Name: Dietitian: Telephone Number: Email: Eating Simply With Renal Disease There is a lot of information in this little nutrition guide. The important thing is to feel comfortable with what you can eat! You are in control Your kidneys are not working enough to get rid of extra nutrients, toxins and fluids that build up in your blood. Dialysis can remove some but not all of these things. You can help keep the amounts in your blood at safe levels in 4 ways: 1. Make good food choices. 2. Take your medicines as instructed by your doctors. 3. Limit how much you drink. 4. Show up for all dialysis treatments and stay for your whole time. The more you understand about nutrition and dialysis, the easier it will be. If you have problems or questions, talk to your dietitian. Your dietitian can help you add variety and spice to your everyday food choices and help you feel your best! Let s look at how you can balance some important nutrients by making food choices. Protein Used to build bones, muscle, skin and hair. It also helps you fight infection. Calories Provide energy for your body. If you skip meals or do not eat enough, you will lose muscle, weight, become weak, and feel tired. Potassium Helps your muscles and nerves work. Too little or too much potassium can make your heart beat irregularly; even cause your heart to stop beating! Dialysis treatments and the foods you eat work together to balance your potassium. Do not use lite salt, salt substitutes or low sodium bouillon - they have a lot of potassium. Sodium Found in table salt, acts like a sponge holding fluids in your body. This can cause high blood pressure, make it hard to breathe or make it hard for your heart to pump. It can be hard to stay away from, but here are some ways to make it easier: do not cook with salt, stay away from quick-prepare foods and snacks and do not add salt to foods at the table. Phosphorus Can build up in your body and dialysis does not remove much. Too much phosphorus makes calcium come out of your bones and make them weak, painful and easy to break. Phosphorus can also damage your brain, your dialysis access or your heart. To stay healthy, limit foods high in phosphorus and take every time you eat! (Add Binder Name Here)
High Potassium Foods Caution: check with your renal dietitian how often to use these foods. 1 2 cup servings Fruits Apricot (3 fresh) Nectarine Banana (1 small) Orange (small or juice) Vegetables Artichokes Parsnips Avocado Potatoes Bamboo shoots: fresh, raw Pumpkin Beets (fresh) Rutabagas Brussels sprouts Spinach Low Potassium Foods Dates Prune (5 dried or juice) Kiwi fruit Raisins Best Choices: Enjoy these foods most often. 1 2 cup serving Fruits Apples Apricot (canned, nectar) Berries (all types) Cranberry juice cocktail Fruit cocktail Grapes Lemon Lime Vegetables Asparagus Bamboo Shoots (canned) Beans, green or wax Beets (canned) Cabbage Carrots Cauliflower Cucumber Chard Sweet Potatoes Dried beans and peas Tomato: fresh, sauce, puree, juice Greens: beet, collards Winter squash Kohlrabi Yams Okra Papaya nectar Peach (canned, nectar) Pear (canned, nectar) Pineapple Plum Tangerine Watermelon Eggplant Lettuce (all types) Mushrooms Mustard greens Onions Peas (canned) Peppers Radishes Sprouts (alfalfa, bean) Other Bran Lite Salt Chili sauce Molasses Chocolate Nuts Coffee over 2 cups Salt substitute Low sodium baking powder Steak sauce Low sodium bouillon Whole wheat bread Good Choices: Use less often Cantaloupe Cherries Figs (2 whole) Grapefruit Honeydew melon Mango Mandarin oranges Papaya Peach (fresh) Pear (fresh) Broccoli Celery Corn Kale Peas (fresh, frozen) Summer squash Turnip Zucchini
High Phosphorus Foods Caution: check with your renal dietitian about how often to use these foods. Milk Cheese Half-n-half Cocoa Ice milk or ice cream Condensed or Evaporated milk Light cream Cottage cheese Milk, all kinds Breads & Cereals Low Phosphorus Foods Best Choices: Enjoy these foods most often Milk substitutes Breads & Cereals 1 oz Biscuits 1 small Corn bread 2X2 square Bran muffins 1/2 Corn tortillas 2 6 inch Bran and whole wheat cereals Oatmeal 1 2 cup serving Dessert, non dairy frozen Frozen nondairy dessert topping Liquid nondairy creamer Rice milk Bread (French, Italian, light rye, sourdough, white) 1 s Bagel (small) 1 2 Bun, hamburger or hotdog 1 2 Cake, homemade Cereals, not whole wheat or bran Cooked cereals (cream of wheat or rice) Cookies: short bread, sugar, sugar wafers 4 Animal crackers, vanilla wafers 10 Crackers, unsalted squares 4 Danish pastry or sweet roll (small) 1/2 Doughnut Dinner or hard roll (small) English muffin Cream Soup Milk Shake Custard Pudding Eggnog Soymilk Fudgesicles 1 Yogurt, plain or fruited Pancakes, waffles 1-4 inch Bread (whole wheat, bran, Pumpernickel oatmeal, dark rye) 1 slice Sandwich cookies 4 Cheesecake 1 slice 1 oz or 1 slice serving, No chocolate, nuts, dried fruits or cheese More than 1 cup a day of these vegetables has as much phosphorus as milk. Other Corn Peas Parsnips Rutabagas Beer Coconut Colas Nuts Caramels Seeds, pumpkin and sunflower Chocolate Flour tortilla, 6 inch Graham crackers (squares) 3 Grits Melba toast 3 Muffin (small) Pasta, (noodles, macaroni, spaghetti) Pita pocket (6 inch diameter) 1/2 Popcorn, plain popped, no salt Pretzels, unsalted 3/4 C Rice, cooked
Protein Choices You lose some protein every time you have dialysis, so you may be surprised at how much protein you need to eat everyday! Choose fresh, unsalted, unprocessed protein sources from these groups: Beef Pork Lamb Egg or Egg Substitute Fish Serving Sizes Veal Wild Game Chicken Turkey Shellfish 1 oz equals size of a matchbox, 1 chicken wing, 1 4 cup cooked, chopped meat. 2 oz equals 1 chicken thigh, 1 2 cup cooked, chopped meat. 3 oz equals size of a deck of cards, smallchicken breast for pork chop. 4 oz equals a large chicken breast. Some protein foods are higher in phosphorus but may be used. Discuss how often you should have these with your dietitian. Questions and Answers C = cup serving Canned salmon, sardines Cooked dried beans and peas Organ meat, Liverwurst 1 oz Vegetarian meat substitute (Garden Burgers) 2 oz Nut butters (peanut, almond, cashew) 1 4C Unsalted nuts 2 Tbsp Tofu 1/3 C Soymilk Cottage cheese Talk to your renal dietitian about your favorite foods that you did not find in this guide. Here is an idea of how many foods you should have from each group each day. Protein: ounces Daily Fluids: cups A Sample Meal Plan Potassium: Best Good High Phosphorus: Best Good High Breakfast Lunch Dinner Snack
If you are diabetic, follow these 3 rules. 1. 2. 3. Eat the same amount of food at about the same time every day. 5-6 small meals spread throughout the day help to better control blood sugars. Check your blood sugar often to keep it in the right range for you. Anytime you feel funny, check your blood sugar! If your blood sugar is low, have a quick sugar snack like apple, grape, or cranberry juice, regular soda pop, honey, or jelly beans. In about 20 minutes, check your blood sugar again and plan on having another snack or meal at that time. Follow your doctor s instructions. Take your medicines as directed. Exercise and check your feet every day. Also, see an eye doctor once a year. Fluid Choices and Limits It is important to keep your daily fluid intake to cups a day. Anything that is a liquid at room temperature is a fluid. Here are some examples of fluids that should be counted as part of your daily fluids: Clear carbonated drinks (soda, pop, soft drinks) Coffee Fruit drink (Hi-C, Kool-Aid ) Gelatin (Jell-O ) Gravy (homemade, unsalted) Ice Ice Cream Frozen yogurt Juice (fruit or vegetable) Milk Non-dairy creamer Popsicles Pudding Sherbet Sorbet Soup Tea Water Helpful Thirst Limiting Ideas Suck on sour candies or chew gum to quench thirst. Eat chilled canned fruit or frozen berries or grapes. Add lemon or lime juice to water to quench thirst better. Freeze some fruit juice drinks or suck on popsicles. Use smaller cups to help limit fluids. Know how much fluid your cups and glasses hold! Remember salty foods make you thirsty!