Proper nutrition for dialysis patients
Eating a balanced diet with the right amount of protein, calories, fluids, vitamins and minerals is essential for people on dialysis or those with end-stage kidney disease to stay fit because their kidneys are no longer fully functional.
- Eat the right type and amount of food every day.
- Take the medications prescribed by your doctor.
- Stick to your dialysis treatment, for example do not skip dialysis sessions.
- Be as physically active as possible.
Get the right amount of calories
- Getting the right amount of energy (calories) is important for overall health and well-being.
- The energy needs of each person are different based on age, gender, height, physical activity and health status.
- For PD patients: The dialysate used supplies additional calories in the form of carbohydrates (dextrose). You may need to reduce your daily carbohydrate intake to prevent excess calorie intake.
- Ask your nutritionist or doctor about the calories provided by the dialysis product you are using.
Sufficient in protein
- Protein is essential for muscle building and muscle repair.
- Dialysis patients require a higher protein intake, since a certain amount of protein is lost during dialysis treatment (PD and HD).
- Inadequate protein intake can lead to weight loss, muscle breakdown, reduced ability to fight infection and thus malnutrition.
- Proteins can be divided into two categories: high quality and low quality.
- Quality proteins include meat, poultry, fish and egg whites.
- Most dairy products such as yogurt, milk, cheese and soy products also contain high-quality protein.
- Getting the right type and amount of protein is critical for dialysis patients to stay healthy.
Great!Protein foods contain phosphates. Dialysis patients must take their phosphate binders with ALL meals.
Low phosphorus content
- Because the kidneys are less efficient at filtering waste, blood phosphate levels rise.
- When phosphate begins to accumulate in the blood, calcium is removed from the bones. The calcium phosphate product forms hard deposits in the patient's tissues, resulting in itchy skin, joint pain, eye irritation and hardening of the patient's blood vessels. Over time, patients' bones become weak and brittle. This leads to fractures and constant pain.
- Patients with persistently high phosphate levels are also at increased risk of cardiovascular death due to hardening of the blood vessels (hardening of the blood vessels).
- Both HD and PD patients need to control the amount of phosphate in their diet. Phosphate binders are prescribed for patients undergoing hemodialysis because this drug helps reduce the amount of phosphate absorbed from food into the bloodstream.
- Avoid foods high in phosphate such as:
- Dairy products (e.g. milk, cheese, yogurt)
- Bone soups (such as chicken feet and pork thighs)
- Bean products (e.g. all types of nuts, seeds, bean paste)
- Cocoa and related products
- Malt beverages (e.g. Milo, Horlicks, Ovaltine)
- Processed and canned foods (eg, canned meats, sausages, steaks)
- Organ meat (e.g. liver, intestines)
- Canned sardines, anchovies (Ikan Bilis) and dried shrimp paste
- Potassium is a metal that is important for nerve and muscle function.
- Potassium must be kept at safe levels in the blood. If potassium levels are too low or too high, it can be dangerous as cardiac arrest may occur.
- Some signs and symptoms of low potassium include muscle cramps, trouble breathing, and an irregular heartbeat, while high potassium can cause muscle weakness, an abnormal heart rhythm, and in extreme cases, heart failure.
- In Parkinson's disease, potassium removal is more efficient because patients are on dialysis daily. In general, Parkinson's patients do not need to limit their potassium intake as much as HD patients.
- In HD patients, high levels of potassium in the blood can occur and be life-threatening. HD patients should limit potassium intake in their daily diet.
- Potassium is found primarily in fruits and vegetables, with significant amounts in nuts, dried beans, and dairy products.
- Other high-potassium foods include:
- Fruits and vegetables from the group with the highest potassium content.
- Whole grains, bread and biscuits.
- Nuts, seeds and related products (e.g. chocolate, peanut butter).
- Coconuts and related products (e.g. coconut milk, kaya).
- All canned fresh fruit and vegetable juices, herbal medicines, strong tea/coffee, cocoa and malt liqueur, milk, wine.
- Brown Sugar, Molasses, Maple Syrup, Candies, Licorice.
- High Potassium Salt Substitutes, Bottled Sauces, Meat & Vegetable Extract, Chicken Broth, Stock Cubes.
suggestion!You can reduce the potassium content of vegetables by soaking chopped vegetables in water for at least 2 hours.
- Sodium occurs naturally in all types of food and is most common in packaged and processed foods. Salt is one of the most important sources of sodium.
- Sodium increases thirst and increases the urge to drink more fluids.
- This leads to a liquid weight gain and, as a result, to an increase in blood pressure and an increased load on the heart.
- Sodium restriction in kidney disease helps maintain normal fluid balance.
- Tips for Reducing Sodium Intake:
- Limit the amount of salt/sauces you add during cooking.
- Avoid using bouillon cubes, meat and vegetable extracts such as Bovril and Marmite.
- Avoid using bottled chicken extracts.
- Read labels on processed foods and choose products that contain less than 120 mg of sodium per serving. 100g of feed.
- Minimize consumption of canned and processed foods. If you want to use them, drain the brine.
- Use fresh herbs and whole spices as a substitute for salt/sauces when cooking.
- Use fresh lime, lemon juice or vinegar to flavor the food.
People with kidney disease should be careful with salt substitutes as they are often high in potassium and should not be taken without consulting your doctor or nutritionist.
- Due to the reduced kidney function, dialysis patients experience reduced urine excretion. It is therefore important for dialysis patients to adhere to their fluid restriction.
- Excess fluid is left in the body and symptoms such as shortness of breath, high blood pressure and swollen legs can occur.
- Both PD and HD patients should consider urine output, residual kidney function, and height to determine fluid intake.
- PD patients should also monitor the amount of fluid withdrawn during an exchange.
- HD patients can track weight gain between two dialysis sessions as a counter.
- Daily fluid intake can vary from 500 mL to 1,000 mL per day, depending on the patient's urine output.
- The daily amount of liquid includes plain water, tea, coffee, milk, sauce, soup and porridge. Other liquids that are liquid at room temperature, such as ice cubes, ice cream, jelly, are also considered liquids.
Great!Dialysis patients should follow the fluid regimen established by your nurse, nutritionist or doctor.
- Anemia is common in dialysis patients as it is one of the complications of kidney failure.
- Erythropoietin (EPO), which stimulates the production of red blood cells in the bone marrow, is produced by the kidneys. As kidney function declines, the amount of EPO produced decreases.
- Other factors that cause anemia in dialysis patients include:
- Shortened lifespan of red blood cells due to accumulation of toxic urea
- iron deficiency
- Lack of folic acid and other vitamins
- Blood loss during hemodialysis
- Symptoms of anemia include fatigue, weakness, dizziness, headache, weakened immunity, shortness of breath or shortness of breath, chest pain, decreased appetite, and looking pale.
suggestion!Adequate intake of protein, iron, vitamin C, vitamin B12, and folic acid are important for preventing and treating anemia because these nutrients are important building blocks for the production of new red blood cells.
*The above information and recommendations are general guidelines and should not be construed as specific advice to individuals. Consult your doctor or other health care professional about personal health choices.