Renal diet for hemodialysis patients

Having a renal diet does not only help you with your renal failure but it also helps you to feel better. Renal diet can be complicated and hard to follow at some times. However, it does not mean one cannot enjoy their meal.  Hemodialysis patients can still have the privilege of dining out by following some simple guidance. The main minerals that a hemodialysis patient will have to cut down on are phosphorus, potassium, sodium and fluid intake. Cutting down on these minerals will avoid further complication of your disease such as fluid overload, high blood potassium, high blood pressure and bone disease.

How does it help?

Phosphorus

Phosphorus is a waste product that will be eliminated by the kidney through urine. In renal failure patients, phosphorus will build up in the blood. Hence, the body will try to balance back the phosphorus and calcium ratio by ‘stealing’ it from the bone, which later on causes bone disease.

Phosphate binders are often prescribed by the doctor to reduce the absorption of phosphate from food. These phosphate binders are taken with meals. Below is a list of foods that are high in phosphate that one should control the intake:

•   Food high in phosphate
  • Beans
  • Chocolate
  • Dark, whole or unrefined grains
  • Dried vegetables and fruits
  • Dark coloured sodas

Potassium

Potassium is another important mineral that helps the muscles and heart work properly. Healthy kidneys will remove potassium as one of their waste. Therefore, patients with kidney failure will have a vice-versa effect. This will cause potassium to build up in our blood resulting in irregular heartbeat.

Renal patient should limit their potassium intake to 2000mg per day. Most of the foods contain potassium. However, some contain larger amount. Following are some foods that are high in potassium:

• Bananas
• Honeydew melon
• Orange
• Chocolate
• Tomato
• Milk
• Nuts
• Papaya
• Prunes

Sodium

Sodium or table salt (sodium chloride) affects blood pressure and water balance of living organisms. When the kidney fails to function, it doesn’t not regulate the sodium content in our body properly thus resulting in high blood pressure. If sodium is taken in excess, one will feel thirsty and it will be more difficult for one to restrict fluid in their diet.

Hemodialysis patient can limit their sodium intake by avoiding:

• table salt and any other salty seasonings
• any salt substitutes because they may contain potassium
• processed meat such as bacon, ham and canned meats
• salty snacks such as chips and salted nuts
• instant food such as canned food, frozen dinner and instant noodles
• bottle sauce, MSG and preserved food such as pickles, olives and pickled cucumber

Fluid intake

Hemodialysis patients normally have decreased output of urine. Therefore, controlling one’s fluid will decrease unnecessary pressure and stress on the lungs and heart.

Fluid intake of a patient on dialysis is calculated by adding the total urine output and additional 500 mL of liquid. The 500 mL covers fluid loss by perspiration from the skin and lungs. Food consumed that melts into liquid state at room temperature (25°C) is also considered as fluid. -dietitians.org.my