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Nutritional Tips

What to Eat when You Have Chronic Kidney Disease

 
Eating well is key to maintaining your health when you are on dialysis. When you have chronic kidney disease, it's important to consult a dietician to create a diet that will help you preserve your kidney function for longer and slow down the progression of kidney disease.

Your dietician will talk to you about the nutrients and minerals you need to manage your kidney disease, such as protein, potassium, salt (sodium), sugar, and phosphate. Your diet may differ depending on your dialysis treatment plan.
 

Protein

 
Your body uses protein to build and repair your muscles, tissues, and immune system. Before you reach end-stage kidney disease, you will need to limit the amount of protein you eat so that your kidneys will not have to work so hard. When you are on dialysis, especially peritoneal dialysis, you will need to eat more protein to replace the amount that is lost during dialysis treatments. Consult your dietician and doctor to see how much protein you need to eat.
 
 

Potassium

 
Your body needs potassium to maintain your heart function, nerve conduction, and muscle contraction. Too much potassium can cause you to experience fatigue, poor respiration, and heart problems.

If you're on peritoneal dialysis, you may not need to restrict your potassium intake very much. If you're on haemodialysis, however, potassium will build up between treatments so you will need to be more careful with the amount of potassium in your diet.

Consult your dietician and doctor to see what foods fit within your potassium requirements.
 
 

Salt (Sodium)

 
Changes in sodium levels determine the amount of fluid your body retains and in turn, influences your blood pressure. If you have high blood pressure, it is even more important for you to be careful with the amount of salt you eat. Both patients on haemodialysis and peritoneal dialysis need to watch their salt intake. Ask your dietician and doctor for more information.
 
 
Source: Food and Chronic Disease: A Guide to Eating Safely and Well, National Healthcare Group, Singapore
 

Phosphate

 
As your kidneys become less effective at filtering waste products, the amount of phosphate will begin to increase in your blood. Excess phosphate can lead to brittle bones, joint pain, and other health problems. Both haemodialysis and peritoneal dialysis patients need to control the amount of phosphate in their diet. Almost all patients with high phosphate levels will also need to take phosphate binders. Phosphate binders prevent the body from absorbing the phosphate from the food you eat. Ask your dietician and doctor for more information.
 
 
Source: A Food Phosphate Guide for Kidney Patients, Malaysian Society of Nephrology, 2003
 

Fluids

 
The amount of fluids you take in during the earlier stages of kidney disease is not restricted. As your kidney function declines, however, you will begin to retain more fluid in your body and you may experience swelling in your ankles or legs. You will need to take into account how much you drink as well as how much you eat in your food, such as soups, porridge, and frozen desserts.

Your dietician will help you determine your daily fluid allowance. Peritoneal dialysis patients will need to see how much fluid is released during an exchange. Both peritoneal dialysis and haemodialysis patients will need to consider urine output, kidney function, and body size.
 

Summary

 
 

Haemodialysis (HD)

Peritoneal Dialysis(PD)

PROTEIN

Based on needs Based on needs, protein needs higher than HD

POTASSIUM

Limited Not usually limited

SODIUM

Limited Limited

PHOSPHATE

Limited Limited

CALORIES

Based on needs Based on needs; reduce sweets and
fats to manage weight gain from
dextrose in dialysate

FLUID

Limited Limited but less restricted than HD
 
Source: http://www.aakp.org/aakp-library/hemodialysis-diet-versus-peritoneal-diet
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