Dialysis is an artificial way of doing some of the work of the kidneys, but it cannot replace the natural function of the kidneys. If you are on dialysis you need to carefully regulate your kidney diet.
All the information about diet for patients in the early stage of kidney failure apply to dialysis and transplant patients, especially the information on potassium, phosphate, and sodium. No matter what your state of health, you can almost always improve your condition by simple measures such as not smoking, eating healthily, and exercising regularly. Such measures will help you lose weight if you are obese.
Pay special attention to specific aspects of kidney diet and nutrition such as your intake of iron, phosphate and calcium, potassium, protein, sodium, and vitamins, all discussed in this section. Check with your dietitian if you are unsure about any aspect of your renal diet.
Iron
Many people with kidney failure suffer from anemia. One of the causes of anemia is a low level of iron in the body. If you have low iron levels you may need to take medication.
Phosphate and calcium
Phosphate and calcium affect the health of the bones. When a person has kidney failure, the calcium level in their body tends to be too low and the phosphate level too high.
Treatment for kidney patients aims to raise blood calcium levels and lower blood phosphate levels. This can be achieved by moderating the phosphate content of your diet, by adequate dialysis, and by the use of a phosphate binder taken with meals.
However, it is difficult to cut down on phosphate intake without also lowering protein intake.
Potassium
If potassium levels in the blood are too high, the heart can stop beating. Low potassium levels may cause arrythmias.
The dietitian will try to find out if a patient is eating anything that might lead to a high level of potassium. Hemodialysis patients might have to avoid such high-potassium foods as chocolate, and moderate their intake of other potassium-contianing foods such as bananas.
Peritoneal dialysis patients rarely need to restrict their potassium intake.
Protein
Protein is an essential nutrient that enables the body to build muscles and repair itself. It also helps the body to fight infection. The main sources of protein in our diet are meat, fish, dairy products, eggs, and vegetables such as peas, beans, and lentils. Low levels of protein can lead to malnutrition, fluid retention and a reduction in the body's ability to fight infections. When protein is used by the body waste products are formed and enter the blood. One of these wastes is called urea. Normal healthy kidneys are good at getting rid of urea. Failing kidneys are not good at this, but kidney patients should still eat protein.
Sodium
Hemodialysis patients often have greater restrictions on fluid intake than peritoneal dialysis patients, and therefore need to be very careful about salt. This is because a salty diet can make a patient thirsty and may increase blood pressure.
Vitamins
Vitamins B and C are lost during dialysis. Your doctor may prescribe vitamin supplement tablets. You should not take any over-the-counter vitamin supplements unless your doctor has prescribed them.
