Kidney Diet Tips

Probiotics for People on Dialysis

Gut health plays a huge role in how well the body’s immune system works. Poor gut health can cause gastrointestinal (GI) symptoms such as nausea, vomiting, diarrhea and constipation. It can also cause malnutrition and inflammation.

People on dialysis are at an increased risk for poor gut health due to many different factors. Dialysis patients are often prescribed many medications, some of which may cause constipation or diarrhea. Toxic waste buildup in the body and changes in the intestinal lining are also common. Dialysis patients are also at a high risk of infection. Antibiotics may be prescribed to treat an infection, but they kill both good and bad bacteria in the gut. Probiotics are a good way to help replenish the good bacteria in the gut.

What are probiotics?

Probiotics are a type of good bacteria that help keep the gut healthy and working properly. Studies show many benefits of probiotics for dialysis patients such as improved gut health and reduced toxin buildup.1

A recent study found that taking a probiotic supplement for two months significantly improved albumin levels, malnutrition status and quality of life in patients on peritoneal dialysis.1 Intestinal health improved and toxic waste buildup was decreased. Probiotic use was also shown to improve the ability to perform some daily physical and social activities.1

The probiotic supplement in this study contained lactobacilli and bifidobacteria.1 Although studies involving probiotic supplements and patients on hemodialysis have not shown quite the same benefit, probiotics are still recommended for those suffering from GI issues.

Where are probiotics found?

Probiotics can be found in foods like yogurt, kefir, kimchi, sauerkraut and kombucha. However, not all of these foods are good for dialysis patients. This is because they may also contain a lot of potassium, phosphorus or sodium. Some kidney-friendly sources of probiotics for dialysis patients include Greek yogurt (limit to 4 to 6 ounces per day), cottage cheese* (1/2 cup) and tempeh (limit to 2-3 ounces per day). Check out these kidney-friendly recipes from that incorporate these ingredients:

*Not all cottage cheese contains probiotics. Your dietitian can help you find ways to include these probiotic-containing foods into your kidney diet.

Probiotic supplements

Probiotics can also be taken in supplement form. Supplements can be a good option for those who struggle to safely include probiotic-containing foods in their diet. Prices vary between brands and types of bacteria. Probiotic supplements can be purchased without a prescription, but it is always best to speak with your doctor or dietitian before adding any new supplement to your diet.


Pan Y, Yang L, Dai B, Lin B, Lin S, Lin E. Effects of probiotics on malnutrition and health-related quality of life in patients undergoing peritoneal dialysis: a randomized controlled trial. J Ren Nutr. 2021;31(2):199-205.

Additional Kidney Diet Resources

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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.