Dialysis and nutrition - the basics

Nutrition plays a vital role in a patient’s survival and quality of life; a well-balanced diet is necessary for them to stay fit as their kidneys are no longer functioning at their full capacity. 

  • I recently started dialysis treatments. Do I need to follow a specific diet?
  • Yes, it's very important that you follow the right diet for YOU.
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  • What is the right diet for me?
  • Each patient is unique. The diet that is right for you should take into account the frequency you are undergoing dialysis, its duration, residual diuresis, potassium levels, phosphate, calcium, urea, etc.
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  • How do I know whether there is a problem with my diet?
  • You should talk to your nephrologist when you notice one of the following:
  • - When there is a change in the amount (decrease) or type of food you want to eat.
  • - When you cannot adjust to the diet recommended by your nephrologist.
  • - When you notice a weight loss while you think you are eating normally.
  • - When you feel satiated with minimum food intakes.
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  • Why do I have to follow a specific diet?
  • Because due to renal insufficiency, the excess amounts of water from the body are not eliminated, as well as various electrolytes (such as sodium, potassium, calcium, phosphorus, etc.), many waste metabolites, etc. Moreover, hemodialysis may be a "substitute" of the kidneys, but it does not manage to "cleanse" blood like your native kidney and we must not forget that native kidneys work 24/7, not three times a week. Therefore, it is logical for some substances to be accumulated in the body.
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  • What is the purpose of the diet since I am undergoing dialysis treatments?
  • - The main purpose is to keep an ideal balance of liquids, to keep the electrolytes (potassium, calcium, phosphorus, magnesium) at normal levels, to receive the right amount of vitamins, energy and nutrients. One main purpose is therefore to check the fluid balance. One should not consume more fluid than he should. This would result in heart failure, increased blood pressure, swelling in the legs and shortness of breath (from the accumulation of fluid in the lungs.
  • - To avoid too much sodium (cooking salt). Consuming too much salt, increases thirst as well as blood pressure.
  • - Potassium is another electrolyte that can be controlled through the diet. Increasing the levels of potassium in the blood is very dangerous and poses risks such as even fatal arrhythmia. So, it is especially important to be careful with our diet and not to increase potassium levels.
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  • How long should I follow a special diet?
  • It is essential for as long as you undergo dialysis. However, it is not necessary, to remain unchanged. You can consult your doctor and vary it according to your wishes and needs.
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  • What are the for a proper diet?
  • • Ask your nephrologist and dietitian to make a diet plan suitable for you.
  • • Keep a food diary, since it gives you an accurate picture of what you eat every day.
  • • Ask your doctor what is your ideal weight.
  • • If your weight increases slowly but steadily, ask your doctor and your dietitian for a safe way to reduce your calorie intake or increase your physical activity.
  • • If your weight is increasing very quickly, especially when accompanied by a pressure increase or swelling (swelling) on ​​your feet, contact your doctor as it is most likely that there is an accumulation of fluid in your body.
  • • If your weight decreases slowly but steadily, ask your doctor and your dietitian to properly examine and treat this condition, 
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  • Mesogeios Dialysis Centers Group Scientific Team  
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  • Bibliography
  • 1: Roach LA, Lambert K, Holt JL, Meyer BJ. Diet quality in patients with end-stage kidney disease undergoing dialysis. J Ren Care. 2017 Dec;43(4):226-234. doi: 10.1111/jorc.12215. Epub 2017 Sep 24. PubMed PMID: 28944596.
  • 2: Polikandrioti M, Koutelekos I, Gerogianni G, Stefanidou S, Kyriakopoulos V, Floraki E, Babatsikou F. Factors Associated with Hemodialysis Machine Dependency. Med Arch. 2017 Apr;71(2):122-127. doi: 10.5455/medarh.2017.71.122-127. PubMed PMID: 28790544; PubMed Central PMCID: PMC5511538.
  • 3: Ko GJ, Kalantar-Zadeh K, Goldstein-Fuchs J, Rhee CM. Dietary Approaches in the Management of Diabetic Patients with Kidney Disease. Nutrients. 2017 Jul 31;9(8). pii: E824. doi: 10.3390/nu9080824. Review. PubMed PMID: 28758978; PubMed Central PMCID: PMC5579617.
  • 4: Gluba-Brzózka A, Franczyk B, Rysz J. Vegetarian Diet in Chronic Kidney Disease-A Friend or Foe. Nutrients. 2017 Apr 10;9(4). pii: E374. doi: 10.3390/nu9040374. Review. PubMed PMID: 28394274; PubMed Central PMCID: PMC5409713.
  • 5: Hand RK, Burrowes JD. Renal Dietitians' Perceptions of Roles and Responsibilities in Outpatient Dialysis Facilities. J Ren Nutr. 2015 Sep;25(5):404-11. doi: 10.1053/j.jrn.2015.04.008. Epub 2015 Jun 23. PubMed PMID: 26116426.

 

 

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