Guidelines for Hemodialysis

Guidelines for Hemodialysis:

Less Sodium and salt:
- Avoid ing salty foods may help control blood pressure and reduce weight gains between dialysis.
- Replace salt with low-salt flavor enhancers, spices, herbs and lemon.
- Avoid salt substitutes that contain potassium.


Meat/protein:
People on dialysis need more protein intake, as it can help maintain blood protein levels and improve health. Eating a high protein food at every meal is recommended, about 8-10 ounces a day.

3 ounces = the size of a deck of cards, a medium pork chop, 1/4 pound hamburger patty, 1/2 chicken breast, or a medium fish fillet.

1 ounce = 1 egg or 1/4 cup egg substitute, 1/4 cup tuna, 1/ cup ricotta cheese or 1 slice of low sodium lunchmeat.

Peanut butter, nuts, seeds, dried beans, peas, and lentils have protein too, but they are not recommended because they are high in potassium and phosphorus.

Grains/Cereals/Bread:

Most people need from 6-11 servings a day.

1 serving equal:
• 1 slice of bread (White, rye, or sourdough)
• ½ English muffin
• ½ bagel
• ½ hamburger bun
• ½ hot dog bun
• 1 6-inch tortilla
• ½ cup cooked pasta
• ½ cup cooked white rice
• ½ cup cooked cereal (like corn flakes or crispy rice)
• 1 cup cold cereal (like corn flakes or crispy rice)
• 4 unsalted crackers
• 1½ cups unsalted popcorn
• 10 vanilla wafers

Avoid “whole grain” and “high fiber” foods (like whole wheat bread, bran cereal and brown rice) to help you limit your intake of phosphorus.

Milk/Yogurt/Cheese
Limit your intake of milk, yogurt, and cheese to ½-cup milk or ½-cup yogurt or 1-ounce cheese per day. Most dairy foods are very high in phosphorus. By limiting dairy-based foods you protect your bones and blood vessels.

The phosphorus content is the same for all types of milk – skim, low fat, and whole!

Dairy foods that are low in Phosphorus:
• Butter
• Cream cheese
• Heavy Cream
• Ricotta Cheese
• Non-dairy whipped topping
If you are at risk, or suffer from any heart disease or condition, some of the listed above high fatty foods are not a good choice for you.

Non-dairy creams and milk (Rice Milk) are low in phosphorus and potassium.

Fruit/Juice:

All kinds of fruits have some potassium, but certain fruits are more than others,

Limit or Avoid:
• Oranges and orange juice
• Kiwis
• Nectarines
• Raisins and dried fruit
• Bananas
• Prunes and prune juice
• Melons (cantaloupe and honeydew)

Choose:
• Apple (1)
• Berries (½ cup)
• Cherries (10)
• Fruit cocktail, drained (½ cup)
• Grapes (15)
• Peach (1 small fresh or canned, drained)
• Pear, fresh or canned, drained (1 halve)
• Pineapple (½ cup canned, drained)
• Plums (1-2)

Drinks:
• Grape juice
• Lemonade
• Apple cider
• Cranberry juice cocktail

Vegetables/Salads
All vegetables have some potassium, but certain vegetables have more than others
Choose:
• Broccoli (raw or cooked from frozen)
• Cabbage
• Carrots
• Cauliflower
• Celery
• Cucumber
• Eggplant
• Garlic
• Lettuce-all types (1 cup)
• Onion
• Peppers-all types and colors
• Radishes
• Watercress
• Zucchini and Yellow squash

Limit or avoid:
• Potatoes (including French Fries, potato chips and sweet potatoes)
• Tomatoes and tomato sauce
• Winter squash
• Pumpkin
• Asparagus (cooked)
• Avocado
• Beets
• Beet greens
• Cooked spinach

Dessert
Limit dairy-based desserts and those made with chocolate, nuts, and bananas.
Sample Menu

Breakfast
Cranberry Juice, 4 ounces
Eggs (2) or ½-cup egg substitute

Toasted white bread, 2 slices, with Butter or tub margarine or fruit spread

Coffee, 6 ounces
Lunch
Tuna salad sandwich made with 3 ounces tuna on a hard roll with lettuce and mayonnaise.

(Other good choices for sandwiches include egg and chicken salad, lean roast beef, low salt ham and turkey breast.)

Coleslaw, ½-cup

Pretzels (low salt)

Canned and drained peaches, ½-cup

Ginger Ale, 8 ounces
(Cola drinks are high in phosphorus. Choose ginger ale or lemon-lime beverages instead.)
Dinner
Hamburger patty, 4 ounces on a bun with 1-2 teaspoons ketchup

Salad (1 cup): lettuce, cucumber, radishes, peppers, with olive oil and vinegar dressing

Lemonade, 8 ounces
Aim for at least 2-3 “fish” meals each week. Many fish are rich in heart-healthy “omega-3” fats. Tuna and salmon (rinsed or canned without salt) and shellfish are excellent heart healthy protein choices.
Snack/Dessert
Slice of apple pie
This meal plan provides 2150 Calories, 91 grams protein, 2300 mg sodium, 1800 mg (46 mEq) potassium, 950 mg phosphorus and 38 ounces of oral fluid.