Once you start dialysis for end-stage kidney disease (ESKD), you will experience both physical and lifestyle changes. Your nutrition needs will be one of these. Here, the Healthwise staff at Alberta Health discuss some diet changes that may be recommended after you start dialysis. 

What will my food plan look like? 

No matter what stage of kidney disease you have, a kidney diet must be individualized. Nutrition needs are based on many factors including your size, bloodwork, and other health conditions. A renal (kidney) dietitian can determine your nutrition needs and help you plan meals.  

While needs will differ, you can prepare yourself for the most common nutrition recommendations in dialysis: 

• Do not go for long periods without eating. Eating smaller and more frequent meals is often encouraged for patients who do not get hungry. Maintaining weight, muscles, and energy through adequate calorie intake is important on dialysis. 
• Eat enough protein. Make sure your protein is from high-quality sources, such as lean meat, poultry, fish, or eggs. If you are vegetarian, your doctor or dietitian may recommend supplementation to ensure you are meeting your protein and nutrient needs. 
• Limit salt use, and monitor sodium in your foods. Many processed foods, fast food, and restaurant foods are packed with preservatives that contain sodium. Get in the habit of reading and understanding nutrition labels. Foods labeled “reduced sodium” and “lightly salted” can still have too much sodium for your safety.
• Know how much fluid you can drink and what constitutes a fluid portion. Many dialysis patients have to restrict their fluid consumption to around 1 liter or 4 cups per day. This includes all types of fluids and anything that melts at room temperature, such as ice cream, ice, gelatin, and ice pops. 
• Limit high-potassium foods. Certain fruits, vegetables, dairy products, and salt substitutes can have high amounts of potassium. Choose low-potassium options like grapes, apples, pineapple, green beans, and cucumber.  
• Avoid foods with inorganic phosphorus or phosphorus additives. By reviewing the ingredients list on the nutrition label, you can learn which foods have phosphorus additives. Look for “PHOS” to find phosphorus additives in the food. Some common foods with phosphorus additives include dark sodas, canned iced teas, chocolate candy, hot dogs, and sausage. 

It is important to remember that many dialysis patients are encouraged to follow all of these recommendations, but some patients may not be. Speak with your dietitian or doctor to learn more about your nutrition-related blood work and what is recommended for you. 

*Diet for End-Stage Renal Disease (Dialysis): Care Instructions. (2021, September 8). Healthwise [Alberta Health Services]. Retrieved April 2, 2023, from https://myhealth.alberta.ca/health/AfterCareInformation/pages/conditions.aspx?hwid=ud1313

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