What Is the Relationship Between Hemodialysis and Nutrition?
Hemodialysis is an artificial way of filtering wastes, fluids, and salts from the blood in cases of kidney failure. This is the only way to manage renal failure. Besides this treatment, a special diet is required to be taken, which is an important part of the treatment plan. Since the kidneys cannot remove enough waste products and fluids from the blood and the body now has special needs. Hence, there arises the need to restrict fluid intake and change the consumption of specific foods in the diet. The dietitian helps in planning the diet for this special circumstance.
What Nutrition Changes Should Be Made for Hemodialysis?
In hemodialysis patients, the following modifications need to be made:
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Consume more high-protein foods.
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Have less high-salt, high-potassium, and high-phosphorus foods.
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Know from your dietician how much fluid you can safely consume, which includes coffee, tea, water, and any other food item which is liquid at room temperature.
Salt and Sodium Intake: Consume less salt and have less salty foods: This helps to control blood pressure. It also aids in reducing fluid weight gains between dialysis sessions since the salt causes thirst and leads the body to hold on to fluid.
Instead of salt, other additives like herbs, spices, and low-salt flavor condiments can be used.
Totally avoid salt substitutes comprising potassium.
Protein Consumption: Dialysis patients need to have more protein. Protein aids in keeping healthy blood protein levels and better health. Protein also helps in keeping the muscles strong, heals wounds faster, strengthens the immune system, and enhances overall health. Consume a high-protein food item like meat, fish, poultry, eggs, etc. at every meal, or around 8 to 10 ounces of high-protein foods daily.
Other food products, such as peanut butter, nuts, seeds, dried beans, peas, and lentils have increased protein content too but these items are generally restricted because of their high potassium and phosphorus components.
Grains, Cereals, or Bread: This group does not need changes unless the patient needs to restrict calorie consumption for weight loss and check carbohydrate intake for normal blood glucose levels. Grains, cereals, bread and cornflakes are recommended as low potassium sources that are high in calories. Usually, people need 6 to 11 portions of them daily. Whole grains and high-fiber foods should be avoided to limit the intake of phosphorus.
Dairy Products: Restrict the consumption of milk, yogurt, and cheese to a half cup of milk or yogurt, and one ounce of cheese in a day. This is advised because the majority of dairy products have a high-phosphorus content. By cutting the intake of dairy-based foods, bones and blood vessels get protected from increased phosphorus amounts.
Fruits or Their Juices: Fruits and fruit juices which are high in potassium content need to be avoided so that it is cardioprotective to the dialysis patient. Fruits with high potassium quantities are:
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Oranges and orange juice.
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Kiwi.
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Prunes and prune juice.
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Raisins and dried raisins.
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Bananas.
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Melons.
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Star fruit (completely avoid).
However, 2 to 3 servings of low potassium fruits should be taken each day. One serving equals one small fruit or 4 ounces of fruit juice. Low potassium fruits and drinks are listed as:
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Apple.
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Berries.
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Cherries.
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Drained fruit cocktail.
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Grapes.
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Peach.
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Pear.
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Pineapple.
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Plums.
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Tangerine.
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Watermelon.
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Drinks like apple cider, cranberry juice, cocktail, grape juice, and lemonade.
Vegetables and Salads: All vegetables comprise certain quantities of potassium so, those with high potassium percentages need to be totally avoided, which protects the heart.
2 to 3 servings of low-potassium vegetables should be eaten each day, where one serving equals half a cup. Some of the low potassium vegetables are:
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Broccoli.
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Cabbage.
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Carrots.
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Cauliflower.
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Celery.
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Cucumber.
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Eggplant.
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Garlic.
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Lettuce.
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Onion.
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Peppers.
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Radish.
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Watercress.
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Zucchini and Yellow squash.
High potassium vegetables are required to be avoided or limited. They are:
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Potatoes (including sweet potatoes).
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Tomatoes and tomato sauce.
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Winter squash.
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Pumpkin.
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Asparagus (cooked).
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Avocado.
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Beets.
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Cooked spinach.
According to your calorie needs, the dietitian may advise you to have high-calorie desserts, but they are high in potassium content too. Dairy-based desserts and those consisting of chocolate, nuts, and bananas should be limited.
What Should Be Done in Cases of High Cholesterol Levels?
Modifying the diet helps in lowering the cholesterol levels in the blood. An increased intake of low potassium fruits and vegetables, and decreased consumption of fried foods, in conjunction with around 2.5 hours of physical activity every week aid in improving cholesterol levels.
What Changes Are Made for Diabetics?
The kidney and the diabetic diet are similar in many ways. Both diet plans recommend having three balanced meals, avoiding increased amounts of protein, and restricting sodium intake. A balanced meal is made up of at least three food groups, that is, proteins, grains, vegetables, fruits, and dairy. Both meal plans advise having a half plate of vegetables, a ¼ portion of carbohydrates, a ¼ serving of high protein food, and a piece of fruit. The biggest change between the two is that the kidney diet does not have a lot of variety in fruit and vegetable options. However, the diabetic diet recommends 45 to 75 grams of carbohydrates with each meal and a gap of 4 to 5 hours between the meals. This advice is helpful for the kidney diet as well. Both the kidney and the diabetic diet support heart health.
What Other Dietary Tips Can Be Followed in Hemodialysis Patients?
The following important tips can further be helpful with the special diet:
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Fresh or plain frozen vegetables possess no added salt. Draining all the cooking liquid before serving help.
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Canned fruits are known to contain less potassium than fresh fruits. However, their liquid should be drained before consumption.
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Rice and almond milk are low in phosphorus and can replace dairy milk.
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Read labels on the packaged foods and limit sodium-containing and avoid phosphorus-containing foods.
Conclusion:
Hemodialysis treatment requires a special diet to be adopted as an adjunct. The diet plan hence requires strict recommendation from a registered dietician, and balance of potassium (not exceeding 2500 mg per day) and phosphorus levels, that varies according to the individual's treatment needs.
