Healthy Eating for Hemodialysis

Healthy eating for haemodialysis Haemodialysis removes water and waste



Diabetes:

Eating

well

for

your

products from your blood by running it

diabetes and monitoring your blood

through a filter. It only partially replaces

sugars is still important while you are

the functions of the kidneys. There are a

on dialysis

number of issues relating to the food and



drinks you eat that are important to

Heart health: It is recommended to have unsaturated fats in your diet

consider. Healthy eating If you have just started dialysis, this

The amount of food you need to eat may

information may be confusing. Your

increase when you start dialysis. It is

Dietitian will go through this handout with

important to eat a variety of different

you and can answer questions you have

foods. Eating enough food is important

about your diet.

because it will:

This handout will give you information on



Stop you losing weight without trying



Give your body energy to do the

the following: 

activities you enjoy

Healthy Eating: This is important to



prevent you from losing weight    



Help

your

body

use

protein

for

building muscles and tissues

Protein: This is important to keep you healthy and strong

Protein

Potassium: You may need to cut

The amount of protein you need to eat

down potassium in your diet

may also increase when you start

Salt (sodium): You may need to cut

dialysis. Eating protein-rich foods at every

down salt in your diet

meal can make it easier for you to eat all

Phosphate and phosphate binders

the protein you need. Your Dietitian can

(tablets): You may need to cut down

work our how much protein you need.

phosphate in your diet and binders

Protein in your diet helps to:

may be needed when you eat food



Fluid:

Cutting

back

on

fluid

is

Protect your body from illness and infection

important to protect your heart This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Revised: May 2015 Due for review: May 2017

 

Help your body build muscles and

your potassium levels by some of the

repair tissue

foods you eat.

Keep you feeling strong and healthy



High levels of potassium are very dangerous, and may cause your heart

The best sources of protein are:

to beat irregularly and even stop



Meat, including red meat, chicken and

beating. Your blood tests help us to

fish

monitor your potassium levels. It is



Eggs

important you are aware of potassium



Milk and milk products e.g. custard,

in different foods.

yoghurt and cheese 

Tofu and legumes eg kidney beans,

Fruits and vegetables

chick peas and lentils



All fruits and vegetables are high in potassium, if you eat large amounts

You may need to see the Dietitian if:



Aim for two (2) serves of fruit each



You are losing weight without trying

day. For example: 1 serve is a piece



Have poor appetite or nausea

of fruit the size of a small apple or



You are unable to eat enough

orange, ½ cup tinned fruit or juice



Are underweight



Aim for five (5) small serves of vegetables each day. For example: 1

Note: You may need to take nutritional

serve is ½ medium sized potato or ½

supplement drinks that are high in protein

cup of cooked vegetables

and

energy.

Your

Dietitian

can

recommend a drink which is best suited to you.

Potassium 

If your kidneys are not working properly, potassium may build up in your blood. There are usually no symptoms of a high potassium level. Regular blood tests will check your

High potassium

High potassium

fruits

vegetables

Apricots Avocado Banana Custard apple Dried fruit Mulberry Rockmelon Stone fruit Tropical fruit salad Mango

Artichoke Baked beans Brussel sprouts Cauliflower Chickpeas Kidney beans Hot chips (Potato) Pumpkin Spinach Tomato

potassium level. You can manage This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Revised: May 2015 Due for review: May 2017



You can decrease potassium in fruit

panel. This does not mean that a food is

and vegetables by:

free or low in potassium.

1. Peeling all fruit and vegetables

Your Dietitian can discuss a potassium

2. Chopping vegetables into small

restriction in more detail if you are having

pieces

problems

3. Boiling vegetables well – do not

potassium in your blood.

controlling

the

level

of

microwave, steam or stir fry and discard the water

Salt (sodium)

4. Drain the juice from tinned or

Salt makes you thirsty, which will make it

stewed fruit

difficult for you to keep to your fluid

Other high potassium foods to be aware of Treacle, molasses, golden syrup Nuts Peanut butter, Vegemite/Marmite Seeds - sunflower, pumpkin Dried fruit and nut mixes Cocoa Chocolate, chocolate chips Coconut milk or cream, fresh coconut Heavy grain breads, dark rye bread Fresh vegetable juices, tomato juice Thick and homemade vegetable soups

Potato crisps, hot chips Yoghurt Milk or soy milk : have less than 1 cup (250mL) each day Evaporated or condensed milk

allowance.

Here

are

some



Aim to avoid adding salt in cooking and to meals



Choose fresh, home-cooked meats



Use “Salt Reduced” or “No Added Salt” products



Avoid salty foods like: o Processed

meat

Red wine

sausages),

Fruit cake

smoked meats

o Packet packet

smoked

fish

or

and

tinned

sauces,

2

soups, minute

noodles, stocks

Salt substitutes

potassium on the nutrition information

(bacon,

o Salted biscuits, nuts and crisps

All Bran, Bran Plus, muesli or cereal with a lot of dried fruit and nuts

Note: Packaged foods no longer display

for

reducing the amount of salt you eat

Percolated coffee

Tomato soup, tomato sauces, tomato paste

tips

o Most take-away foods 

Some foods labelled “reduced salt” can still contain high levels of sodium. Check the nutrition panel – a sodium (Na) content less than 150 mg per serve is desirable

This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Revised: May 2015 Due for review: May 2017

Phosphate

and

phosphate

binders

Fluid 

(tablets)

It is important to manage your fluid

Phosphate is a mineral that combines

intake so that excess fluid does not

with calcium to form the hard structure of

build up in your body

bones and teeth. Normally, the kidneys



Fluid includes all liquids and anything

control the levels of phosphate in your

that

blood.

not

temperature. For example: water, ice,

working, the level of phosphate in your

tea, coffee, milk, ice cream, iceblocks,

blood can build up. High levels of

custard, juices, soft drinks, cordials,

phosphate can cause severe itchiness,

soups, gravy and jelly

When

your

kidneys

are

lumps of calcium and phosphate in the



becomes

liquid

at

room

Some solid foods, such as porridge,

bones, joints and blood vessels, causing

rice, pasta and fruit, contain large

brittle bones and painful joints bone

amounts of fluid. If you eat large serves

disease.

of these foods, count these as part of your allowance

Making lower phosphate food choices



Changes in your weight that occur

where possible can help to lower the level

over a couple of days are usually due

of phosphate in your blood. Phosphate

to your fluid intake

binders (tablets) are an important way to



Changes in your weight that occur

control blood phosphate levels. These

slowly over longer periods of time

work by binding the phosphate in food so

(weeks to months) are more likely to

that less is absorbed from your intestine

be changes in your actual dry body

(and it passes out in your bowel motions).

weight 

You should aim for a weight gain of no

It is important to take your phosphate

more than 1kg per day between

binders

dialysis sessions

(Caltrate,

Calsup,

Alutabs,

Renagel, Lanthanum) as they have been



Your fluid allowance differs depending

prescribed. This may include with main

on dialysis, urine output and kidney

meals and snacks, depending on what

function

you are eating.


Hints for fluid control

Remember that ice is fluid and should



Use jugs and measuring cups to

be measured e.g. 1 cup of ice equals

accurately measure your fluid intake

½ cup water. Your fluid allowance

Keep a moist face washer in the fridge

differs depending on dialysis, urine

or freezer and use it as a rub down to

output and kidney function



keep cool   

Spread your fluid allowance over the

Diabetes

day - don't drink it all at once!

If you have diabetes, it is still important for

Brush your teeth to freshen your

you to eat well and manage your blood

mouth

sugar levels. To do this, make sure you:

Drink from small rather than large



your

blood

sugar

levels

regularly

cups 

Check

Suck on lollies or a slice of lemon



Take your diabetes medication

instead



Attend regular diabetes appointments

of

drinking.

Try

mints,

peppermints or chewing gum 

 

Stay out of the heat. If you need to go

Heart Health

outside, choose the cooler part of the

It is very important for everyone with

day

kidney disease to maintain a healthy heart

Keep lips from getting dry by using lip

and blood vessels. Eating the right kinds

balm

of fats and oils can help. Remember if

Choose foods low in salt - fruit, fresh

using fat, choose a polyunsaturated or

vegetables, fresh meats, chicken, fish,

monounsaturated fat as these are best for

eggs, porridge, rice, pasta and “low

your cholesterol levels.

salt” or “no added salt” foods. Look for

increase your cholesterol and so should

sodium content less than 150 mg per

be avoided.

Saturated fats

serve on the nutrition panel. Do not add salt at the table or in cooking 

Freeze some of your fluid allowance. Ice or iceblocks, sucked slowly, last longer than a drink, and are better at quenching thirst. You can freeze water, lemon juice and soft drinks.


Recommended

Not recommended

Unsaturated fats

Saturated fats

Most vegetable oils eg. safflower oil, sunflower oil, olive oil, canola oil, etc





Butter, ghee, dripping, lard, copha, suet Fats on meats and chicken

You may need to see a Dietitian if: 

You have more questions about your diet



Your appetite is poor or you’re losing weight without trying to



If your fluid, potassium or phosphate



Solid vegetable cooking fat eg. Supafry, Hifry



Cream

You should see your Dietitian at least



Coconut and palm oils

once every 6 months

levels are too high

Your Dietitian is: _________________ Contact phone number: _____________
