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If you have CKD and are on dialysis, this is the basic information you need to follow your dialysis meal plan. Your dietitian will give you more detailed information as you need it, but this should get you started. There are several nutrients you need to limit: sodium, fluid, potassium, phosphorus. Some nutrients you may need to increase: protein and calories.
A. Sodium
Ordinary table salt is sodium chloride. Cook your foods without salt and don’t add it to food at the table; instead, season with lemon or lime, vinegar, onion, garlic, herbs, or salt-free broth. The following are very high in sodium and should be avoided or limited to only once per week:
Click here for more tips on limiting sodium (link to previous sodium section above)
B. Fluid
You can drink 3 cups of fluid daily plus the amount equal to your urine output or a total of 4-5 cups per day. Fluids include all drinks such as coffee and tea, juice, water, etc. Foods which are liquid at room temperature (soups), or melt and become liquid at room temperature (like Jell-O, ice cream, ice, etc) are fluids. They need to be counted into your daily fluid limit also.
C. Potassium
To avoid high potassium foods, limit fruits, vegetables and juices to 4-6 “half-cup” servings per day. Do not use salt substitutes or other foods containing “potassium chloride.” Ask your dietitian for a potassium food list.
D. Phosphorus
Phosphorus is a mineral that combines with calcium in the body to make bones and teeth. Normally kidneys get rid of extra phosphorus. When your kidneys aren't working well they can't get rid of the extra phosphorous and it builds up in your blood. High blood phosphorus makes blood calcium go down. Your body tries to fix this by taking calcium from the bones which makes them weak. The extra phosphorus and calcium in your blood can damage your heart, lungs and blood vessels.
To control your phosphorus level, choose only 1 dairy product per day, such as:
In addition to limiting foods high in phosphorus, you may need to take “phosphate binders.” These medications should be taken when you eat to bind with the phosphorus from food, in your stomach. This bound up phosphorus passes out of your body through the stool.
If your doctor has told you to take phosphate binders (Tums, Phoslo, Renagel, Renvela, Fosrenol) take them with meals and snacks.
E. Protein
Protein is used by the body to build new tissues and replace old or damaged tissues. When you are on dialysis you should eat protein every day so you have the building blocks you need. Good quality protein is in unsalted meats, fish, shellfish, poultry and eggs. If you have been on a low protein diet, you should start eating more protein foods now.
F. Calories
It is very common for people with kidney disease to have a low appetite. If your appetite has decreased, you may not be eating enough calories to stay healthy, and your body will use the protein you eat for energy instead of building blocks.
It is very important that you maintain a healthy weight when you have kidney disease. If you are losing body weight, check with your dietitian. Even if you are overweight, it is important to eat enough protein and calories to spare your muscles.
If you need extra calories, you can add more:
Some convenience or “ready made” cookies, pastries, gravies, and sauces are high in sodium. Homemade choices are usually much lower so stick with these.
If you have diabetes, check with your dietitian before adding “sweets” to your meal plan.
