By Rita Solomon-Dimmitt, RD, CSR, LDN

Home dialysis programs are customized for each individual patient and monitored by a patient’s healthcare team. The healthcare team monitors home dialysis patients just as they would if they visited a dialysis center for their treatments. One challenge for patients is maintaining a healthy diet which means consuming less salt.

Sodium is a natural element found in many foods. Salt is made of sodium chloride and is a major source of sodium for most of us. There are various sources of salt available in the market today. Sodium is added during processing to preserve the foods. Most people consume their daily sodium intake without adding any salt to their meals. Eating too much sodium can contribute to your thirst. Home dialysis patients need to control their fluid intake just like in-center patients. Fluid overload can contribute to swelling, weight gain and high blood pressure.

Home dialysis patients should speak to a renal dietitian about steps to take to limit their sodium intake. Learning how to read food labels is a good start. Important words to look for when reading the ingredient list on labels are: “salt,” “sodium,” and flavor enhancement such as “monosodium glutamate” or preservatives such as “sodium phosphate.” The Food & Drug Administration (FDA) has also set guidelines to help consumers better understand food labels.

• “Sodium-Free:” less than 5 mg of sodium per serving
• “Very Low Sodium:” 35 mg or less per serving
• “Low Sodium:” 140 mg or less per serving
• “Reduced or less Sodium:” At least 25 percent less sodium than the regular product
Some typically high sodium foods to avoid include:
• Processed meats (hot dogs, bologna, corned beef, ham)
• Canned soups or canned dinners
• Fast foods
• Snack foods (pretzels, popcorn, chips)
• TV dinners or prepared foods
• Pickles, pickle juice, olive and other pickled foods

There are many ways to reduce your sodium intake. Discuss with a dietitian about herbs and spices and other healthy foods you can use to flavor your foods. List them in Figure 1.

How can patients maintain a lower sodium diet?
• Limit foods if salt is one of the first five ingredients.
• Limit food with more than 300 mg of sodium per individual serving or 600 mg of sodium per meal
• Use behavior modification: Put the salt back in the kitchen cabinet and cook with herbs and spices instead.
• When eating out, ask for your food to be prepared without salt. Have the chef place the sauces and gravies on the side so you can control the amount you eat.

Before you make any changes to your diet, speak with a renal dietitian. A renal dietitian will tailor a nutritional plan just for you, taking into account medical and social factors, as well as your own food preferences. Not all patients have the same nutrition goals.

Home dialysis allows you to have much more knowledge of the dialysis process, control of your dialysis schedule and better understanding of your nutrition goals. You must be knowledgeable about the foods you consume. Your food intake has a big impact on your daily life, and the dietitian can assist you in making wise choices.

Rita Solomon-Dimmitt, RD, CSR, LDN, has been involved in renal dietetics in an outpatient setting for several years. She has worked with CKD, hemodialysis, peritoneal dialysis, transplant and pediatric patients, and has served as a facility manager and work in operational aspects of a major dialysis provider.

Figure 1
My dietitian says I can use:
Spice: ___________________________
Spice: ___________________________
Spice: ___________________________
Spice: ___________________________
Spice: ___________________________

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