Dialysis Diet — What to Eat & Avoid

Dialysis removes amino acids and albumin during treatment. Protein needs increase to 1.0–1.2 g/kg/day — higher than pre-dialysis CKD. Good sources: eggs, chicken, turkey, fish, lean red meat, tofu, and low-phosphate dairy (ricotta, cottage cheese in controlled portions). Protein malnutrition on dialysis is common and harmful — do not restrict protein without dietitian guidance.

Haemodialysis (3×/week): potassium builds up between sessions, so dietary K usually needs restriction. Avoid or limit: bananas, oranges, tomatoes, potatoes, spinach, dried fruit, avocado, chocolate, nuts. Use leaching (double-boiling) for potatoes and vegetables. Peritoneal dialysis (daily): potassium is removed continuously; some patients even need K supplements. Your dietitian will tell you which group you are in.

Phosphate target on dialysis: ~ 0.9–1.5 mmol/L. Sources to limit: cola, processed cheese, processed meats, baked goods with raising agents, dairy (moderate portions), and foods with E338–E452 additives. Phosphate binders (such as sevelamer, lanthanum or calcium acetate) are taken with meals to bind dietary phosphate in the gut. They must be taken with every meal and snack containing protein or phosphate — timing matters.

Fluid allowance = urine output + 500–750 ml. If you make no urine, total daily fluid is typically 750–1000 ml. All drinks count, plus: soup, gravy, ice cream, jelly, yoghurt, and high-water fruits (melon, grapes, cucumber). Tips: use small cups, measure fluids, suck ice cubes (last longer than water), avoid very salty foods (they increase thirst), and spread intake across the day.

Salt restriction (under 6 g/day) is even more important on dialysis because salt drives thirst, and thirst drives fluid overload between sessions. Fluid overload raises blood pressure, strains the heart, and can make dialysis sessions more difficult. Avoid: bacon, ham, crisps, stock cubes, soy sauce, gravy granules, and most ready meals.

Dialysis removes water-soluble vitamins (B1, B2, B6, B12, folate, vitamin C). Many dialysis units prescribe a renal-specific multivitamin (e.g., Renavit, Dialyvit). Over-the-counter multivitamins may contain potassium, phosphate, magnesium or high-dose vitamin A that are unsuitable. Check with your renal dietitian before adding any supplement.