Kidney Diet Tips

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How the dialysis diet affects those with kidney failure (or end stage renal disease)

In addition to cleaning the blood, the kidneys perform other important functions. Loss of kidney function has a direct impact on some important balances in the body. While medicines and dialysis help restore some of the balances, in end stage renal disease, what you eat or don’t eat plays a major role in restoring balance and health.

What kidneys normally do and how the dialysis diet helps the body:

Regulate fluid balance
When kidneys fail excess fluid builds up in the body. On the dialysis diet it is recommended that fluid consumption is limited. In order to control thirst, high-sodium foods are not recommended.

Balance minerals in the blood
Those on dialysis will get routine lab work to check for levels of sodium, potassium, phosphorus and calcium. Based on lab results and trends, the dialysis diet may limit foods with these minerals. Dialysis helps remove excess minerals from the blood to control help reduce levels to a normal range.

Produce hormones that regulate blood pressure and red blood cell production
As kidney function declines, so does the production of hormones that regulate blood pressure and red blood cell production. The dialysis diet is low in sodium to help control blood pressure (and control thirst). In addition to a low-sodium diet, blood pressure medicine may also be prescribed. To stimulate red blood cell production and help prevent anemia, iron supplements and anemia medicines may be prescribed.

Convert vitamin D into its active form
Vitamin D helps keep calcium in balance and bones healthy. When kidneys no longer work, vitamin D is not activated, and phosphorus levels rise which makes calcium go out of balance. This causes calcium to come out of the bones and into the bloodstream. Calcium can mix with phosphorus causing hard deposits in soft tissues such as eyes, skin, heart, lungs and arteries. The dialysis diet is low in phosphorus and phosphorus binders are taken with meals to help keep phosphorus in a normal range. Special-activated vitamin D therapy and careful calcium monitoring help to restore balance and protect bones.

Filter Waste
Some of this waste comes from excess dietary protein the body does not need, and from body cell turnover. People on dialysis need good nutrition so they need to eat protein. (People in the earlier stages of chronic kidney disease may be told to eat less protein to help preserve kidney function, but once dialysis begins the protein requirement increases.) The doctor or renal dietitian will recommend the amount of protein to be eaten on the dialysis diet based on the person’s weight and other factors. While the dialysis diet can be challenging, following the diet and getting good nutrition can help restore the balance the kidneys no longer provide. Most people feel better and become healthier when following the dialysis diet prescribed by their doctor and renal dietitian. Learn more about how the dialysis diet affects the way you feel.

Check out the Diet and Nutrition section on DaVita.com

Sara Colman, RD, CDE

Sara Colman, RD, CDE

Sara is a renal dietitian with over 20 years experience working with people with diabetes and kidney disease. She is co-author of the popular kidney cookbook "Cooking for David: A Culinary Dialysis Cookbook". Sara is currently the Manager of Kidney Care Nutrition for DaVita. She analyzes recipes and creates content, resources and tools for the kidney community. In her spare time Sara loves to spend time with her young grandson, including fun times together in her kitchen.