Your body needs enough energy, or in other words enough calories. This is important for your overall health and gives you energy for your daily activities. Calories come from all foods you eat. Eating the right amount of calories each day will prevent you from losing body weight.
Caloric and basic needs of patients undergoing chronic hemodialysis (European guidelines)
Getting the right amount of protein
Before starting on hemodialysis treatment, you may have been prescribed a low-protein diet by your physician. After starting dialysis you need more protein. Getting the right amount of protein is important for your overall health and your wellbeing. Your body needs protein for:
• Building muscles
• Repairing tissue
• Fighting infection
Ideally your protein intake will be half animal protein – good sources are eggs, dairy products, meat, poultry, and fish – and half vegetable protein: good sources are potatoes, pasta, legumes (soya beans, peas, lentils), and cereals.
Food rich in protein usually contains a certain amount of phosphate – dairy products, fish, and meat have high phosphate content. This is why almost all hemodialysis patients are prescribed phosphate binders to keep serum phosphate normal.
Our body takes up phosphate from food. If the kidneys are not functioning well enough, the excretion of phosphate is decreased and serum phosphate rises. If the amount of phosphate eliminated during the dialysis sessions is too low, you will be prescribed phosphate binders. Phosphate binders are drugs that inhibit your body from absorbing the phosphates contained in food.
You can limit your intake of phosphate by avoiding certain foods – such as nuts, cola drinks, or certain types of cheese. In general, processed food and soft drinks contain phosphate and potassium-rich additives. Whenever possible, use fresh food – meat and poultry – and avoid processed food containing phosphate additives. Read nutrition labels and look for phosphorus in the ingredients.
Be aware of potassium
As a rule, you can drink a volume equaling the amount of urine from the previous day plus one liter of fluids per day. This may differ individually and your doctor or dietician will help you to determine the right amount of fluid to drink each day. Please note that ‘fluid’ includes beverages and other foods that are liquid at room temperature such as soup, ice cream, and other frozen desserts.
The less you drink, the less water has to be removed during a dialysis session and the gentler your dialysis treatment will be. The lower the quantity of fluid that must be removed by ultrafiltration – the greater your long-term success with hemodialysis.
Changing your diet doesn’t necessarily mean less enjoyment. It is a fact that food and drink keep the body and soul together. But changing your consumption habits doesn’t have to be a burden. As a renal patient, you’re helping to keep your body functioning properly.
Consult your dialysis team about what exercise you can do and with what intensity. Here are some ideas to get you started:
Out and about