By Ann Mader, Dietitian
How do you feel you are currently eating? Healthy eating is more important when you are on dialysis than if you are not. Your dietitian can help.
Although you may hear your dietitian referred to as the "food police," we want your diet to work for you, and we will help you with an individualized meal plan. Your diet may consist of adjustments in one or more of the following areas: calories, protein, sodium, potassium, phosphorus and fluids.
Calories come from the food you eat in the form of carbohydrate, protein, and fat. Eating the right amount of calories can help you maintain a healthy weight and vive you energy to enjoy your daily activities. For people on peritoneal dialysis, there is dextrose (a form of sugar) in the dialysate solution that is absorbed during dwells which provides extra calories. If you are gaining or losing weight, an adjustment in your meal plan may be needed.
Protein is needed for the body to build muscles repair tissue and fight infections, all forms of dialysis require you to eat more protein because it is lost during the dialysis process. Protein rich foods include meat (fish, chicken, beef, pork), eggs, and milk products (limited due to their high phosphorus content). Soy products are also a good source of protein. Check with your dietitian about eating this and other non-animal sources of protein.
Sodium is a mineral found naturally in almost all foods to a certain extent. Eating processed foods and adding salt to your foods will result in more sodium than is recommended for you. Excess sodium intake can cause increased thirst, fluid intake, shortness of breath, high blood pressure and more work o your heart. Example of foods high in sodium includes ham, soup, pickles, chips, sauerkraut, soy sauce and vegetable juice. To lower the sodium content of your diet, make foods from scratch, use herbs and spices in place of salt and avoid eating out too often.
Potassium is another important mineral found in foods. It helps your heart and muscles work properly. Too much or too little potassium intake can be dangerous. When the kidneys no longer get rid of the excess potassium in the blood, it is retained and levels can get too high. Dialysis can regulate potassium levels to a certain extent but it is important for you to not eat too much within a short period of time. Foods that contain large amounts of potassium include fruits such as bananas, oranges, cantaloupe and honeydew melon, vegetables such as potatoes, tomatoes, spinach and winter squash. Other foods high in potassium include milk, avocados, nuts and seeds and dry beans and pees. Some salt substitutes contain potassium chloride. Be sure to check labels for this ingredient.
Phosphorus is another mineral found in many foods. It is very difficult to limit your phosphorus intake to the recommended amount due to higher protein needs for dialysis. All protein foods contain phosphorus. Therefore, a phosphate binder (calcium supplements, Renagel) is needed for you to take with meals to help prevent the absorption of this mineral in to the blood stream. Foods very high in phosphorus include milk products, nuts and seeds, dry beans and peas, chocolate and cola drinks. Elevated phosphorus levels in the blood can result in a number of problems including bone disease and heart problems.
Fluid intake may also need to be limited. Since the damaged kidneys can no longer get rid of the excess fluid you take in, it is retained and you can gain too much fluid weight between treatments. It is hard on your body to take this fluid off during your dialysis treatment. Limiting the amount of salty foods or sodium can help regulate how much you drink (see sodium above). Examples of fluids include water, milk, ice, sherbet, soup, gelatin, juices and soda.
Eating well can help you feel better and hopefully enjoy a healthier lifestyle. Meet with your dietitian to discuses your diet so that you can eat the foods you like and still keep safe. We realize that eating is an important part of life and we went you to enjoy every bite of it.
Facts to Chew On
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