Essential Tips for Dialysis Patients: Diet, Fluids, and Daily Care

Dialysis patient care is crucial for managing kidney failure and maintaining overall health and well-being. It removes waste products and excess fluid from the blood, helps maintain chemical balance, and can significantly extend a patient's life. Effective care involves not only dialysis sessions but also adherence to dietary and medication guidelines, managing other health conditions, and proactive self-care.
Eating Right
1. Adequate Protein

Protein is vital for building and repairing muscles, and dialysis patients require a higher intake since some protein is lost during each treatment session. Insufficient protein can lead to weight loss, muscle wasting, weakened immunity, and eventually malnutrition. To prevent this, patients should include high-quality protein sources in their diet such as meat, poultry, fish, egg whites, as well as dairy products like yoghurt, milk, cheese, and soy-based foods.
2. Low in Phosphorus

When kidney function declines, phosphate accumulates in the blood, which can cause joint pain, eye irritation, brittle bones, and increased risk of cardiovascular disease. To manage phosphate levels, dialysis patients should avoid high-phosphate foods such as dairy products (milk, cheese, yoghurt), all forms of nuts, seeds, and bean products, cocoa and chocolate-based items, and processed or canned meats like sausages and patties.
3. Potassium Management

Managing potassium levels is crucial for dialysis patients, as elevated potassium can disrupt heart rhythms and become life-threatening. It is important to limit potassium-rich foods such as avocados, bananas, kiwis, and dried fruits. Patients should choose fruits and vegetables that are lower in potassium and consume higher-potassium items like raisins or cherry tomatoes only in small portions. A helpful tip to reduce potassium content in potatoes is to dice or shred them and boil them thoroughly in a full pot of water before consumption.
4. Low in Sodium

High sodium intake increases thirst and fluid retention, which can raise blood pressure and stress the heart.

Tips to reduce sodium:

Use less salt and sauces in cooking

Avoid processed/canned foods

Use herbs, whole spices, lime, vinegar for flavour

Skip stock cubes and extracts
5. Fluid Control

For dialysis patients, reduced urine output makes strict fluid control essential. Excess fluid retention can lead to symptoms such as breathlessness, swelling in the legs, and high blood pressure. The recommended daily fluid intake typically ranges from 500 to 1,000 mL, depending on individual urine output. This allowance includes not just plain water, tea, coffee, and milk, but also foods with high water content such as soups, gravies, porridge, ice cream, and water-rich fruits like melons and oranges
6. Calories

Many dialysis patients experience poor appetite and low energy levels, making it challenging to meet their nutritional needs. To maintain energy, healthy calorie sources like olive oil, canola oil, and safflower oil can be added to meals. Simple sugars such as honey, jam, and jelly can also help boost calorie intake when weight gain is necessary. However, patients with diabetes should consult their renal dietitian before incorporating sweets into their diet.
Living Well with Dialysis
Manage Stress

Practices like meditation, prayer, gentle yoga, and regular exercise help reduce stress and improve mood.
Monitor Blood Pressure

Reduce salt intake to help control blood pressure and limit fluid weight gain.
Get Enough Sleep

Good sleep boosts appetite. Proper nutrition can improve both sleep and overall health.

(The author is Director, Nephrology & Renal Transplant Services, VPS Lakeshore Hospital, Kochi)