Dietary Guidelines for Adults Starting on Hemodialysis
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- Eating the right kind and amounts of food.
- Having the hemodialysis treatments your health professional orders for you
- Taking the medicines your health professional orders for you.
- Eat more high protein foods.
- Eat less high salt, high potassium, and high phosphorus foods.
- Learn how much fluid you can safely drink (including coffee, tea, water, and any food that is liquid at room temperature).
Salt & Sodium
- Use herbs, spices, and low-salt flavor enhancers in place of salt
- Avoid salt substitutes made with potassium.
Meat/Protein
Grains/Cereals/Bread
Unless you need to limit your calorie intake for weight loss and/or manage carbohydrate intake for blood sugar control, you may eat, as you desire from this food group. Grains, cereals, and breads are a good source of calories. Most people need 6 -11 servings from this group each day.
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Amounts equal to one serving
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Avoid “whole grain” and “high fiber” foods (like whole wheat bread, bran cereal and brown rice) to help you limit your intake of phosphorus. By limiting dairy–based foods you protect your bones and blood vessels.
Milk/Yogurt/Cheese
Dairy foods “low” in phosphorus: (ask your dietitian about the serving size that is right for you)
- Butter and tub margarine
- Cream cheese
- Heavy cream
- Ricotta cheese
- Brie cheese
- Non-dairy whipped topping
- Sherbet
If you have or are at risk for heart disease, some of the high fat foods listed above may not be good choices for you.
Certain brands of non-dairy creams and “milk” (such as rice milk) are low in phosphorus and potassium. Ask your dietitian for details.
Fruit/Juice
All fruits have some potassium, but certain fruits have more than others and should be limited or totally avoided. Limiting potassium protects your heart.
Limit or avoid :
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Always AVOID star fruit (carambola).
Eat 2-3 servings of low potassium fruits each day.
One serving = ½-cup or 1 small fruit or 4 ounces of juice.
Choose:
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Vegetables/Salads
Choose:
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Limit or avoid:
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Dessert
Depending on your calorie needs, your dietitian may recommend high-calorie deserts. Pies, cookies, sherbet, and cakes are good choices (but limit dairy-based desserts and those made with chocolate, nuts, and bananas). If you have diabetes, discuss low carbohydrate dessert choices with your dietitian.
Sample Menu
Breakfast
Eggs (2) or ½-cup egg substitute
Toasted white or whole wheat bread (2 slices)
Coffee, 6 ounces
Lunch
(Other good choices for sandwiches include egg and chicken salad, lean roast beef, low salt ham and turkey breast.)
Coleslaw, ½-cup
Pretzels (low salt)
Canned and drained peaches, ½-cup
Ginger Ale, 8 ounces
Dinner
Salad (1 cup): lettuce, cucumber, radishes, peppers, with olive oil and vinegar dressing
Lemonade, 8 ounces
Snack/Dessert
Slice of apple pie
How will I know if I am eating right to stay healthy?
- Have you noticed a change in the kind or amount of food you eat each day?
- Have you had any problems eating your usual or recommended diet?
- Have you lost weight without trying?
- Have you noticed any changes in your strength or ability to take care of yourself?
What if I have high cholesterol?
Changing your diet may help lower the cholesterol level in your blood. Your dietitian will talk with you about the kinds of fat and animal foods you eat. Increasing intake of low potassium fruits and vegetables, decreasing the amount of fried foods, in addition to 150 minutes of physical activity per week can help to improve cholesterol levels.
What if I have diabetes?
At first the kidney and diabetic diet appear to be very different, but they are alike in many ways. Both diets recommend eating 3 balanced meals, avoiding large amounts of protein, and limiting sodium. A balanced meal has at least 3 of the food groups (protein, grain, vegetables, fruits, and dairy). The kidney diet limits the amount of milk that you drink, but many people with diabetes already limit milk to 4 ounces a day. Both recommend ½ plate of vegetables, ¼ plate of carbohydrate rich food, ¼ plate of high protein food, and a piece of fruit. The biggest change is that the kidney diet does not have as much variety in the types of fruits and vegetable choices because some have more potassium than others. The diabetic diet recommends 45 to 75 grams of carbohydrate with each meal and spacing meals 4 to 5 hours apart. This recommendation is good for the kidney diet, too. Both the kidney and diabetic diet help to keep your heart healthy.
In some cases, you may need to make only a few changes in your diet to fit your needs as a kidney patient. For example, you may need to limit some of the free foods you have been using may need to be limited on your kidney diet. Your dietitian will help make a meal plan especially for you.
Is there anything else I should know?
- Fresh or plain frozen vegetables contain no added salt. Drain all the cooking liquid before serving.
- Canned fruits usually contain less potassium than fresh fruits. Drain all the liquid before serving.
- Rice and almond milk are low in phosphorus and can be used in place of milk.
- Labels on food packages will give you information about some of the ingredients that may not be allowed in your diet. Learn to read these labels to help you limit sodium and control phosphorous. Avoid foods with ingredients that contain “PHOS”
- To help you avoid salt, many herbs and spices can be used to make your diet more interesting. Check with your dietitian for a list of these.
If you would like more information, please contact us.
Reviewed by the Council on Renal Nutrition: April 2019
© 2019 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.