When you start hemodialysis, you must make many changes in your life. Watching the foods you eat will make you healthier. This article will help you choose the right foods.

Food gives you energy and helps your body repair itself. Food is broken down in your stomach and intestines. Your blood picks up nutrients from the digested food and carries them to all your body cells. These cells take nutrients from your blood and put waste products back into the bloodstream. When your kidneys were healthy, they worked around the clock to remove wastes from your blood. The wastes left your body when you urinated. Other wastes are removed in bowel movements.

Now your kidneys have stopped working. Hemodialysis removes wastes from your blood. But between sessions, wastes can build up in your blood and make you sick. You can reduce the amount of wastes by watching what you eat and drink. A good meal plan can improve your dialysis and your health.

Your clinic has a dietitian to help you plan meals.
A dietitian specializes in food and nutrition. A dietitian with special training in care for kidney health is called a renal dietitian.

What do I need to know about Fluids

You already know you need to watch how much you drink. Any food that is liquid at room temperature also contains water. These foods include soup, Jell-OŽ, and ice cream. Many fruits and vegetables contain lots of water, too. They include melons, grapes, apples, oranges, tomatoes, lettuce, and celery. All of these foods add to your fluid intake. 
Fluid can build up between dialysis sessions, causing swelling and weight gain. The extra fluid affects your blood pressure and can make your heart work harder. You could get serious heart trouble from overloading your system with fluid. 

Control your thirst!

You can keep your fluids down by drinking from smaller cups or glasses. Freeze juice in an ice cube tray and eat it like a popsicle. (Do not forget to count the popsicle in your fluid allowance!) The dietitian will be able to give you other tips for managing your thirst. 


Your dry weight is your weight after a dialysis session when all of the extra fluid in your body has been removed. If you let too much fluid build up between sessions, it is harder to get down to your proper dry weight. Your dry weight may change over a period of 3 to 6 weeks. Talk to your doctor regularly about what your dry weight should be. Even though you are on hemodialysis, your kidneys may still be able to remove some fluid. Or your kidneys may not remove any fluid at all. That is why every patient has a different daily allowance for fluid. Talk to your dietitian about how much fluid you can have each day.

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What do I need to know about Potassium

Potassium is a mineral found in many foods, especially milk, fruits, and vegetables. It affects how steadily your heart beats. Healthy kidneys keep the right amount of potassium in the blood to keep the heart beating at a steady pace. Potassium levels can rise between dialysis sessions and affect your heartbeat. Eating too much potassium can be very dangerous to your heart. It may even cause death.

To control potassium levels in your blood, avoid foods like avocados, bananas, kiwis, and dried fruit, which are very high in potassium. Also, eat smaller portions of other high-potassium foods. For example, eat half a pear instead of a whole pear. Eat only very small portions of oranges and melons. 

Dialyzing potatoes and other vegetables
You can remove some of the potassium from potatoes and other vegetables by peeling them, then soaking them in a large amount of water for several hours. Drain and rinse before cooking. Your dietitian will be giving you more specific information about the potassium content of foods. 

Make a food plan that reduces the potassium in your diet. Start by noting the high-potassium foods (below) that you now eat. A dietitian can help you add other foods that are not on the list.
Kiwi fruit
Lima beans
Prune Juice

Brussel sprouts
Winter Squash

Pears (fresh)
Orange juice

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What do I need to know about Phosphorous

Phosphorus is a mineral found in many foods. If you have too much phosphorus in your blood, it pulls calcium from your bones. Losing calcium will make your bones weak and likely to break. Also, too much phosphorus may make your skin itch. Foods like milk and cheese, dried beans, peas, colas, nuts, and peanut butter are high in phosphorus. Usually, people on dialysis are limited to 1/2 cup of milk per day. The renal dietitian will give you more specific information regarding phosphorus.

You probably will need to take a phosphate binder like PhosLo, Tums, or calcium carbonate to control the phosphorus in your blood between dialysis sessions. These medications act like sponges to soak up, or bind, phosphorus while it is in the stomach. Because it is bound, the phosphorus does not get into the blood. Instead, it is passed out of the body in the stool.


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What do I need to know about Protein

Before you were on dialysis, your doctor may have told you to follow a low-protein diet. This is changed now. Most people on dialysis are encouraged to eat as much high-quality protein as they can. The better nourished you are, the healthier you will be. You will also have greater resistance to infection and recover from surgery more quickly

Protein helps you keep muscle and repair tissue. In your body, protein breaks down into a waste product called urea. If urea builds up in your blood, you can become very sick. Some sources of protein produce less waste than others. These are called high-quality proteins. High-quality proteins come from meat, fish, poultry, and eggs (especially egg whites). Getting most of your protein from these sources can reduce the amount of urea in your blood.

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What do I need to know about Sodium

Sodium is found in salt and other foods. Most canned foods and frozen dinners contain large amounts of sodium. Too much sodium makes you thirsty. Then, if you drink more fluid, your heart has to work harder to pump the fluid through your body. Over time, this can cause high blood pressure and congestive heart failure.
Do not use salt substitutes because these contain potassium. Talk to a dietitian about other spices for your food. The dietitian can help you find spice blends without sodium or potassium.

Try to eat fresh foods that are naturally low in sodium. Look for products labeled low sodium.

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What do I need to know about Calories

Calories provide energy for your body. If your doctor recomends it, you may need to cut down on the calories you eat. A dietitian can help you plan ways to cut calories in the best possible way.

But some people on dialysis need to gain weight. You may need to find ways to add calories to your diet. Vegetable oils--like olive oil, canola oil, and safflower oil--are good sources of calories. Use them generously on breads, rice, and noodles.

Butter and margarines are rich in calories. But these fatty foods can also clog your arteries. Use these less often. Soft margarine that comes in tubs is better than stick margarine. Vegetable oils are the healthiest way to add fat to your diet if needed.

Hard candy, sugar, honey, jam, and jelly provide calories and energy without clogging arteries or adding other things that your body does not need. If you have diabetes, be very careful about eating sweets. A dietitian's guidance is very important for people with diabetes.

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Should I take Vitamins & Minerals

Vitamins and minerals may be missing from your diet because you have to avoid so many foods. Your doctor may prescribe a vitamin and mineral supplement like Nephrocaps.

Warning: Do not take vitamins that you can buy off the store shelf. These may contain vitamins or minerals that are harmful to you. Only take vitimains prescribed by your doctor.

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Owes and Church's Food Values of Portions Commonly Used. Seventeenth Edition.
Jean A. T. Pennington. J. P. Lippincott Co. 1997.
ISBN: 0-397-55435-4.

The Complete Book of Food Counts. Fourth Edition.
Corinne T. Netzer. Dell Publishing Co. 1997.
ISBN: 0-440-22110-2.


These cookbooks provide recipes for people on dialysis:

The Renal Gourmet. Mardy Peters
Emenar Inc.
320 Charmille Lane
Wood Dale, IL 60191
ISBN: 0-9641730-0-X
Phone: 1-800-445-5653

Southwest Cookbook for People on Dialysis
Developed by the El Paso Chapter Council on Renal Nutrition and the National Kidney Foundation of Texas, Inc.
Published by a grant from Amgen Inc.
Cookbooks are available from the
National Kidney Foundation of Texas
13500 Midway Road, Suite 101
Dallas, TX 75244
Phone: (972) 934-8057

Charts and posters

Kidney HELPER Potassium Guide,
Kidney HELPER Phosphorus Guide.
(Chart or poster)
Available from Consumer MedHelp
94 New Salem Street, Suite 104
Wakefield, MA 01880-1906
Phone: 1-800-556-7117 or (617) 246-7700
Fax: (617) 246-3086

Picture Renal Diet. (Poster)
Available from University Hospital, Food and Nutrition Services
619 South 19th Street, Birmingham, AL 35233
Phone: (205) 934-8055


Nutrition and Hemodialysis,
How To Increase Calories in Your Renal Diet.

National Kidney Foundation.
30 East 33rd Street, New York, NY 10016.
Phone: 1-800-622-9010 or (212) 889-2210.

Creative Cooking for Renal Diets
Creative Cooking for Renal Diabetic Diets
Cleveland Clinic Foundation
Senay Publishing
P.O. Box 397
Chesterland, OH 44026
ISBN: 0-941511-00-6
Phone: (440) 256-4435

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