Top 7 Diet Plan For Dialysis Patients

Top 7 Diet Plan For Dialysis Patients

For dialysis patients or patients suffering from end-stage kidney disease to remain fit because their kidneys are no longer operating at their maximum potential, a healthy diet with the correct amount of proteins, calories, fluids, vitamins and minerals is required.

Key points to remember:

  • Eat the right kind of food and the right amount every day.
  • Take medications as prescribed by the doctor.
  • Do not miss any dialysis session, comply with your dialysis care.
  • Be as engaged as physically as possible.
Dialysis Food

1. Intake of adequate amount of calories

  • It is critical for optimal health and well-being to obtain the right amount of energy (calories).
  • Due to their age, gender, body size, levels of physical activity and medical conditions, the energy needs of every person vary.
  • The dialysate used contains extra calories in the form of carbohydrate (dextrose) in PD (Peritoneal Dialysis) patients. You will need to limit your regular consumption of carbohydrates to avoid excessive intake of calories.
  • Check with your dietician or physician about the calories that dialysate uses.

2. Adequate in protein

  • For the building and repair of muscles, protein is important.
  • The patients with dialysis need a higher protein intake as a certain amount of protein is lost during the process of dialysis (PD and HD).
  • Inadequate intake of protein can lead to weight loss, loss of muscle, reduced infection potential and therefore to malnutrition.
  • Protein can be classified into two categories: high and low quality.
  • The protein of high quality includes meat, poultry, fish, and white eggs.
  • Even high-quality protein is found in most of the dairy products such as Yogurt, milk, cheese and soy products.
  • For patients with dialysis, it is important to maintain the right form and the right amounts of protein.

3. Low amount of phosphorous

  • Blood phosphate levels increase as the kidneys become less effective in removing waste products.
  • Calcium is drawn from the bone as phosphate starts building in the blood. The calcium phosphate compound produces a hard deposit of skin itchiness, joint pain, inflammation of the eye and hardening of blood vessels in the patient’s tissues. The bones of the patient become weak and fragile over time. This causes frequent fractures and discomfort.
  • In patients with prolonged and elevated levels of phosphate, the risk of cardiovascular death by hardening of blood vessels (vascular calcification) is also higher.
  • The amount of phosphate in their diet must be regulated by both HD (Haemodialysis) and PD patients. Dialysis patients are given phosphate binders as this drug helps to decrease the amount of phosphate ingested into their bloodstream from food.
  • Avoid foods that are rich in phosphates like:
    • Dairy products (e.g milk, cheese and yoghurt)
    • Bone-based soups (e.g. pork’s bone and chicken feet)
    • Products of beans (e.g. all kinds of nuts, seeds, soup of beans)
    • Colas
    • Cocoa and associated goods
    • Drinks of malt (e.g. Milo, Ovaltine, Horlick).
    • Processed food and frozen food (e.g. canned meat, sausage, meat patty) 
    • Meats of the organ (e.g. liver, intestine)
    • Canned sardines, anchovies (Ikan Bilis) and dried paste from shrimps 

4. Potassium

  • Potassium is an important type of mineral for nerve and muscular functioning.
  • Potassium must be held safely in the blood. It may be dangerous as it could lead to cardiac arrest if the potassium levels are too low or too high.
  • Some symptoms and signs of low potassium are muscle cramping, difficulty in breathing and irregular heartbeat, whereas high potassium levels can cause muscle weakness, abnormal heart rates, or heart failure in extreme cases.
  • The reduction of potassium in PD is more effective as dialysis happens every day in patients. PD patients are generally not required to restrict their intake of potassium as strictly as HD.
  • The blood may have a high level of potassium which may pose a danger to life in HD patients. HD patients must restrict their dietary consumption of potassium.
  • Potassium is mostly present in nuts, dried beans and dairy products and is primarily found in fruits and vegetables.
  • Other foods with high potassium are:
    • High potassium fruits and vegetables.
    • Cereals, bread and biscuit wholegrain.
    • Nuts, seeds and related products (e.g. chocolate, peanut butter).
    • Coconuts and associated goods (e.g. coconut milk, kaya).
    • All fresh/canned Vegetables and fruit juice, medicinal herbal beverages, tea and coffee, malt, milk and wine.
    • Brown sugar, molasses, syrup, toffees, liquorice.
    • High potassium salt substitute, bottled sauces, chicken meat and extract of vegetables, stock cube.
Potassium rich foods

5. Low in sodium

  • Naturally, sodium is present in all food types and in packaged and processed foods more commonly. Salt is one of the principal sodium sources.
  • Sodium raises thirst and the tendency to drink more fluid.
  • As a result, fluid weight gains occur and thus, blood pressure increases and the heart’s strain is increased.
  • The restriction of sodium in kidney disease helps restore the normal balance of fluids.
  • Sodium intake reduction tips:
    • Limit the salt/sauces that are added in the cooking process.
    • Avoid using stock cubes, vegetables and meat extracts. For instance, Bovril and Marmite.
    • Stop using extracts of bottled chicken.
    • Read labels on packaged foods and select items containing less than 120 mg sodium per 100g of a food product.
    • Reduce canned and processed food intake. Do drain the salt water if you want to use them.
    • To substitute salt/sauces in cooking, use fresh herbs and whole spices.
    • To flavoured food, use fresh lime, lemon juice or vinegar.

Renal patients should be careful of salt substitutes since they are typically rich in potassium and should not be used without the consultation of your doctor or dietitian.

Low Salt food

6. Control in fluids

  • Owing to impaired kidney activity, urine production has been reduced in dialysis patients. For dialysis patients, it is therefore important to respect their fluid limitations.
  • The extra fluid is stored in the body and there may be signs such as difficulty in breathing, high blood pressure and swelling of the legs.
  • In order to assess fluid consumption, patients with PD as well as HD would have to consider their urine production, remaining kidney function and body size.
  • The amount of fluid removed during exchange must also be tracked by PD patients.
  • In between two dialysis sessions, HD patients should maintain a track of weight gain.
  • Depending on the patient’s urine production, the daily fluid intake will vary between 500ml and 1000 ml per day.
  • The daily fluid supply consists of freshwater, tea, coffee, milk, soup and porridge. Certain liquids, such as ice cube, ice cream or jellies, that are liquid at room temperature are often known as fluids.

7. Prevention of Anaemia

  • Anaemia is a common complication of kidney failure in dialysis patients.
  • The kidney develops erythropoietin (EPO), which causes the bone marrow to produce red blood cells. The amount of EPO released will be decreased if the kidney function decreases.
  • Factors causing anaemia in patients with dialysis include:
    • Red blood cell life shortened due to urea toxic accumulation
    • Malnutrition
    • Deficiency of Iron
    • Folate and other vitamins are lacking
    • Hemodialysis causes depletion of blood
  • Anaemia signs include fatigue, exhaustion, dizziness, headache, poor immunity, respiratory failure or shortness of breath, chest pain, decreased appetite and pale appearance.

Top 7 Diet Plan For Dialysis Patients

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