Haemodialysis and Food

This FAQs will give you information about foods to choose if you are having Haemodialysis (HD) to treat your kidney disease.  Some people may have medical reasons why they need different information.  Always follow advice from your own dietitian or doctor.

You may not need to change what you eat because you have started HD.  Each dialysis unit has a dietitian who usually visits once a month.  The dietitian will speak to you shortly after you start HD to talk about what you eat and offer you information.

What should I eat to keep well on Haemodialysis?

You may need to eat more protein foods after you start dialysis.

Eating less salt can improve your blood pressure and make you feel less thirsty. 

You may need to limit the amount you drink if recommended by your doctor, nurse or dietitian.

Some people need to reduce foods high in potassium and phosphate.   Your dietitian will tell you if you should do this.

Starfruit can be harmful to people with kidney disease and you are recommended to avoid eating it.

How can I eat more protein foods?

Protein foods include meat, fish, chicken, eggs, milk, yoghurt, cheese, lentils, beans, Quorn and tofu.  These foods are important for maintaining your strength, repairing muscles, healing wounds and fighting infection. 

HD increases your need for protein as some is lost during dialysis.  It is important to make sure you are eating enough protein now.  Not eating enough protein can cause muscle loss and weakness.  Try to eat 2 to 3 larger portions of protein foods a day.  Your dietitian can guide you on portion sizes to meet your protein needs.

What should I do if I have lost my appetite?

Eating well is important to help you feel better and cope with any treatment you may need.  Many people find the following can help them to eat more:

• Eating little and often throughout the day
• Eating small nourishing snacks between meals such as cereal and milk, cheese and biscuits, cakes, biscuits, desserts, pastries
• Having a snack, sandwich or a milky drink if you cannot manage your normal meal
• Trying easy to prepare high protein meals such as cheese, scrambled egg, poached egg on toast or omelette
• Using full fat and full sugar versions of foods and drinks such as full fat milk, full fat yoghurt instead of diet or low fat ones
• Trying to eat more on days or at times you feel better
• Spreading butter, margarine, honey,  jam and marmalade thickly on bread, croissants, crumpets
• Adding honey or sugar to cereals and puddings
• If you have diabetes or you are limiting potassium or phosphate speak to your dietitian for more information
• Having food ready for when you get home from dialysis

Eating on dialysis days

Your dialysis sessions can mean you are away from home at your usual meal times.  Many people take a packed lunch or snack with them to dialysis.  This can be particularly helpful if you have diabetes, or if your appetite is poor.

Should I cut down on salt?

Yes – most people eat too much salt.  Eating less salt can improve your blood pressure.   If you have been advised to limit how much you drink, less salt reduces fluid build-up in your body (oedema) and makes you less thirsty.

Around ¾ of the salt we eat comes from salt in manufactured foods.  This salt FAQs will give you more information.

Salt substitutes such as LoSalt, Saxa So Low and Solo are not recommended for people with kidney problems.

What about fluid?

Most fluid comes from drinks.  The body passes out extra fluid in your urine.  You may notice you are passing less urine.  Some fluid is removed by dialysis.  If you drink more than is being removed this can cause sudden weight gain, swollen ankles, breathlessness and a rise in your blood pressure.

If this happens, your Doctor, nurse or dietitian may recommend you limit the amount you drink.  It is important you also eat less salt to reduce the fluid build-up and feel less thirsty.

Ideas to help if you need to reduce your fluid:

• Try to have fewer drinks and spread your fluid throughout the day
• Use a small cup or glass for drinks
• If eating sloppy or liquid foods such as soup, custard, yoghurt, ice-cream, reduce how much you drink during the day
• Spicy and salty foods can make you thirsty so try to reduce these foods
• Try using plastic ice-cubes in drinks to save extra fluid
• Rinsing your mouth, gargling with mouthwash and brushing your teeth can help freshen your mouth
• You can quench your thirst with slices of lemon, orange, frozen grapes, pineapple cubes, boiled sweets, sugar free mints and chewing gum
• If you have a dry mouth, artificial saliva sprays may help such as Glandosane (available on prescription)

Ask your dialysis nurse, doctor or dietitian for guidance on the amount of fluid to have.

What if I have diabetes?

Managing your blood glucose levels is important to reduce the risk of more damage to your kidneys. 

Good control of your blood glucose levels can give you more energy, restful sleep, healthier skin and gums and prevent problems with your nerves, eyes, feet, heart.  Find out more about Complications of diabetes at www.diabetes.org.uk.

If you are on HD, well controlled diabetes can improve how well you dialyse.

You may find your blood glucose levels change when you start dialysis.  Continue to check your blood glucose levels regularly.  You can speak to your diabetes nurse or doctor about your diabetes tablets or insulin to help manage your levels. 

After you start HD you will speak to a dietitian for advice on eating well with diabetes and how to balance this with dialysis diet recommendations.

Do I need to eat less potassium?

Some people on HD will need to eat less potassium.  It depends on your blood potassium levels.  If your potassium level is regularly above 5.5mmol/l, you may be recommended to eat less potassium.   If you were limiting potassium prior to starting HD you may need to continue.

  Your levels will be checked each month and your dietitian will provide you with information.  Sometimes there can also be other causes for a high potassium level which will be looked at by your dialysis team.  This potassium FAQs will give you information about foods to choose if you have high blood potassium levels.

Do I need to eat less phosphate?

Some people on HD will need to eat less phosphate.  It depends on your blood phosphate levels.  If your phosphate level is regularly above 1.5mmol/l, you may be recommended to eat less phosphate.  If you were limiting phosphate prior to starting HD you may need to continue. 

Your levels will be checked each month and your dietitian will provide you with information. 

If your blood levels stay high, you may also be prescribed tablets called ‘phosphate binders’.   These are taken with food to reduce the amount of phosphate absorbed from food.  Your dietitian, doctor or pharmacist can tell you how and when to take these tablets.

Why have I been prescribed a renal multivitamin tablet?

Water soluble vitamins are lost during the dialysis process.  A multivitamin tablet suitable for people with kidney disease is usually prescribed to replace those lost.  You are recommended to discuss any supplements with your dietitian or doctor before taking.

Haemodialysis and Food