The mineral phosphorus is also controlled by this diet. Phosphorus is not effectively removed by dialysis treatments. Patients need to reduce their intake of dairy products and other foods high in phosphorus.

They are usually prescribed calcium supplements, which bind the phosphorus in food. It is important to take these calcium tablets with meals. Some patients may be given a non-calcium phosphorus binder, such as Renagel. The amount of binders that need to be taken by each patient is determined by their blood levels of phosphorus and their intake of phosphorus-containing foods in the diet.

FLUIDS

During kidney failure, the amount of urine produced drops. The urine output usually stops completely once patients have been on dialysis for more than 6 months. Patients on peritoneal dialysis usually retain their urine output for a longer time and have less restriction on fluid intake.

The recommended daily amount of fluid is based on the amount of urine produced in a 24-hour period and the amount of weight gained between dialysis treatments. Other considerations are the amount of fluid retention, the level of dietary sodium, and whether the patient has congestive heart failure.

Patients on peritoneal dialysis usually have less restriction on their fluid, sodium, and potassium intake as they have dialysis treatments every day. The intake of these substances needs to be individualized in these patients.

OTHER FACTORS

People with kidney disease are more prone to heart disease and often need to follow a low-fat diet. The daily calorie intake needs to maintain the person’s nutritional status and prevent the breakdown of body tissue. The person’s weight and protein status should be monitored regularly.

Vitamin supplementation is usually needed. The requirements for the fat-soluble vitamins (A, D, E, and K) are usually met by the diet. Vitamin D is supplemented depending on calcium, phosphorus, and parathyroid hormone levels. Vitamin D is usually given intravenously during the dialysis treatment.

The patient's intake of water-soluble vitamins is often inadequate, as several good food sources of water-soluble vitamins are restricted on this diet. Water-soluble vitamins are also lost during the dialysis treatments. All dialysis patients should receive supplementation of water-soluble vitamins.

The minerals calcium and iron are monitored. Supplementation of daily calcium depends on the patient's blood calcium levels. Calcium is also given in the dialysis solution and is adjusted according to the blood calcium levels. Iron supplementation is based on iron studies, usually monitored every 3 months. Most dialysis patients are iron deficient and receive intravenous iron during dialysis treatments.

SUPPORT

The Kidney Foundation has chapters in most states and is an excellent resource for educational materials and programs for people on dialysis and their families.

Most dialysis centers have registered dietitians who work with patients and physicians to educate the patients about their diet while on dialysis.

Images

Kidney anatomy

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Review Date: 02/03/2006
Reviewed By: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)