Haemodialysis Diet Guidebook

Dietary
Management

for
Patient on
Haemodialysis

CONTENT

What is haemodialysis? --------------------------- 3
Overview of dietary management ----------- 4 – 5
Get the right amount of calorie --------------- 6
Get adequate protein ---------------------------- 7
Low in phosphorus ---------------------------------- 8
Pay attention on potassium --------------------- 9
Control sodium intake ---------------------------- 10
Watch out on fluid intake ----------------------- 11
Helpful resources ------------------------------------12

What is haemodialysis?

Healthy kidneys clean your blood and remove
extra fluid in the form of urine. They also make
substances that keep your body healthy. Dialysis
replaces some of these functions when your
kidneys no longer work.

You need dialysis if your kidneys no longer remove
enough wastes and fluid from your blood to keep
you healthy. This usually happens when you have
only 10 to 15 percent of your kidney function left.
You may have symptoms such as nausea,
vomiting, swelling and fatigue as a result of high
level of toxic wastes that build up in your body.

Haemodialysis is a procedure where a dialysis
machine and a special filter called an artificial
kidney, or a dialyzer, are used to clean your
blood. Haemodialysis is usually done 3 times per
week for about 4 hours at a time.

3

Overview of
Dietary Management

A well-balanced diet, with the right amount of
protein, calorie, fluid, vitamins and minerals, is
necessary for patients on end stage kidney disease
to stay fit.
This booklet will further discuss on nutrients that
needs to be focused on – their importance and
practical tips to get it adequately through diet.

4

Remember to:
1. Eat the right kind and right amount of food on

daily basis.
2. Take medication according to doctor’s

prescription.
3. Comply with your dialysis treatment
4. Be physically active as possible.

5

1

Get the right amount of calorie

Getting the right amount of energy (calorie) is
important for overall health and well-being.
The energy needs of every individuals is different
due to their age, gender, body size, physical
activity level and medical conditions.
Your dietitian will advice on the right amount of
calorie you need every day considering the factors
listed above.

6

2

Get adequate protein

Protein is essential for building and repairing
muscles. Patients on haemodialysis treatment
require a higher protein intake as some amount of
protein are lost during the treatment process.

Insufficient protein intake could result in weight loss,
muscle wasting, reduced ability to fight infections
and lead to malnutrition.

Food contains protein can be divided into high
quality and low quality protein. Choose high quality
protein such as: fish, poultry, meat, egg, soybean
products.

Food of high quality protein are digested and used
by our body more effectively and create lower
amount of urea (toxic).

Warm reminder:
Protein food contains phosphate.
Patient must take their phosphate binders
when eating protein food during meals.

7

3

Low in phosphorus

As the kidneys become less effective at filtering
waste products, blood phosphate level rises.

When phosphate begins to build up in the blood,
calcium is drawn from the bone. Phosphate will
combine with calcium to form a product that
deposits in patient’s tissues leading to skin itchiness,
joint paint and harden of blood vessels. Over time,
patient’s bones become weak and brittle.

Practical tips to control phosphate intake:
❑ Remember to take phosphate binders along with

protein food. It helps to reduce the amount of
phosphate being absorbed from food into
bloodstream.

❑ Avoid bone-based soups
❑ Avoid processed meat
❑ Avoid food products with phosphate additives

(check out the ingredient labels)

8

4

Pay attention on potassium

Potassium is a type of nutrient which is important for
the functioning of nerves and muscles.

Potassium needs to be maintained at a safe level in
the blood. When the levels are too high or too low,
it may result in cardiac arrest.

Potassium is found mainly in fruits and vegetables.
Discuss with your dietitian about the food and right
amount that is right for your condition.

Practical tips to limit potassium intake:
❑ Reduce the potassium content of vegetables by

soaking the vegetables that has been cut into
smaller pieces in water for 1 to 2 hours before
cooking.
❑ Peel off skin from fruits prior consuming
❑ Avoid taking gravy from cooked vegetables
❑ Use whole rather than ground spices for cooking

9

5

Control sodium intake

Sodium is naturally found in all types of foods, and
more commonly in packaged and processed food.
Salt is one of the main sources of sodium.

Sodium restriction helps to maintain normal fluid
balance. Too much sodium in the blood will
increase thirst and thus drinking more fluid. As a
result, weight gain from fluid arises, causing
increase in blood pressure and added burden to
the heart.

Practical tips to reduce sodium intake:

❑ Limit the amount of salt and sauces added
during cooking.

❑ Avoid using stock cubes or meat extracts. Use
fresh herbs and whole spices to add flavour to
food. Such as: lime, pepper, onion etc.

❑ Avoid processed meat. Choose fresh meat.

❑ Limit processed food products. Read labels and
choose products that contain less than 120mg
sodium per 100g food product.

10

6

Control in fluid intake

Due to reduced kidney function, patients have
reduced urine output. So, it is important for patients
to adhere to fluid restriction advice by doctor.

Excess fluid is retained in the body and will cause
shortness of breath, high blood pressure and
swelling of legs.

Consider patient’s urine output and discuss with
doctor to determine the fluid intake allowed daily.

Practical tips for fluid intake:
❑ Fill up water in a container. Distribute and drink

the amount equally through the day.
❑ Coffee, tea, soup, porridge, ice-cream, jellies,

fruits also contain fluid. They should be
considered as a part of fluid restriction.
❑ Avoid salty foods.
❑ Sip on ice cubes when thirst. One ice cube
contains 20 to 30ml water.

11

Helpful Resources

1. National Kidney Foundation Malaysia
https://nkf.org.my/

2. National Kidney Foundation United States
https://www.kidney.org/

3. DaVita: Kidney disease and dialysis information
https://www.davita.com/

12

Do you have questions for
your doctor or dietitian?

Take a few minutes to write down your questions for
the next time you see your health care providers.

13

This booklet is intended to serve as a guide for patients.
Please consult your healthcare providers with any
concerns you may have regarding your condition.

This educational booklet is prepared by:
Ang Jia Yu
Dietitian
BSc. Dietetics (Hons.) UniSZA
• Jia Yu is a member of Malaysian Dietitians Association.
• She is professionally trained in translating the science of food

and nutrition to meet the needs of individuals with health issues.

Scan Me

For dietary consultation, please contact:
Tel. : 604 5955 365

(or WhatsApp 011 5861 2986)
Email : [email protected]