounces of crab or oysters
- 1 large whole egg or 2 large egg whites, or ¼ cup of low-cholesterol egg substitute
- Fats: These foods have very little protein and about 45 calories, 55 milligrams of sodium, 10 milligrams of potassium, and 5 milligrams 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)
- Ice
- Lemonade or limeade
- Water or mineral water
What foods should I limit or avoid? - Starches: The following foods have added sodium and phosphorus.
- 1 small biscuit or muffin
- 2 x 2-inch square of cake
- 1 (4-inch) pancake or waffle
- ½ cup of oatmeal
- ½ cup of whole-wheat cereal or bran cereal
- 1 piece of cornbread
- ¾ ounce of salted pretzel sticks or rings
- 4 sandwich cookies
- Meat and protein foods: The following meats and cheeses are high in sodium.
- 1 ounce of deli-style meat, such as roast beef, ham, or turkey
- 1 ounce of canned salmon or sardines
- ¼ cup of cottage cheese
- Processed cheese, such as American cheese and cheese spreads
- Smoked or cured meat, such as corned beef, bacon, ham, hot dogs, and sausage
- 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 whole avocado
- Brussels sprouts or okra
- Potatoes
- Spinach
- Sweet potato (Sweet potatoes have 40 mg of phosphorus or more per serving.)
- Tomatoes, regular and low-sodium tomato juice, or ¼ cup of tomato sauce
- Winter squash
- Fresh beets
- Fruit: The following fruits are high in potassium. Each serving has more than 250 mg of potassium.
- 1 cup of canned or fresh apricots, or 5 dried 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 small banana
- ½ cup of prune juice or 5 dried prunes
- Fats: Limit unhealthy fats, such as saturated fats, which are listed below.
- 1 teaspoon butter
- 2 tablespoons coconut
- 1 tablespoon powdered coffee creamer
- 1 teaspoon solid shortening
- 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)
- Seasoned salt, such as onion or garlic salt
- Barbecue sauce, ketchup, mustard, and chili sauce
- 2 medium green olives or 3 large black olives
- 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 and wine
- Coffee (regular or decaffeinated)
- Fruit-flavored drinks with added vitamin C
- 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 diet guidelines should I follow? - Also count foods that contain liquid. Some foods contain liquid, such as soup or gravy. This liquid must be included in the amount of liquid that you are allowed to have each day. 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.
What are the risks of a dialysis diet? You may lose interest in eating because foods taste different or because you are not able to eat certain foods. If you do not eat enough, you may lose weight. Your body may not get the calories, protein, and other nutrients you need to be healthy. If you do not follow a dialysis diet, extra waste may build up in your blood. You may retain water and develop swelling. You may also have trouble controlling your blood pressure. The buildup of waste may cause other serious health problems. When should I contact my healthcare provider? - You are gaining or losing weight very quickly.
- You have shortness of breath.
- You feel very weak and tired.
- You have trouble following the dialysis diet.
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