Information on diet for twice weekly dialysis

RENAL DIETARY INFORMATION for unit haemodialysis patients during COVID-19 (coronavirus) outbreak: Information for patients & carers.

Due to the changing circumstances because of coronavirus there may be additional dietary changes you need to make. Particularly if you are a haemodialysis patient, your dialysis days may be changed or altered.

You may have already had advice from a renal dietitian regarding your diet and fluid intake, and this will still be important to follow.

This link to Kidney Care UK is a great read – please take a look.

The British Dietetic Association also have some useful information:

https://www.bda.uk.com/uploads/assets/512622be-c771-4352-82032df8f0213ae6/Renal-Food-Pack-Ideas.pdf

You may also have other health conditions (e.g diabetes, coeliac disease) that requires you to follow a certain diet, please continue with this.

While one ‘renal diet’ doesn’t fit all, people may need to restrict certain foods and drinks, this is always assessed on an individual basis, and it will be based on the blood tests that are taken.

My potassium level often runs high, what foods do I need to be careful with?

Potassium is a mineral which is needed for the normal functioning of the muscles and heart. High levels of potassium in the blood can be dangerous as it can affect your heart.

Potassium is found in many foods and drinks including fruit, vegetables, potatoes, milk and some snack foods. It is the amount and how often you eat these foods that may put your blood potassium level up.

Ways to reduce your intake of high Potassium foods:

Reduce intake of:

Lower Potassium alternatives:

FRUIT-

Bananas, kiwi fruit, mango, plums, rhubarb dried fruit (raisins, sultanas, prunes, dates)

Lower potassium fruit includes apple and pears.

Fruit should be limited to a maximum of 3 portions per day.  A portion is 80 g or about a handful e.g. one small apple, clementine or about 10 grapes.

 

VEGETABLES –

Mushrooms, beetroot, spinach, steamed or microwaved vegetables.

Pulses & dried beans, Limit baked beans to once/week

 

2 – 3 (80 g) portions of other vegetables ,

Boil vegetables if possible

 

Limit salads to one small bowl per day

 

 

STARCHY FOODS

Jacket/baked potatoes or sweet potatoes

 

oven/microwave/retail chips,

 

manufactured potato products e.g. hash browns, potato waffles, frozen roast potato, potato wedges.

 

 

 

 

AVOID salt substitutes e.g Lo-salt, So-Lo, reduced sodium salt

Boiled potatoes or sweet potatoes, (after boiling throw the cooking water away, and do not use to make gravy or stock).

 

Potatoes that have been par-boiled then roasted/fried

           

Pasta, rice, noodles, cous cous, bread.

 

Have no more than one serving of potato per day.

 

Other seasoning e.g pepper, herbs spices.

SNACKS & MICELLANEOUS –

Potato crisps/snacks, nuts, chocolate, fudge Biscuits and cakes, containing lots of nuts, dried fruit, peanut butter

 

Corn or maize based snacks, plain popcorn, mints, boiled/chew/jelly sweets, marshmallow, plain biscuits and plain cakes

Jam, honey, marmalade & lemon curd  

 

DRINKS –

Coffee (including de-caff), malted milk drinks (e.g. Ovaltine/Horlicks), drinking chocolate, cocoa, fruit and vegetable juices, smoothies, wine, beer, cider and stout

 

Limit milk to 2/3 pint per day or 1/3 pint milk + 1 pot yoghurt per day

 

Tea, herbal tea, squash/cordial, mineral water, flavoured water, fizzy drinks.

 

Spirits are generally lower in potassium than other alcoholic drinks

 

Remember to keep within safe limits for alcohol intake

 

 

 

Other things that can affect your potassium levels are:

  • Bowel function- if you become constipated let the renal team know.
  • Blood glucose levels -good control of your blood sugar levels, if you are diabetic, will help control your blood potassium levels.
  • Some medications- your renal team will look into this for you.

The renal team may have also provided you with a potassium-binding powder (Lokelma), it is important to take this if you are instructed by the team. If you are unsure and have any questions about your diet please contact the renal dietitian.

I have been told I am putting on too much fluid between dialysis sessions, what can I do?

If you are drinking more than your fluid allowance (if you’re uncertain as to what this is check with your renal team), this will lead to too much fluid in the body, a rapid weight gain, significant breathlessness and a high blood pressure.

  • Fluid is everything that you drink: water, tea, milk, squash & fizzy drinks, alcohol.
  • There is also fluid in foods such as: Gravy, soups, stews, puddings, jelly, ice cream & ice lollies, porridge. You must include these in your fluid allowance.

Hints to help you with your fluid allowance:

  • Use smaller cups for drinks.
  • Sucking on ice cubes (even make them up with diluted squash)
  • Some people find mints, sweets or chewing gum also helps.
  • Keep your mouth and teeth fresh by brushing your teeth can help.
  • Avoid salt & limit salty foods or snacks which will make you thirsty:
  • Bacon, ham, sausages, burgers, tinned meat.
  • Smoked & tinned fish, prawns, cockles, laver bread.
  • All hard cheese, except cream cheese
  • Tinned & packet soups(this would also need to be include in your fluid allowance)
  • Salted crisps & nuts
  • Oxo, Bovril & marmite
  • Ready & convenience meals (try not have more than 1 ready meal/day)                        

I feel like I’m losing weight?
If you have been unwell and off your food, you may have lost flesh weight. When you begin eating better and putting on weight this will be a gradual increase in weight.

The team of renal dietitians is based in Morriston Hospital Swansea, and we are here to support all of our patients in the South West Wales renal service. If you have any questions please do not hesitate to contact us on: 01792 703239

(there is an answer machine so leave us a message and we will get back to you when we are able to)

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