Fatigue is a common symptom experienced by patients on dialysis. Renal dieticians assist dialysis patients by educating them on the importance of balancing and consuming sources from the three macronutrient groups: carbohydrates, fats, and proteins.

Since food is a major source of energy, choosing the right foods can ward off sluggishness. Dialysis patients who balance these three macronutrients will feel more energetic throughout the day.*

Carbohydrates

Carbohydrates are the body’s main source of energy. Choosing complex carbs, such as whole grains, prevents blood sugar from fluctuating and sustains a feeling of fullness for a longer period overall. On the other hand, simple carbohydrates give a quick boost of energy, are often less nutritious, and should be limited. Simple carbohydrates include fruits and milk products.

Some examples of complex carbs include:

• Whole wheat bread, pasta, and flour
• Brown and wild rice
• Barley
• Quinoa
• Potatoes

If a person on dialysis also has diabetes, spreading out carbohydrates throughout the day will help control blood sugar and contribute to feeling energized. Some carbohydrates that contain potassium and phosphorus, like legumes and milk, may need to be limited. 

“Prescribed phosphate binders taken with each meal plus working with a dietitian to learn the best food choices can help balance phosphorus and potassium in a person’s dialysis diet,” according to DaVita Kidney Care.

Protein

When a patient undergoes dialysis, they lose some protein. When a patient is protein deficient, they may not only feel fatigued, but the deficiency can compromise the immune system and lead to a delay in healing damaged tissue. It’s important to replenish protein stores by eating two ounces (2 oz.) of high-protein food or taking a protein supplement with 14 grams of protein both before and after each dialysis treatment.

Renal dietitians counsel patients on how much protein they need. Quality sources of protein include lean meats, including the eye of round beef, lean ground beef, pork tenderloin, poultry, fish, eggs, and egg substitutes.

In addition to some carbohydrates, protein-rich foods are also high in phosphorus. In addition to balancing potassium, taking phosphate binders before or with your meals can also help keep phosphorus in range. 

Fats

Fats, another form of energy, often have a bad reputation, but they are important for giving us energy. They also play other roles, such as keeping us warm and helping us absorb certain vitamins, like vitamin A and D. It’s through the overconsumption of certain fats that issues like weight gain and heart disease can arise. 

Saturated fats come from animal foods and become solid at room temperature. They can raise cholesterol levels and increase the risk of heart disease. Some examples include lard, butter, hydrogenated cooking oils, and processed meats, such as bacon, hot dogs, sausages, and pepperoni. Limit these foods and opt for unsaturated fats.

Unsaturated fats include non-hydrogenated vegetable oils (canola, olive, and corn oil) and soft, trans-fat-free margarine. While these fats provide health benefits, moderation is key, because overconsumption can still lead to unwanted weight gain and other health problems.

*Trigg, D. and Rodriguez, Y. (n.d.). Getting More Energy from Kidney-Friendly Foods. DaVita Kidney Care. https://www.davita.com/diet-nutrition/articles/basics/getting-more-energy-from-kidney-friendly-foods