Name: Paula Rubello

Renal: new HD—low Na, low K, low phos, fluid restriction and high protein

 Hemodialysis (HD) is a treatment for when your kidneys are failing. HD

removes waste and extra water from your blood.
 What you eat and drink while on HD can have an impact on how you feel and
the effectiveness of the treatment.
 Waste can build up in your blood between dialysis treatments. This is not
favorable since it can make you sick. By controlling what you eat and drink,
waste buildup can be avoided. If there is too much waste accumulated in the
blood, HD may not be able to remove it all.
 Very good!

Nutrition Recommendations
 Before you started dialysis, you may have been on a low-protein diet to limit
the amount of waste products in your blood. Now that you have begun HD,
your diet will include more protein. You will have to limit the amount of
sodium, potassium, phosphorus and fluid.
 Avoid using salt and use spices instead.
 Add lemon juice, herbs, and spices that do not contain salt to add flavor.
 Measure portions of food and ingredients using standard measuring cups and
spoons (or we can teach them how to use the palm of the hand or fist or
finger, etc.
 Soaking vegetables can lower potassium. Peel and cut into pieces that are
approximately 1/8 inch thick. Rinse and soak them in warm water for at least
2 hours. Use approximately 10 times more water than vegetables. Drain and
rinse them under warm water, and then boil them for 5 minutes. Still
important to limit.
 Soaked potatoes can be made into several dishes. For instance, they can be
French fried, mashed, boiled, home fried with onions, or scalloped.
 Avoid processed foods to reduce your intake of sodium and phosphorus.
Phosphorus is widely used in processed meats, leavening agents, and as an
anti-caking agent in some powdered drink mixes. Phosphorus and
polyphosphates are also used as emulsifiers in some frozen fish and chicken
("enhanced" meats are significantly higher in sodium than fresh
meats). Select fresh or frozen vegetables instead of the higher-sodium
canned products.
 Foods that are liquid at room temperature, such as soup, contain water.
Gelatin, pudding, ice cream, and other foods that include a lot of liquid in the
recipe also count. Most fruits and vegetables contain water, such as melons,
grapes, apples, oranges, tomatoes, lettuce, and celery. When you count up
how much liquid you have in a day, be sure to count these foods.

Foods to Avoid or Limit Foods to Include

 Fruits high in potassium:  Fruits low in potassium:
 Name: Paula Rubello

bananas, raisins, prunes, berries, apples, grapefruit,

oranges, pineapple, cranberries,
 Vegetables high in grapes
potassium: tomatoes,  Vegetables low in potassium:
avocados, spinach, brussels cauliflower, broccoli,
sprouts, potatoes, split peas, eggplant, green beans
pumpkin  Low phosphorus meat and
 Cheese poultry: beef, chicken, lamb,
 Chocolate pork, turkey, veal
 Cream soup  Low phosphorus seafood:
 Dried beans and peas salmon, yellowfin tuna, sea
 Ice cream bass, mahi mahi, lobster,
 Milk oysters, shrimp
 Nuts  Low phosphorus bread: corn
 Foods liquid at room tortilla, English muffin, flat
temperature bread, white pita bread,
 Soy sauce, bottled salad sourdough bread, white
dressings bread
 Deli style meats (turkey,  Low phosphorus pasta and
ham, roast beef), sausage, hot rice: egg noodles, pearled
dogs barley, plain white rice, rice
 Boxed meals (macaroni and noodles, spaghetti
cheese, ricearoni, ramen  Low phosphorus dairy, dairy
noodles, stuffing) substitutes and eggs: almond
 Potato chips, pretzels, salted milk, nondairy creamer
crackers, croutons, popcorn without phosphate additives,
 Canned soups, canned sherbet, sour cream, soymilk,
vegetables, canned beans egg whites
 Ready-to-eat frozen meals  Low phosphorus cheese
(burritos, pizza, dinner (keep portions small): blue
entrees) cheese, cottage cheese,
 Table salt cream cheese, feta cheese,
parmesan cheese
 Fast food
 Foods that state “no salt’/”no
 Soda
sodium” on label

How to read a nutrition label specific to this dietary recommendation

 Look at sodium content. If a food has more than 300 mg per serving, or 20%
of the” % Daily Value” it is high content. Goal is to eat less than 2000 mg a
day which translates to less than 1 tablespoon of salt
 Food labels show milligrams (mg) of sodium. A sodium level of 300
milligrams or more in each serving is too high in sodium for you to eat.
 If salt or sodium is listed as one of the first five ingredients, the food is high in
sodium and should not be bought
 Look for the word “phos” on the ingredients list and avoid these products
 Name: Paula Rubello

 It will help you to avoid eating foods that have the words “calcium fortified”
on the food label
 Watch portion sizes!
 Example of sodium on a label:

 How to follow portion sizes: very good!

Sample Meal(s) or Day: good food options

 Breakfast: 2 poached eggs, 2 slices of whole wheat toast with 1 tbsp of
almond butter, ½ c of berries, ½ c of coffee
 Lunch: 3 oz chicken breast on rye bread with 2 tsp of mustard and 10 baby
carrots, 1 c of water
 Snack: ½ c of grapes and 1 small Greek yogurt container
 Dinner: 4 oz fish fillet, baked with lemon juice and parsley, ½ c of boiled
green beans, ⅓ c of cooked white rice
 Snack: ½ c of cheerios with ½ c of soymilk