Eating & Nutrition for Hemodialysis?

How does what I eat and drink affect my hemodialysis?
Your choices about what to eat and drink while on hemodialysis can make a difference in how you feel and can make your treatments work better.

Between dialysis treatment sessions, wastes can build up in your blood and make you sick. You can reduce waste buildup by controlling what you eat and drink. You can match what you eat and drink with what your kidney treatments remove.

Some foods cause wastes to build up quickly between your dialysis sessions. If your blood contains too much waste, your kidney treatment session may not remove them all.

How can I learn what I should eat?
Your dialysis center has a renal dietitian to help you plan your meals. A renal dietitian has special training in caring for the food and nutrition needs of people with kidney disease.

Use this information to help you learn how to eat right to feel right on hemodialysis. Read one section at a time. Then, review with your renal dietitian the sections marked “Talk with Your Renal Dietitian.”

What foods count as liquid and why?
Foods that are liquid at room temperature, such as soup, contain water. Gelatin, pudding, ice cream, and other foods that include a lot of liquid in the recipe also count. Most fruits and vegetables contain water, such as melons, grapes, apples, oranges, tomatoes, lettuce, and celery. When you count up how much liquid you have in a day, be sure to count these foods.

What is my dry weight?
Your dry weight is your weight after a hemodialysis session has removed all extra fluid from your body. Controlling your liquid intake helps you stay at your proper dry weight. If you let too much fluid build up between sessions, it is harder to achieve your dry weight. Your health care provider can help you figure out what dry weight is right for you.

Talk with Your Renal Dietitian
Even though you are on hemodialysis, your kidneys may still remove some fluid. Or, your kidneys may not remove any fluid at all. Work with your renal dietitian to set a goal for how much liquid you can have each day. Keep track of the liquids you drink and other foods you eat.
What do I need to know about potassium?
Healthy kidneys keep the right amount of potassium in your blood to keep your heart beating at a steady pace. Potassium levels can rise between hemodialysis sessions and affect your heartbeat. Eating too much potassium can be dangerous to your heart and may even cause death.

To control potassium levels, limit potassium-rich foods such as avocados, bananas, kiwis, and dried fruit. Choose fruits and vegetables that are lower in potassium. Have very small portions of foods that are higher in potassium, such as one or two cherry tomatoes on a salad or a few raisins in your oatmeal.

You can remove some of the potassium from potatoes by dicing or shredding them and then boiling them in a full pot of water.

What do I need to know about phosphorus?
Too much phosphorus in your blood pulls calcium from your bones. Losing calcium may make your bones weak and likely to break. Also, too much phosphorus may make your skin itch. Limiting phosphorus can be hard because foods that contain phosphorus, such as meat and milk, also contain the protein you need. You should be careful to eat enough protein; however, not so much that you get too much phosphorus. Processed and packaged foods contain especially high levels of phosphorus. You can also find phosphorus naturally in foods such as poultry, fish, nuts, peanut butter, beans, cola, tea, and dairy products. Usually, people on hemodialysis should only have a 1/2 cup of milk per day. Your renal dietitian will give you more specific information about phosphorus.

Talk with Your Renal Dietitian
Limiting phosphorus and getting enough protein can be difficult. See the “Talk with Your Renal Dietitian” section under the next section about protein.

More information is provided in the NIDDK health topic, Phosphorus: Tips for People with Chronic Kidney Disease.

What do I need to know about sodium?
Sodium is a part of salt. Sodium is found in many canned, packaged, frozen, and fast foods. Sodium is also found in many condiments, seasonings, and meats. Too much sodium makes you thirsty, which makes you drink more liquid.

Try to eat fresh, naturally low-sodium foods. Look for products labeled “low sodium,” especially in canned and frozen foods.