What is the diet for haemodialysis patient

A patient under haemodialysis must keep a track of how much he eats or drinks and how much it can affect his body. During the sessions of haemodialysis, managing your diet is as important as taking up the treatment. You must recommend a renal dietitian who will help you to get the best possible food and diet for the body.

However, according to the guide you dietician prepare for a Personalised meal plan that will allow you to

• Eat high protein foods
• Reduce the amount of salt, high potassium and high phosphorus content.
• Limit fluid intake such as coffee, tea, water or any food which is liquid at room temperature.

 What are the right amounts of vitamins and minerals ?

Calories:- calories are actually the energies that are extracted from food a person eats each day. It helps to maintain the weight and energy level in the body. 

Patients with haemodialysis should limit foods and add on a few calories to maintain a healthy weight and perfect balance of the body. You can eat fruits and vegetables that are low in potassium and non dairy creamers or fat free milk. However, the daily intake of calories for haemodialysis patients are recommended to be about 35 Kcal/kg/body weight. 

Protein :- Haemodialysis patients are encouraged to have high quality proteins. Renal dieticians recommended this because it produces less waste during dialysis. You can get high quality proteins from meat, poultry, fish and eggs but should avoid processed meats as they contain high amounts of sodium and phosphorus as well. The early staged CKD patients need to limit dietary protein to be not more than 0.8 grams per kilogram of their body weights. And for the kidney patients of higher stages should have 0.6 grams per kg of body weight when GFR rate drops below to 25. You can get rich sources of protein from foods such as fish , egg whites, yogurt, soybeans , apricots ,melons etc.

Sodium

The renal dieticians suggest that kidney dialysis patients should limit dietary salt intake to 5g/day, that is 2g or 85 mmol of sodium. Most people on haemodialysis have reduced the ability to balance sodium and water in the body , so they need to restrict sodium and fluid intake. The best options to choose for low sodium foods include fresh fish, turkey breast, unsalted nuts and seeds , dried beans, lentils , papaya, melon , guavas , apricots, berries etc.

Potassium

The kidney patients are advised to have low potassium foods in the diet. The recommended amount of potassium should be up to 2.7-3.1 g/day for haemodialysis patients and for peritoneal dialysis it is close to 3-4 g/day. However, serum potassium levels are adjusted. Otherwise, high potassium levels in the body causes nausea, weakness, numbness and slow pulse. High potassium foods are limited in such cases. 

Phosphorus

Phosphorus helps to maintain healthy bones , keep blood vessels and muscles working. An optimum amount of phosphorus is required in diet because when you have CKD, phosphorus can easily build up in the body causing weak and thin bones and even itchy skin.

Get some low quality phosphorus foods such as fresh fruits and vegetables, corn and rice cereals, bread etc.

Other special renal vitamins are also prescribed to provide with such extra water soluble vitamins such as vitamins B1, B2,B6, B12 , folic acid , niacin , pantothenic acid , biotin including small doses of vitamins . 

Diet for haemodialysis patients

Haemodialysis patients should first of all monitor the intake of following contents in the food:- 

• Potassium
• Phosphorus
• Sodium
• Fluids

Major changes that you need to take in diet includes:- 

• Limit high phosphorus foods that include meat, poultry, dairy and fish.
• Avoid foods such as black beans , red beans , white beans , unrefined grains , refrigerator doughs , dried vegetables, chocolate and dark coloured sodas. 
• Limit your diet to 1000 mg of phosphorus per day. 
• A haemodialysis patient should have a diet limited to 2000 mg of potassium per day. Foods high in potassium include banana , orange juice, tomatoes , nuts , avocado , tomato juice or its puree , milk.
• You should take 7-8 ounces of protein per day. For reference, 1 whole egg is equal to 1 ounce of protein.
• Do not drink more than what your doctor recommends which is usually 4 cups of fluids each day.

Some renal friendly vegetables include

• Corn
• Carrots
• Cauliflower
• Broccoli
• Eggplant
• Zucchini
• Cabbage
• Sweet peas
• Tossed salad

Why do haemodialysis patients require more protein?

• Haemodialysis patients are required to eat high quality proteins because less waste products are removed during dialysis. Renowned sources for high quality protein come from meat, poultry, fish and eggs but try to avoid processed meats due to high amounts of sodium and potassium that it contains.
• For stable maintenance, the recommended protein is 1.2 g/kg/day.
• But during the course, also check or track your protein intake because excessive intake would lead to some conditions such as intestinal discomfort, unexplained exhaustion, nausea , irritability, headache , diarrhoea etc.

Diet for dialysis patients with diabetes

About every 1 in 5 adults in developed countries CKD patients are diagnosed with diabetes. Figuring out the best possible diet in such a case is a major challenge but not impossible. Let’s check it out some of the major suggestions regarding this:-

• You must consult a dietician trained in both diabetes and CKD nutrition. The dialysis patients with diabetes should include more and more fruits and vegetables which contain optimum amount of nutrients, and should generally avoid processed foods such as red meats. Such patients need to limit salt /sodium content from the food, reduce potassium, phosphorus and protein in the diet.
• Include more fruits such as berries, grapes , cherries, apples and plums. Vegetables such as cauliflower, turnips , carbs involve white bread , sandwich buns , unsalted crackers and when it comes to the drink , you can have unsweetened tea and plain water. 

What should you eat after dialysis?

• After dialysis, you need to rest for a few hours and do not start eating immediately after dialysis.
• Drink 1 cup of water after taking a rest.
• A light meal can be taken before dialysis so that you can remain without food after dialysis for a few hours. 
• Avoid eating snacks after dialysis.
• After a rest, you can start your day as usual.

Why is Albumin given during dialysis?

A normal range of albumin in the body is 3.4 to 5.4 g/dL. A higher albumin level is a sign of dehydration and in severe cases, it may even cause diarrhoea or other conditions.

• An albumin level is given during dialysis because it helps with the fluid removal. It helps in pulling extra fluid from swollen tissues back into the blood which can be easily removed during the dialysis.
• It can be given up to two times during the haemodialysis treatment.

How do dialysis patients gain weight?

• In dialysis patients, fluid weight is the actual weight that you gain between dialysis treatment from the foods and fluids you take in. 
• In dialysis patients, when kidneys do not work well, it does not form enough urine to remove extra fluid from the body that causes fluid weight gain in the body.
• To manage fluid weight, patients must follow a strict diet with optimum calories in the food. Do not eat excess calories enriched food , limit fluid intake , divide the drinking of water a day in the form of cups.

Indian diet for dialysis patients

Best fruits that you can have when you are on a dialysis includes:-

• Apple
• Strawberry
• Grapes
• Pineapple
• Cranberries
• Lemon
• Guava
• Papaya 

Best vegetables that you opt includes :- 

• Brinjal
• Capsicum
• Cabbage 
• Bottle gourd
• Tendli
• Zucchini
• Radish
• Onion
• Lettuce
• Cucumber
• Round gourd

Mouth-watering dishes that you can have when you are in a dialysis includes:- 

• Baingan bhaji
• Doodhi Ki sabzi
• Shimla mirch paratha 
• Strawberry salsa
• Mooli Ki sabzi
• Rice pancakes
• Moong dal recipe
• Apple salad
• Grilled zucchini
• Zucchini thepla
• Cabbage and grape salad.

How many eggs a dialysis patient can eat?

• Before including eggs on diet, you must first check your cholesterol levels.
• Limiting dietary cholesterol limits to less than 200 mg per day which is equal to 2-6 whole eggs per week.
• Prefer eating egg whites only as they are a high quality , kidney friendly source of protein. Eggs are an excellent choice for dialysis patients who have higher protein requirements in the body but need to limit phosphorus as well.

Is rice good for dialysis patients?

Rice is considered as a very good choice for kidney problems as it provides energy and is also low in minerals of concern for patients undergoing dialysis.

Prefer eating plain white rice because it is generally low in sodium, potassium and phosphorus.

How do dialysis patients increase more protein intake?

It is not so difficult to have a rich protein diet while being on dialysis.

• An optimum amount of protein is very important to help build muscle, repair tissue and fight infection.
• While being on dialysis , it also removes some protein from the body and this loss may cause you fatigue, higher chances of infection, and muscle wasting.
• You can opt for some vegetables which are rich in protein such as soy, nuts.
• Protein from animal sources includes boiled chicken, egg whites, fish ,milk.
• Contact your dietician to help you with this.

How much protein do you need in CKD stage 4?

• The guidelines from the nutritionists suggest that patients with CKD stage 4 should intake 0.6 grams per kg of body weight to assist in kidney functioning.
• Try to maintain low protein intake during CKD stage 4 as it would help decrease the build-up of protein waste.
• Eating an optimum amount of protein in the body helps to decrease the protein waste as it will help to preserve existing kidney function.

How much protein do you need in CKD stage 3?

• The recommended amount of protein needed during CKD stage 3 is 0.8 g/kg of body weight.
• Protein amount could also range from 0.55 to 0.6 grams per kilogram of body weight.
• High protein intake also leads to increased intraglomerular pressure and glomerular hyperfiltration.
• Maintaining a healthy diet and proper medication helps to prevent any further progression of CKD.

How much protein do you need in CKD stage 5?

• The recommended amount of protein required in CKD stage 5 is 0.6 to 0.75 grams of protein per kilogram of body weight. 
• A healthy diet is required for maintaining CKD stage 5 should include more and more fruits and vegetables that don’t contain more protein, phosphorus or potassium.

What Can you not take with haemodialysis?

While being on haemodialysis you need to take care of proper care of your kidneys. Here are some of the following tips

• Avoid whole green and high fibre food because they are high in phosphorus.
• Limit dairy based foods as it would protect your bones and blood vessels but builds excess cholesterol.
• Instead of eating processed foods, switch to high quality protein rich foods such as fish, egg and poultry and organic fruits.
• Avoid phosphorus potassium rich foods.

What is the daily recommended potassium amount?

• Dialysis patients with moderate to severe kidney disease having a global filter rate below 45 ml/minute should eat less than 300 milligrams of potassium per day.
• The kidney disease outcomes quality initiatives guideline recommends that patients having CKD stage 3 to stage 5 should limit for potassium 2 to 4 gram/d.
• A majority of patients with CKD stage 3 to 4 can also take potassium supplementation as well but these should be generally avoided and natural sources of potassium should be encouraged such as fruits and vegetables.
• Drinking an optimum amount of water also leads to depletion of potassium in the body. But low potassium levels may cause you some symptoms such as leg pain ,irritation ,chest pain and many more.
• And also high potassium should be avoided in the body because when your potassium levels are high you may feel high heart palpitations, shortness of breath, chest pain, nausea or vomiting. 

What are the suitable protein snacks for a kidney patient on dialysis?

Some kidney friendly protein snacks for kidney patient food includes

• You can have some low sodium crackers, pita chips, or unsalted pretzels.
• Go for a low or no sodium microwave popcorn
• Dried foods for low potassium nuts
• Eat fruit such as apples, grapes and strawberries, dried cranberries.
• You can eat a pouch of tuna with some packages of mayonnaise.
• You can also eat baked veggies seasoned with some herbs.

Calorie needs dialysis patients

• Dialysis patients require a daily energy uptake of about 35 kcal/kg body weight per density.
• Among all, glucose is one of the main resources for dialysis patients to intake calories in the body.
• Dialysis patients need Calorie or glucose in the body because most of the weight and muscle loss are likely to happen and need to add more calories during dialysis.
•  Having an optimum amount of calories in the body also helps to maintain blood cholesterol, blood sugar and muscle health.

Does eating protein increase creatinine levels?

• Eating more protein increases serum creatinine levels in the body.
• High protein diets also cause problems such as bad breath, headache and Constipation in the body.
• Along with increase in creatinine levels ,high protein amounts in the body also increases the chances of patients heart disease.
• Other symptoms of high protein include hypertension, kidney hyperfiltration, global injury and proteinuria.

protein powder for dialysis patients

• Patients having kidney disease who are currently not on dialysis and taking protein supplements are generally not recommended to have high protein powder.
• Patients on dialysis can have some amounts of protein powder in their diet as it is vital for fighting infection, healing wounds and achieving a good nutritional status.
• However, no significant evidence has been shown for detrimental effects on having high protein powder intake.
• Also an increased protein intake shows a significant increase of creatinine levels.

nutritional supplement drinks for renal patients

• According to the study of kidney guidelines, animal based protein causes the greatest strain on the kidney, so it is recommended to have plant based and low dairy protein as they don’t affect much and also has less straining effect on the kidneys.
• The best recommended nutritional supplement drinks include whey ,soy or casein protein shake. They are regarded as a good choice for adding to the daily regimen.
• Patients with CKD up to stage 3 may drink nutritional supplements such as Ensure. You can also have special renal vitamins to provide extra soluble vitamins needed. Another famous nutritional shake is the Nepro nutritional shake. It helps to meet the nutrition needs of people who are on dialysis.

How do you calculate your potassium intake?

• A healthy person is recommended to consume 3500 to 4700 mg daily from natural foods.
• Potassium plays a great role for maintaining muscle contraction, heart functions and fluid balance. A potassium rich diet is associated with the lower risks of blood pressure, kidney stones, osteoporosis along with other benefits.
• You can interpret that you are having a deficiency of potassium in your body through some of the following symptoms:-
  • A mild deficiency of potassium However causes no symptoms.
  • A moderate deficiency of potassium causes some of the symptoms such as cramping , muscle pain, discomfort and weakness. 
  • A severe deficiency of potassium in the body causes irregular heartbeat and in very severe cases paralysis

You can get enough of potassium from these rich dietary sources such as :- 

• Tomato products
• Beet greens.
• Baked potatoes
• Spinach
• Soybeans 
• Avocado
• Baked sweet potato
• Salmon
• Bananas

How many mgs are 20 mEq of potassium?

20mEq of potassium contains 1500 milligrams of potassium.

How many mg 10 mEq of potassium is?

1080 milligrams of potassium is equal to that of 10 mEq of potassium.

How much phosphorus should the analysis patient take?

• . The recommended amount of phosphorus that a dialysis patient should take is 3.0- 5.5 mg/dL.
• A healthy adult with a normal functioning kidney should have 4 milligram per decilitre of phosphorus. Humans over 70 years of age should consume less than 3 milligrams per day.
• Kidney patients also deal with the build-up of phosphorus between dialysis treatments and most of the time these phosphorus are removed from the body through dialysis , so an optimum amount of phosphorus is required in the body that you can get from many natural sources such as fruits and vegetables.
• Also during CKD, kidneys aren’t well enough to remove out phosphorus and high phosphorus amount in the body causes weak bones and sometimes phosphorus combines with calcium leading to dangerous deposits of these compounds in the blood vessels lungs eyes ,heart , so you need to contact your nephrologist time to time.
• A dangerously high level of phosphorus in the body is 4.5 milligram per decilitre and in this case you need to go for some major test in check-ups to regulate it properly.
• Some phosphorus foods that you need to limit include dairy foods,, lentils, nuts, brown serials, oatmeal, colas and other phosphate additives drink or other bottled iced tea.
• Instead you can go for some low phosphorus vegetables such as cucumbers, Peppers,, all forms of lettuce, spinach, asparagus,cabbage, eggplant, cauliflower,carrots, radish, onions and tomatoes.

What is a good phosphorus binder?

The most common phosphorus binder is calcium acetate which is also called PhosLo. The others are calcium carbonate, but clinicians are nowadays prescribing more non calcium based phosphate binders , particularly the Sevelamer.

How can I lower my phosphorus naturally?

• To lower your phosphorus quantity naturally in the body, first of all , you need to make certain dietary changes . Switch to lower phosphorus foods that includes some fresh fruits and vegetables
  •  Go for rice milk that is unenriched.
  • Breads.
  • Rice is a very good choice for kidney patients as they are rich in carbohydrates and low phosphorus content .
  • You can go for soda without phosphate additives.
  • You can also take phosphate binders.
  • Stay on dialysis until recommended by the nephrologist.
  • You can also start exercising that is recommended by the doctors.

What are the foods that are hard on kidneys?

Foods that are actually hard on the kidneys are :- 

• Dark coloured sodas.
• Canned foods.
• Dairy products with rich fat.
• Oranges .
• Phosphorus rich fruits such as bananas.
• Reduce salt and sugar content from foods.

What are the initial symptoms of a kidney disease?

The first signs of a kidney disease that you should not ignore at once are :- 

• Continued nausea.
• Vomiting at times.
• Appetite loss for the major time.
• Fatigue.
• Sleep problems (insomniac), trouble sleeping.
• Increased or decreased rate of urination.
• Decrease in mental sharpness.
• Muscle cramps.
• Foamy urine.
• Puffiness around the eyes.
• Dry and itchy skin.