TIPS ON HOW DIALYSIS PATIENTS CAN MAINTAIN A HEALTHY LIFE
Patients on hemodialysis or peritoneal dialysis are to be on kidney-friendly diet. Controlling also your fluid level is critical because your kidney can no longer expel excess liquid waste. The following tips will serve as a guide for maintaining a healthy lifestyle while you are on dialysis:
Maintain a Healthy Food Choice
- Eat protein-containing food items
During the dialysis process protein is lost in the body. Therefore eat food with high content of protein to replace the lost protein in your body. Both plant and animal proteins are good for your body. However, your dietician will guide you further on the right combination of these two types based on your health status.
- Eat high calorie food items
Calories maintain your body weight and gives you energy. If you do not take sufficient calories, your body will not be able to use the protein you eat for growth and repair.
- Eat high calorie food items
- Calories maintain your body weight and gives you energy. If you do not take sufficient calories, your body will not be able to use the protein you eat for growth and repair.
- Balance your intake of Phosphorus
Normal working kidneys can remove extra phosphorus in your blood. When you have Chronic Kidney Disease (CKD) your kidneys cannot remove phosphorus very well. High phosphorus levels can cause damage to your body. Extra phosphorus causes body changes that pull calcium out of your bones, making them weak. High phosphorus and calcium levels also lead to dangerous calcium deposits in blood vessels, lungs, eyes, and heart. To prevent this from occurring, phosphorus must be controlled through diet and phosphate binders. The key to phosphorus control is:
- Take phosphate binders with all meals and snacks; and
- Potassium For the Heart
When kidneys fail they can no longer remove excess potassium, so the level builds up in the body. High potassium in the blood is called hyperkalemia. This may occur in people with advanced stages of chronic kidney disease (CKD).
Some of the effects of high potassium are:
- numbness or tingling
- slow pulse
- irregular heartbeat
- heart failure
- sudden death
How to prevent potassium levels from getting too high
The following are the tips for people with kidney failure to keep their potassium at safe levels:
- Watch your diet. Limit foods that are high in potassium. These are some of the foods containing high potassium:
- Dried fruits
- Oranges & orange juice
- Papaya (pawpaw)
- Prune juice
- Dried beans & peas
- Potatoes, French fries
- Spinach (cooked)
- Sweet potatoes
- Tomatoes, tomato sauce
- Vegetable juices
- Winter squash
- Salt substitute
- Seeds and nuts
- Limit fruits and vegetables to the amounts recommended by your dietitian.
- Limit milk and milk products or replace with nondairy substitutes recommended by your dietitian.
- Discard liquids from canned fruits and vegetables.
- Avoid salt substitutes and other seasonings that contain potassium.
- Read labels on "low salt" or "low sodium" packaged foods to be sure potassium ingredients like potassium chloride are not added.
- Keep an eye on serving size. Almost all foods have some potassium, so even a low potassium food can turn into a high potassium food when eaten in large amounts.
- Do not skip dialysis. Stay on dialysis for the full treatment time. The full treatment time is necessary to clean the blood adequately.
- Leach high potassium vegetables, if including them in your diet. Leaching removes some of the potassium. Ask your renal dietitian which vegetables to leach and how much you can eat
Fluid Balance and Removal
Healthy kidneys maintain fluid balance and prevent swelling in feet, ankles, legs, hands, or face. When the kidneys lose their ability to get rid of extra fluid, the extra water can raise blood pressure, cause strain on the heart, and make it hard to breathe.
One of the primary goals of dialysis is fluid removal. Less fluid gained between treatments results in a better-tolerated treatment and is easier on the heart. Higher fluid gains can lead to cramping during dialysis and possibly longer treatment times (some people may need an extra treatment if not all of the water weight is removed). The goal for fluid gain should be no more than 1-2 pounds per day between dialysis treatments.
The fluid allowance for HD is determined by the amount of urine produced in a 24-hour period. Most people are limited to 700-1000 ml of fluid per day plus urine output. For example, if you urinate 500 cc, your total daily fluid allowance would be 1200 cc (500 + 700). Fluid allowances vary from person to person. Other considerations include how much of the remaining kidney function is left and the person's body size.
Controlling Fluid Intake
Tips for controlling thirst and your fluid intake include the following:
- Ice lasts longer in your mouth than liquid. Make sure to measure ice as fluid.
- Use small cups or glasses instead of large ones. Know how much your favorite glasses or cups hold.
- Chew gum. Make sure it's sugarless gum if you are diabetic.
- Add a drop of lemon juice to water or suck on a lemon wedge.
- Rinse your mouth without swallowing.
- Keep mouthwash in the refrigerator and rinse the inside of your mouth occasionally to refresh and moisten it.
- Try very cold, low potassium fruit such as frozen grapes.
- Eat bread with margarine and jelly, or applesauce (but, again, watch the sugar in jelly or applesauce if you are diabetic).
- Pass on the salt! Do not add salt to food, and keep the salt shaker off the table.
- Brush your teeth more often to feel refreshed.
- Suck on a lemon wedge. You can freeze it first if you like.
- Suck on a few ice chips. Ice stays in your mouth longer than water.
- Eat sugar-free sour candy or chew gum to wet your mouth.
- Eat frozen fruit like peaches, or pineapple chunks.
- If you have diabetes, keep your blood glucose (sugar) levels at the level your physician prescribes.
Sodium and Salt Substitutes
Although sodium is essential for the body functions, too much sodium can be harmful for people with kidney disease. Sodium (salt) helps your body to retain a healthy fluid balance. But having renal disease means your kidneys cannot eliminate excess sodium and fluid from your body. As sodium and fluid build up in your tissues and bloodstream, your blood pressure increases and you feel uncomfortable.
Particularly damaging is sodium's link to high blood pressure. High blood pressure can cause more damage to unhealthy kidneys. This damage further reduces kidney function, resulting in even more fluid and waste build up in the body.
Other sodium-related complications include the following:
- Edema: noticeable swelling in your legs, hands and face
- Shortness of breath: fluid can build up in the lungs, making it difficult to breathe