Kidney Diet Tips

Missed Dialysis Treatments and Nutrition

Did you know that dialysis does not replace all of your kidney function? That’s right. Healthy kidneys work 24 hours a day, 7 days a week to clean your blood. Hemodialysis only works about 12 to 16 hours a week – just enough to keep you healthy. Home hemodialysis may be prescribed 5 to 6 days a week for 2 to 3 hours. Because of this, every minute spent on dialysis is important for keeping your blood clean and your body healthy. Missed dialysis treatments can mean trouble.

Your doctor has prescribed a “treatment time” designed specifically for you. This is the right amount of dialysis you need to keep your blood clean. Missed dialysis treatment, whether it’s a few minutes each treatment or an entire treatment altogether, can have serious consequences on your health.

Missing just one treatment may increase your risk of death. (1) In addition to this, missed dialysis treatments may cause shortness of breath, tiredness, nausea, decreased appetite, and confusion. All of these can affect your eating habits and nutrition level.

Watch this video that explains more about missed treatments.


Albumin is a type of protein in your blood. A low albumin level can cause you to feel tired. It can also prevent wounds from healing and make you more likely to get an infection. If you are not eating enough protein or calories, your albumin level may be low. However, even if you eat enough protein and calories, your albumin level may be low if you are missing treatments. Missed dialysis treatments causes extra fluid to build up in your body. Having too much fluid in your body causes your albumin level to go down.

Hemoglobin and Iron

Low hemoglobin or iron levels may cause you to feel tired due to anemia. You may receive important IV medications at your treatment that help maintain your red blood cell count and iron levels. When you miss a treatment, you miss an important dose of these medications.


Potassium helps keep your heart and nerves working well. Having potassium levels that are too high or too low may cause problems with your heart. Even if you follow a low-potassium diet, you still need dialysis to help remove any excess potassium from your blood.


Having a good phosphorus level is important for keeping your bones and heart healthy. Even if you follow a low-phosphorus diet and take phosphate binders, you still need dialysis to help remove any excess phosphorus from your blood.

Calcium, PTH and Vitamin D

Like phosphorus, calcium, parathyroid hormone (PTH) and vitamin D each play an important role in keeping your bones healthy. You may receive important medications at your treatment to help maintain your calcium, PTH and vitamin D levels within a certain range. Missed dialysis treatments will cause you to miss getting these medications.


Dialysis cleans your blood and removes excess fluid from your body. Missing treatments causes this fluid to build up, resulting in swelling, shortness of breath, difficulty sleeping, decreased appetite, and tiredness.

Life Happens!

Your dialysis care team understands that dialysis treatments can sometimes get in the way of other scheduled activities in your life. If you need to miss a treatment, let your dialysis care team know. Your team can help you reschedule your treatment to make sure you get enough dialysis to keep you healthy.



Additional Kidney Diet Resources

Visit and explore these diet and nutrition resources:

DaVita Food Analyzer

DaVita Dining Out Guides

Today’s Kidney Diet Cookbooks

DaVita Kidney-Friendly Recipes

Diet and Nutrition Articles                                                      

Diet and Nutrition Videos

Kidney Smart® Virtual Classes

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.

Natalie Sexton, MS, RDN, CSR, LD

Natalie Sexton, MS, RDN, CSR, LD

Natalie is a registered dietitian and Board Certified Specialist in Renal Nutrition. She has and continues to work in many different healthcare settings including acute care hospitals, LTACHs, nursing homes, private practice, wellness companies, outpatient clinics, research, and writing. She stays busy but loves all of her jobs! When she’s not working, she fills her time with family, friends, pets, gardening, crafting, reading, and learning new hobbies.