There are three main restrictions in the renal diet which includes: sodium, potassium, and phosphorus. For most people the allowance for sodium and potassium is 2000 mg day and for phosphorus 1000 mg day. There are several lists of foods that indicate high and low food sources as well as guides that include milligrams to help with measuring your daily intake. Your dietitian in the clinic will be able to help you choose the right amount of food by monitoring your monthly lab values to your daily food intake.
Sodium food sources: Follow the food label on prepared foods is the best guide. Become an expert in label reading and measure your food according to the recommended portion size. Do not add salt to your food since one teaspoon of salt equals 2000 mg of sodium. Use fresh herbs, onions, garlic and dried herbs instead of salt. Avoid all processed foods in the deli as well as canned or boxed foods. Choosing fresh fruits, vegetables, and meat is preferred. All fast food items are loaded with salt and should be limited or avoided all together.
Potassium food sources: All fruits and vegetables contain potassium as well as dairy products, beans, nuts, bran, and chocolate. Using a low, medium, and high food source list can help control your level by limiting your daily intake to 6 (1/2 cup) portions / day and avoiding all high potassium food sources. Some potassium can be "washed" out by using a soaking method since potassium is water soluble. The general rule is ½ cup food to 10 cups of water, boiled for 10 minutes then soaked for a minimum of 2 hours. Some patients are permitted to have a liberalized potassium diet so check with your nephrologist or dietitian for their recommendation and monitor your monthly labs.
Phosphorus food sources: Most foods have some phosphorus in it with the exception of fruit. Since meat is a high phosphorus food but a very necessary source of protein, most dietitians will recommend to avoid the following to help with phosphorus control: bran, dairy to 1 cup day, chocolate, biscuits, cornbread, pancakes, nuts, PB, cheese, chocolate, cakes, cokes, and any processed food that has "phosphate" as a food additive listed on the ingredient lists. Phosphorus is not easily removed from the blood and therefore most dialysis patients will need to use a phosphorus binder to lower this level. This is a medication that is prescribed by your nephrologist and needs to be taken at meal time. Consequences of high phosphorus can lead to calciphylaxis a serious skin lesion that may bleed or become infected. Additionally, deposits of calcium crystals within blood vessel walls can produce vascular stiffness that is a cause of cardiovascular mortality.
Reference: AAKP Nutrition counter has milligrams of sodium, potassium, and phosphorus for common foods and can be purchased at aakp.org.
Living Well on Dialysis: A cookbook for patients and their families www.kidney.org
Cooking for David-renal cookbook by www.culinarykidneycooks.com
Patients with kidney disease retain fluids and this can cause high blood pressure. Following a low sodium diet, taking your blood pressure medication regularly and limiting the amount of fluid you take in can help. Your doctor will tell you how much fluid you can have each day. Often that amount is one liter or (32 oz) day. Gaining more than two pounds a day is a warning sign that you are taking in too much fluid.
What is a fluid?
Any food or liquid that is liquid at room temperature is considered a liquid. Gernerally ice will melt by 50 %, so a 20 oz cup of ice will equal 10 oz of fluid. Other items that you need to restrict are: jello, popsicles, ice cream, soup, juices, water, tea, coffee, etc.
Chew sugar free gum.
Suck on hard candy especially sour candy or mints.
Eat small amounts of frozen grapes or strawberries one at a time.
Rinse your mouth more often with cold mouth wash.
Brush your teeth several times day.
Suck on lemon or lime wedges.
Avoid all salty foods.
This is the weight you actually weigh without added fluid on your body. This may change if you are eating more than usual and gaining weight or not eating because you have been sick. After your dialysis treatment you are basically dehydrated or "dry" so you are able to eat and drink until the next treatment time. It is crucial to come to all dialysis treatments so your blood can be cleaned and your fluids removed. Never miss a treatment even if you are sick.
Once dialysis is started protein intake may need to be increased. Your dietitian will assess your protein needs and inform you of the amount to eat each day. Choose protein foods that are not high in sodium and seek advise on needed protein supplements.
There are prescribed renal vitamins especially designed for the dialysis patient since most water soluble vitamins are washed out with each treatment. Ask your nephrologist or dietitian for their recommendation.