WELCOME
to the University of Mississippi Medical Center
Dialysis treatments are used to remove waste products and
fluid from your body that your kidneys can no longer handle.
Nutrition plays an important part of your dialysis treatment
plan. Your renal dietitian can work with you to help with
your diet.
Dialysis patients should include protein in their diet as well as
watch their sodium and fluid intake. Your labs will be drawn
monthly, which will include your phosphorus and potassium
that should be avoided/restricted as well. These handouts are
designed to help you choose good dialysis friendly choices that
are low in sodium, phosphorus, and potassium and high protein.
If you have any questions about your diet, just ask your renal
dietitian. The more you understand your diet, the easier it is to
follow it. As you learn more about your diet, you will be able to
eat a wider variety of foods.
NAME ___________________________________________________
DATE ____________________________________________________
DIETITIAN ________________________________________________
PHONE __________________________________________________
REFERENCES
National Kidney Foundation (NKF) | www.kidney.org
American Association of Kidney Patients (AAKP) | www.aakp.org
Academy of Nutrition and Dietetics (AND) | www.eatright.org
United States Department of Agriculture (USDA) | www.usda.gov
PROTEIN
It is important to include protein in your diet while on dialysis. Protein helps to
build, repair, and maintain your body. It also helps fight against infection. Having
too little protein can cause complications such as muscle breakdown, poor wound
healing, and increased risk of infections and complications. Your albumin and
other lab values will be checked monthly to give us an idea of your protein status.
Most people on dialysis need 6–8 ounces of protein per day. A 3-ounce serving of
protein is about the size of a deck of cards. Highly processed meats such as bacon,
hotdogs, sausages and canned meats are high in phosphorus additives and sodium
and need to be avoided.
Good Sources of Protein
Beef
Veal
Eggs/Egg Substitutes
Wild Game
Chicken & Turkey
Pork & Fresh Pork
Seafood (scallops,
shrimp, oysters)
Fish
Beans*
Cheese*
Milk*
Yogurt*
*These foods are high in phosphorus. Check with your renal dietitian first before eating.
SODIUM
Too much sodium in your diet can cause thirst, high blood pressure, and fluid gain. Avoid
adding salt to your food because most foods already contain lots of sodium. Do not use
salt substitutes unless your RD or MD approves it. Your renal dietitian can work with
you to help you cook and flavor foods without salt. When buying foods, look at labels and
choose products with less than 300 mg/serving.
Seasoning Suggestions
High Sodium Foods
Salt is not the only seasoning that can make food
taste good. With a few spices and a little creativity, a
plain meal can turn into a special treat.
BEEF/PORK: onion, garlic, pepper, sage, basil, caraway
seed, celery seed, thyme, marjoram, rosemary, chives
CHICKEN: paprika, onion, garlic, pepper, thyme, sage,
rosemary, marjoram, oregano, chives, parsley
FISH: bay leaf, onion, garlic, pepper, paprika, dry
mustard, lemon juice, parsley, dill, chives
EGGS: pepper, dry mustard, paprika, curry, green
pepper, onion, fresh mushroom, jelly
GREEN BEANS: pepper, onion, garlic, dill seed, celery
seed, marjoram, lemon juice, sesame seeds
CARROTS: parsley, onion, garlic, dill seed, mint, tarragon, chives, sugar
CORN: green pepper, onion, pepper, hot chili peppers
TOMATOES: bay leaf, onion, garlic, pepper, hot chili
peppers, basil, oregano
POTATOES: chives, onion, garlic, pepper, dill
Instant/Boxed
Meals
Condiments
(mustard, ketchup,
barbeque sauce)
Canned Products
(choose fresh/
frozen vegetables)
Pickles, Olives,
Relish
Snack Foods such
Seasoned salt, garlic
as pretzels, chips,
or onion salt, lemon
nuts, crackers
pepper seasoning,
(choose low sodium Tony Chachere’s®, etc.
or sodium-free)
Pancakes/Waffles
Ham, Sausage, Bacon
Processed Foods
(hotdogs)
Luncheon meats
(salami and bologna)
Soups (choose low/
reduced sodium and
add more water)
Canned Meats
(potted meat,
Vienna sausages)
FLUIDS
You may need to limit your fluids while on dialysis.
Most people on dialysis can have at least 4 cups of
fluid plus the amount equal to their urine output.
What counts as fluid?
Fluid is anything that is liquid at room
temperature.
Water & Ice
Soda
Coffee/tea
Juice
Alcohol
Milk
Popsicle
Jell-O
Ice Cream
Soup
How do I determine my fluid restriction?
How much fluid can you consume a day? KDOQI
suggests 1000ml plus urine output.
240 ml
1 cup
480 ml
2 cups
1000 ml
4 cups
EXAMPLE: Let’s say you are urinating 480 ml.
Add 480 ml (2 cups) to 1000 ml (4 cups) to get 1480
ml (a total of 6 cups). This is a good number to start
with. If you are gaining more than 3.0 kg (6.6 pounds)
between treatments, you may want less than your
calculation.
How do I control my fluid?
Controlling fluid can be challenging at times, especially during the summer. Here are some hints for
controlling fluids.
•
•
•
•
Chew sugar-free candy or gum.
Lemons
Eat chilled fruit such as frozen grapes.
Know the amount of fluids your cups and
glasses hold.
• Limit salty foods and seasonings.
• If diabetic, control your blood sugars.
nt
leme
Supp
Syrup & Gravy
Nutritional
Supplements
PHOSPHORUS
Phosphorus is a mineral found in many foods. Having the right amount of
phosphorus and calcium in the blood is needed for strong bones. When kidneys
fail, excess phosphorus is not removed and will build up in the blood. High levels
of blood phosphorus will cause calcium to be pulled from your bones, making your
bones weak and brittle. High phosphorus can also cause itching and hardening of
blood vessels, tissues and organs, which can increase your risk for heart attack
and amputations.
Your doctor may prescribe a medication to reduce the amount of phosphorus
absorbed into your blood called a phosphorus binder (Renvela, Renvela Powder,
Renagel, Phoslo,
Fosrenol, or Tums).
You must take this
binder with meals
and snacks because it
absorbs the phosphorus from the foods
you eat. Also, don’t
Beer
Bran Cereal/Muffins Biscuits/Cornbread Chocolate/Caramel
forget to bring your
binders when you
leave the house and
go out to eat. Foods
at restaurants can
contain more phosphorus than foods
Dark Colas (Coke®,
Peanut Butter
Organ Meats
Prepared/Processed
prepared at home.
Pepsi®, Dr. Pepper®,
Foods (macaroni &
Many restaurants use
Mr. Pibb®)
cheese, pizza, hotdogs)
phosphorus additives that are 100%
absorbed. Restaurant
foods do not have
ingredient labels.
High Phosphorus Foods
Milk— ½ cup
Yogurt—½ cup
Cheese—1 oz.
Ice Cream—½ cup
Dairy products contain phosphorus. Limit to 1 serving per day.
Eggnog
POTASSIUM (K+)
Potassium is an electrolyte that helps with muscle function and regular heartbeat. The
kidneys get rid of potassium. During kidney failure, potassium can build up in the blood
or be lowered (Peritoneal Dialysis, vomiting, diarrhea, etc.). Both high and low potassium levels can cause muscle weakness, cramps, nausea, diarrhea, problems regulating
blood pressure, heart attack and even death. Your monthly labs should tell you if you
need to eat either more or less potassium in your diet.
Almost all foods have some potassium. That is why
serving size is very important. A large amount of
a low potassium food can equal a high potassium
food.
What is a safe level of
potassium in my blood?
TIPS FOR REDUCING POTASSIUM IN POTATOES, SWEET
POTATOES, CARROTS, BEETS, AND RUTABAGAS
1. Peel and place the vegetables in cold water so
they don’t darken.
2. Slice vegetables 1/8 inch thick.
3. Rinse in warm water for a few seconds.
4. Soak for a minimum of two hours in warm water. Use ten times the amount of water to the
amount of vegetables. If soaking longer, change
the water every four hours.
5. Rinse under warm water again for a few seconds.
6. Cook vegetables with five times the amount of
water to the amount of vegetable.
You are in the
SAFE zone
Legumes (Beans and Peas)
3.5–5.0
5.1–6.0
You are in the
CAUTION zone
HIGHER THAN 6.0
You are in the
DANGER zone
Legumes are high in potassium and phosphorus (canned beans/peas should be
rinsed well.) You may include ________ (1/2 cup) servings of the following per week.
• Dried beans/peas
• Lima beans (butter beans)
• Baked beans
• Navy beans
• Black beans
• Northern beans
• Black-eyed peas
• Pinto beans
• Chick peas (garbanzo)
• Refried beans
• Field peas
• Soy beans
• Lentils
• Red (kidney) beans
High Potassium Foods
No more than one 1/2 cup serving of high potassium food per day.
Do not eat star fruit, otherwise known as carambola.
Apricots
Avocados
Bananas
Cantaloupe
Honeydew Melon
Dried Fruits (raisins, apricots, dates, figs, prunes)
Kiwi Fruit
Mangos
Nectarines
Oranges
(fresh or juice)
Papayas
Pomegranate &
Prune Juice
Asparagus
Artichokes
Beets
Brussels Sprouts
Mushrooms
(cooked)
Potatoes (sweet,
baked, or fried)
Tomatoes
Tomato/Vegetable
Juice or Sauce
Winter Squash &
Pumpkin
Greens & Spinach
Granola
Bran Cereal/Muffins
Chocolate
Coconut
Nuts/Seeds/Peanut
Butter
Molasses
Milk (limit to
½ cup/day)
Ice Cream (limit
to ½ cup/day)
Salt Substitutes/
Light Salt
Sports Drinks
Snuff/Chewing
Tobacco
Legumes (see note
on page 6)
Low Potassium Foods
Apples
Berries
Grapes
Peaches
Plums
Pineapple
Cranberry Juice
Apple Juice
Grape Juice
Eggplant
Cucumbers
Green Beans
Raw Mushrooms
Carrots
Lettuce
Cauliflower
Non-Dairy
Whipped Topping
Non-Dairy
Creamer
Sherbet
Sorbet
Unenriched
Rice Milk
Grocery List Suggestions for Dialysis Patients
MEAT/PROTEIN FOODS
c Raspberries
BREADS/CEREALS/GRAINS
c Cherry 7-up®
roast, steak, stew)
c Chicken
c Eggs, Egg substitute (Egg
Beaters®, Scramblers®)
c Fish (fresh or frozen)
c Salmon (canned in water)
c Tuna (canned in water)
c Lamb
c Pork (fresh) chops,
loin, roast
c Shellfish (clams, crab,
crawfish, lobster, scallops, shrimp)
c Tofu (soft)
c Turkey
c Veal
c Wild Game (deer, duck,
goose, pheasant, rabbit,
squirrel)
c Tangerines
egg, raisin)
c Bread (white, French,
Italian, rye, soft wheat,
sourdough)
c Bread sticks (plain)
c Cereals, dry, low salt
(Chex® [Rice, Corn],
Cornflakes, Corn Pops®,
Cocoa Puffs®, Fruity
Pebbles®, Product 19®,
Puffed Wheat®, Puffed
Rice®, Rice Krispies®, Special K®, Sugar
Smacks®)
c Cereals, cooked (Cream
of Rice®, Cream of
Wheat®, Farina®, Malto-Meal®, Oatmeal
c Couscous
c Crackers (unsalted)
c Dinner rolls or hard rolls
c English muffins
c Grits
c Hamburger/hot dog buns
c Noodles/Pasta
(macaroni, spaghetti)
c Melba toast
c Oyster crackers
c Pita bread
c Popcorn, unsalted
c Pretzels, unsalted
c Rice (brown, white)
c Rice cakes (unsalted)
c Tortillas (flour)
c Ginger ale
c Beef (chuck, ground,
FRUITS
(Serving size=l medium-size
fruit or 1/2 cup canned)
c Apple juice
c Apples
c Applesauce
c Apricots (canned)
c Blackberries
c Blueberries
c Cherries
c Cranberries
c Cranberry juice
c Cranberry sauce
c Figs (fresh)
c Fruit cocktail
c Grapefruit (1 half)
c Grape juice
c Grapes
c Lemons
c Lemon juice
c Limes
c Lime juice
c Loganberries
c Nectars (apricot,
peach, pear)
c Peaches (canned)
c Pears (canned)
c Pineapples
c Plums
c Strawberries
VEGETABLES
(Serving size=1/2 cup, no
added salt)
c Arugula
c Asparagus
c Beets (canned)
c Broccoli
c Cabbage (green, red)
c Carrots
c Cauliflower
c Celery
c Chili peppers
c Chives
c Coleslaw
c Corn
c Cucumbers
c Eggplants
c Endive
c Garlic
c Ginger root
c Green beans
c Greens (mustard, turnip)
c Hominy
c Jalapenos (fresh)
c Kale
c Leeks
c Lettuce
c Mixed vegetables
c Mushrooms (raw)
c Okra
c Onions
c Parsley
c Peas (English)
c Peppers (green, red, yellow)
c Pimentos
c Radicchio
c Radishes
c Seaweed kelp
c Spaghetti squash
c Sprouts (alfalfa, bean)
c Summer squash (yellow,
scallop, zucchini)
c Tomatillos
c Turnips
c Water chestnuts
c Watercress
c Wax beans
c Bagels (plain, blueberry,
DAIRY/DAIRY SUBSTITUTES
c Nondairy creamers
c Nondairy frozen dessert
topping (Cool Whip®)
c Nondairy frozen desserts (Mocha Mix®)
c Rice milk, unfortified
BEVERAGES
(Remember your fluid
restriction)
(Diabetics, watch your sugar
intake)
(Regular or diet)
c 7-up®, Sprite®, lemonlime soda
c Cream soda
c Grape soda
c Mello Yello®
c Mountain Dew®
c Orange soda
c Root beer
c Slice®
c Coffee
c Fruit punch Hi-C®
(cherry, grape)
c Horchata®
c Juices (apple, cran-
berry, grape, grapefruit,
pineapple)
c Kooi-Aid®
c Lemonade or limeade
c Mineral water
c Nectars (apricot, peach,
pear, 1/2 c serving)
c Nondairy creamers (Coffee
Rich®, Mocha Mix®, etc.)
c Tea
c Water
FATS
c Butter
c Cream cheese
c Gravy
c Margarine
c Mayo
c Miracle Whip®
c Nondairy creamers
c Salad dressings
c Sour cream
c Vegetable oils (prefer-
ably canola or olive oil)
SEASONINGS & SPICES
c Allspice
c Basil
c Bay leaf
c Caraway seed
c Chives
c Cilantro
c Cinnamon
c Cloves
c Cumin
c Curry
c Dill
Remember—just because a food is listed doesn’t mean you can eat unlimited quantities. Your Registered Dietitian will help you determine the correct number of servings from each food group to help keep your weight and lab values within a healthy range.
c Extracts (almond,
lemon, lime, maple,
orange, peppermint,
vanilla, walnut)
c Fennel
c Garlic powder
c Ginger
c Horseradish (root)
c Lemon juice
c Lime juice
c Mrs. Dash®
c Nutmeg
c Onion powder or flakes
c Oregano
c Paprika
c Parsley or parsley flakes
c Pepper (black, red, white)
c Pepper sauce
c Pimentos
c Poppy seed
c Rosemary
c Saccharin
c Saffron
c Sage
c Savory
c Sesame seeds
c Tabasco®
c Tarragon
c Thyme
c Turmeric
c Vinegar
DESSERTS/SNACKS/
SWEETS
(Diabetics, use caution)
c Animal crackers
c Cake (angel food, butter,
lemon, pound, spice,
sponge, strawberry,
white, yellow)
c Candy corn
c Chewing gum
c Chewy candy
c Cinnamon drops
c Cookies (ginger snaps,
shortbread, sugar, vanilla
wafers)
c Corn cakes
c Cotton candy
c Doughnuts
c Fruit ice
c Graham crackers
c Gumdrops
c Beef Chow Fun
c Chicken Pesto Classico
c Hard candy
c Grilled Chicken Caesar
c Roasted Chicken Fresca
c Gummy Bears®
c Hot Tamale® candy
c Italian Ice
c JELL-O®
c Jelly beans
c Jolly Ranchers®
c LifeSavers®
c Lollipops
c Lorna Doones
c Marshmallows
c Melba toast
c Newtons® (fig, straw-
berry, apple, blueberry)
c Pie (apple, berry, cherry,
lemon, peach)
c Popcorn (unsalted)
c Pretzels (unsalted)
c Rice cakes (unsalted)
c Rice Krispie® squares
c Sorbet
c Tortilla chips (unsalted)
OTHER
(Diabetics, use caution)
c Apple butter
c Corn syrup
c Honey
c Jams/jelly
c Maple syrup
c Marmalade
c Powdered sugar
c Sugar (brown or white)
FROZEN MEALS
Look for frozen meals which
have less than:
­—600 mg sodium
­—600 mg potassium
—300 mg phosphorus or less
than 30% phosphorus *Phosphorus often is not on the food
label, so in general avoid meals
with dairy, nuts or beans. Here
are some examples of meals
that meet the above criteria.
LEAN CUISINE
(Nutrition info as of January
2010)
Café Cuisine
c Glazed Chicken
c Lemon Pepper Fish
c Orange Chicken
c Tortilla Crusted Fish
c Steak Tips Portobello
c Dinnertime Selects
c Chicken Portobello
Simple Favorites
c Asian Style Pot Stickers
c Chicken Chow Mein
c Chicken Fried Rice
c Chicken Teriyaki Stir Fry
c Spaghetti with Meatballs
Spa Cuisine
c Apple Cranberry Chicken
c Butternut Squash Ravioli
c Ginger Garlic Stir Fry
with Chicken
c Grilled Chicken Primavera
c Lemon Chicken
c Roasted Honey Chicken
c Rosemary Chicken
c Sesame Stir Fry with
Chicken
c Salmon with Basil
c Szechuan Style Stir Fry
with Shrimp
HEALTHY CHOICE
(Nutrition info as of November 2009)
Complete Meals
c Mandarin Beef Lo Mein
c Chicken Pesto Alfredo
c Fire Roasted Tomato
Chicken
c Chicken Parmigiana
c Country Breaded
Chicken
c Roasted Chicken
Monterey
c Chicken Balsamico
c Roasted Sesame Chicken
c Sweet & Sour Chicken
c Spicy Shrimp Diavolo
c Lemon Pepper Fish
Café Steamers
c Cajun Style Chicken &
Shrimp
c Chicken Margherita
c Grilled Basil Chicken
c Roasted Chicken Marsala
Asian Inspired Café
Steamers
c Chicken Pad Thai
c Five-Spice Beef &
Vegetables
c General Tso’s Spicy
Chicken
c Sweet & Spicy Orange
Zest Chicken
c Sweet Sesame Chicken
All-Natural Entrees
c Portobello Marsala Pasta
c Mediterranean Pasta
c Portobello Spinach
Parmesan
c Pumpkin Squash Ravioli
c Sweet Asian Pot Stickers
c Tomato Basil Penne
Select Entrees
c Chicken Alfredo
Florentine
c Bacon and Smokey
Cheddar Chicken
c Honey Ginger Chicken
c Salisbury Steak
c Slow Roasted Turkey
Medallions
NOTES
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
NUTRITION LABELS
When you feel better and begin grocery shopping, check food labels:
• Simple rule of thumb: If salt is listed in the first five ingredients, the item is usually
high in sodium. Ingredients are listed in order of the highest to the lowest amounts
contained in the product.
• Next, look at the package label. Check the serving size. Nutrition values are listed
per serving.
• If the sodium level is 300 mg or more per serving, or 600 mg per meal, the item is
usually a higher sodium food.
• Compare labels of similar products. Select the lowest sodium level for the same
serving size.
SERVING SIZE:
Serving size is
now based on
the amount most
commonly eaten.
LOOK FOR
PROTEIN CONTENT:
Larger meat portions provide
higher protein.
Eat at least 70
grams of protein
per day.
Nutrition Facts
Serving Size 1 Hot Dog (45g)
Servings Per Container 10
Amount Per Serving
Calories 45
Total Fat 1.5 g
Saturated Fat 1 g
Cholesterol 15 mg
Sodium 430 mg
Total Carbohydrate 2 g
Dietary Fiber 0 g
Sugars 2 g
Protein 5 g
Vitamin A 0%
Calcium 0%
Calories from Fat 15
% Daily Value*
2%
5%
5%
18%
1%
0%
SERVINGS PER
CONTAINER:
Refers to the
number of servings included in
the package.
CALORIES AND
CALORIES FROM
FAT: Calories provide energy and
protect protein.
Vitamin C 8%
Iron 2%
*Percentage daily values are based on a 2,000 calorie diet.
Your daily values may be higher or lower depending on your
calorie needs:
Calories:
2,000 2,500
Total Fat
Less than
65 g 80 g
Sat Fat
Less than
20 g 25 g
Less than
300 mg 300 mg
Less than
2,400 mg 2,400 mg
Total Carbohydrate
300 g 375 g
Dietary Fiber
25 g 30 g
The above information was taken from
an actual product label.
LOOK AT SODIUM
CONTENT: If a food
has more than
300 mg sodium
per serving, it
may make you
more thirsty.