Transcript Dietary guidelines for the different types of Dialysis from the talk the

What can I eat?
Renal Dietitians
Diet is an important part of your
treatment, along with any medication
you choose
Why do I need to change my diet?
• The kidneys remove waste products
and excess fluid from the blood
• When they do not work properly these waste
products and excess fluid build up in our blood
• As the levels increase other parts of our body
can be affected and we can feel unwell
• Altering our diet can help prevent some levels
increasing too much
When do I need to change my diet?
• When your blood levels and/or fluid start to build up to
harmful levels
• Your Doctor or Nurse will let you and the Dietitian know
when this happens
• Alternatively you may lose your appetite and/or
experience weight loss
• You might see a Dietitian before starting dialysis
• All people on dialysis are seen by a Dietitian
What happens when I see a Dietitian?
• Your diet will be individually assessed and tailored
according to:
• Your appetite
• The type of food you normally eat
• Other specific diets you may be following
e.g. if you have diabetes
• Your blood results
• Your urine output
• Your weight and height
• The type of dialysis you choose
Dialysis
• Helps remove waste products and fluid from the blood
• Unfortunately it is not as efficient as normal healthy
kidneys
• Usually some type of dietary modifications
are necessary
Haemodialysis
• You attend the unit three times a week
• The dialysis machine removes waste products
and fluid
• Waste products and fluid build up between
dialysis sessions
• Your diet is designed to stop these waste products and
fluid getting to a level that could be harmful
Peritoneal dialysis
• You do this type of dialysis every day
• It allows a slow continuous removal of waste
products and fluid from your body
• Less build up of waste products but some care with diet
and fluids might be needed
• A high protein intake and healthy eating are important to
help maintain adequate nutrition and avoid undesirable
weight gain
Dietary guidelines
Nutrient
Recommended intake
on haemodialysis
Recommended intake
on peritoneal dialysis
Energy (calories)
Sufficient to keep you at a
healthy weight
As for haemodialysis, but you
may find weight gain a problem
due to absorption of glucose
(calories) from the dialysis fluid
(about 320 calories a day from 4
bags)
Protein (meat, fish, eggs,
cheese, milk and pulses)
Moderate, which may be more
or less than your usual intake
High, as protein is removed into
the bags during dialysis
Potassium (a mineral found
naturally in most foods)
Depends on blood levels, but
intake often needs to be
modified
Depends on blood level, but
intake less likely to need
adjusting
Phosphate (a mineral found
naturally in protein foods,
particularly in offal, shellfish, oily
fish and game)
Depends on blood levels, but
intake is often modified. May
also require phosphate binders
to achieve phosphate control
(see drug section)
Depends on blood levels.
Intake is likely to be modified.
May also require phosphate
binders to achieve phosphate
control (see drug section)
Dietary guidelines (continued)
Nutrient
Recommended intake
on haemodialysis
Recommended intake
on peritoneal dialysis
Fluid
Depends on urine output,
allowance is usually 500ml plus
equivalent of your 24 hour urine
output
Depends on urine output and
amount of fluid removed daily by
dialysis (ultrafiltration). Usually
more than on haemodialysis
Salt
Okay to use small amounts in
cooking, none to be added at
the table. Reduce your intake of
salty and processed foods and
use alternative flavourings
As for haemodialysis
Fibre (fruit, vegetables and
wholemeal products)
Normal amount to keep your
bowels healthy
Normal / high intake to prevent
constipation, as constipation
reduces the effectiveness of the
dialysis
Vitamins
Supplements of water soluble
vitamins will be prescribed
routinely
Supplements will be prescribed
as necessary
What happens when I see a Dietitian?
• The aim of our advice is to keep you in the best
nutritional status possible
• We will give you ideas on what to eat as well as what to
avoid
• You may receive written information
• We will give you our contact number for future
queries
• We will arrange follow up as needed
What shall I do now?
• If you have seen a Dietitian follow the advice given
• Try to maintain a healthy weight
• Try to eat a variety of foods to ensure a
balanced diet
• Aim to drink about 8 glasses/cups of fluid
each day
• If your appetite is reduced and you are losing weight let
your Doctor, Nurse or Dietitian know as soon as possible
What shall I do now?
• Reducing your salt intake can help reduce your blood
pressure. Try:
- adding less in cooking
- not to add salt at the table
- to avoid salty foods, e.g. processed foods
- to avoid salt substitutes
- using alternative flavourings
• Refer to the ‘Healthy eating for your kidneys’ information
sheet in your pack for further advice
How do I contact a Dietitian?
• Telephone our department to arrange to speak with one
of the Renal Dietitians – 01603 287011
• Leave a message with any of the renal team
• Remember, you do not have to wait for a
Doctor to refer you.
Thank you for listening – are there any questions?