Dietary advice for dialysis patients

Dietary advice for dialysis patients

 

DIALYSIS AND FOOD

It is crucial to understand that dialysis cannot replace the working of a kidney. Dialysis is a therapy that only offers help to patients with end-stage kidney diseases. Hence, a conscious choice of food must be made to maintain health. 

  • Dialysis is when the kidneys are incapable to perform their normal function and the job is done by a machine.
  • The dialyzer used in the dialysis machine itself can be regarded as an artificial kidney.
  • The machine filters the patient’s blood to remove excess water and food waste. 
  • In between 2 dialysis, waste products accumulate in the blood.
  • By following the diet recommended by a nephrologist, the amount of waste products can be minimized.
  • This diet will help maintain low levels of potassium, phosphorus, sodium, and water in the blood.

 

WHAT SHOULD YOU EAT WHEN ON  DIALYSIS ?

 

  1. HIGH AMOUNT OF PROTEIN

During dialysis, some proteins are lost. In general, you are advised to take 1.2 gm/kg/day of protein.

 

Proteins are of two types:

 

  1. a) First class proteins

 

           These proteins can be efficiently used by our body and are available in: 

 

  1. Soya beans, soya milk, tofu, etc.
  2. Milk, dairy products (Paneer is the best)
  3. Egg white
  4. Non-vegetarian foods like mutton, chicken, fish, etc.

 

  1. b) Second class proteins

 

These proteins are secondary to proteins of animal origin. All types of pulses, lentils, vegetables, and grains are categorized as incomplete proteins because these foods are low in one or more essential amino acids and our body cannot utilize them effectively. Lentils and grains can be used to make khichdi, idli, dosa, dhokla, and more.

 

  1. LOW SALT IN DIET

 

  • Salt and other foods contain sodium.
  • When the kidneys become inactive, the increased amount of sodium causes water to accumulate in the body, resulting in swelling  in different parts of the body.
  • You can consume 4 to 5 grams of salt per day.
  • It is recommended to use lemon, ginger, garlic, mint, tamarind, mango powder (amchur), vinegar, basil, oregano, etc. to maintain the salt proportion low and make the food more tasty.
  • Salt should only be used in vegetables and dals (lentils pure)
  • It is better to not use salt in roti, rice, curd, etc.
  • In addition, do not use canned foods, ready-to-eat foods for making vegetables, gravy, etc.
  • TATA lite salt must not be used because it contains high potassium.

 

  1. LOW AMOUNT OF POTASSIUM

 

  • The kidneys subtract excess potassium from the blood. Kidneys that are not functioning cannot remove excess potassium which is dangerous for our body.
  • When potassium levels rise in the blood, the heartbeats become irregular and the risk of cardiac arrest is high.
  • If the level of potassium in the blood is greater than 5.5 mg/dl, vegetables and beans should be used after the leaching process.
  • Leaching process: Leave the vegetables and pulses in lukewarm water for 30 minutes and then discard the water. Use fresh water for cooking. During this process, the vitamins in the food are also extracted, so they need to be supplemented with the right dosage.

 

Foods Rich in Potassium

  • Green leafy vegetables (except fenugreek that is kasuri methi in hindi)
  • Indian gooseberry (amla), cherry, mango, sweet lemon, peach, sapodilla (chickoo), custard apple, muskmelon, kiwi, raspberry, watermelon, banana, etc.
  • Coconut, chocolate, peanuts, dry fruits
  • All kinds of soups and juices
  • Potatoes, tomatoes, drumsticks, colocasia, sweet potatoes, elephant foot yam (suran) mushrooms, etc.

 

  1. DRINK WATER IN REDUCED QUANTITY

 

  • Drinking a large quantity of water causes water accumulation in the body, resulting in your face and feet swelling.
  • Other problems can occur, such as the rise in blood pressure, irregular heartbeats, water accumulation in lungs, breathlessness, etc. 

 

How much water to drink?

  • Urine volume of the previous day + 500 ml of water. Daily weight measurement can also help in this regard.
  • If you  urinate 800 ml, then 800 ml + 500 ml = 1300 ml of water can be taken.
  • Anything that is liquid at room temperature should be considered in the water part.
  • To reduce thirst- Do not eat salty, spicy, or fried foods.
  • To drink less liquid, use smaller glasses
  • Do not take the medicine with lots of water; instead, drink it with morning tea or milk.
  • You can also use Sugar-free or mint gum
  • If diabetes is not controlled, it will increase thirst, so take medicines to manage diabetes appropriately.
  • Ice cubes can be consumed, but they should be pondered in the liquid intake. 

 

  1. CONSUME PHOSPHORUS IN A LOW AMOUNT

 

High levels of phosphate in the blood can lead to low calcium levels, which can lead to weak bones. Therefore, phosphorus intake must be controlled through diet.

 

  1. ITEMS TO AVOID

 

Avoid cold drinks, milk, and dairy products, dry fruits, peanuts, baked products, and foods made from wheat.

 

TIPS

  • Eat curd and salads without salt.
  • Non-vegetarians can consume egg whites instead of paneer.
  • Vegetables like ladies finger, bitter gourd, onion, french beans, carrot, broad beans (papdi), brinjal, cauliflower, cabbage, tomato, capsicum can be used from 1 to 2 times a day.
  • Always use only a fixed amount of salt as recommended by your nephrologist, set it aside, and use only that salt.
  • Consume less high-fat foods but don’t stop completely.
  • Do not eat coconut, drink coconut water, or chutney.
  • Chocolate drinks and coffee contain a lot of potassium and should not be consumed.
  • Do not eat ready-made foods like cheese, salted butter, popcorn, Maggi, macaroni, pasta, and corn flakes.
  • Foods with high salt content, such as papad, pickles, chutney, sauce, roasted dry fruits, wafers, salted khakhra, bakery items (like cake, puff, biscuit, pastry), sea fish, tomato sauce, soya sauce, garlic sauce should not be consumed

Morning (7 to 7:30) 1 Cup of tea/milk(100 ml)+4 protein biscuits.

(10 to 12:30) 1 plate Upma/Idli/Poha/Chickpeas/Roti/Bread/+with 4 gm paneer + bowl curd

Lunch (12:00 to 12:30) 3 to 4 roti + bowl vegetable [bottle gourd, ridged gourd(touri), pointed gourd (parwal), ivy gourd (tindora), green peas, fenugreek leaves].+1 bowl dal + 1 bowl rice + bowl salad(beat +cucumber)

Evening (4 to 4:30) 1 Cup tea/100 ml/milk +4 protein biscuits+besan puda/dhokla/chickpeas + puffed rice (murmure) / poha chivda/Sorghum pops (jowar pops)

(6:30 pm) 1 fruit (apple , pear, 1 bowl papaya/2-3 slices of pineapple)

Dinner: 2 paratha + 2-3  rice/2 jowar bhakri (thick roti) +1 bowl vegetables + 1 bowl masala khichdi with paneer (40 gm paneer) + ½ bowl curd..    

 

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