By Peggy Harum, RD, LD

Facts:

• More than 350,000 people are on dialysis
• By 2010, an estimated 600,000 people will be on dialysis
• 20 million people are in the early stages of kidney disease
• 100,000 people begin dialysis each year
     • 1/3 are African American
     • 1/8 are Hispanic
• The most common causes of kidney disease are high blood pressure and diabetes

If you eat too much sodium you can be thirsty, your blood pressure can rise. If you have too much potassium in your diet, it can cause irregular heartbeats. If there is too much phosphorus in your diet, you can develop calcification in your eyes, heart, skin and joints.

Before you restrict sodium, potassium, phosphorus, protein and/or calories in your diet, please check with your dietitian. The diet for dialysis is not necessarily low calorie and is not low protein. The secret of the diet is the size of the portion.

Low Protein Diet for the Predialysis Patient

Beverages or Liquids Allowed
• Water or carbonated water
• Juices
• Unsalted broth
• Coffee or tea
• Popsicles
• Italian Ice
• Clear sodas or root beer
• Sorbet (Haagen-Dazs or Dole Fruit Sorbet)

Beverages or liquids not allowed
• Milk
• V-8 juice
• Tomato juice
• Colas
• Milkshakes

Spices permitted
• Vinegar
• Lemon or lime
• Dry mustard
• Onions
• Garlic cloves
• Parsley
• Tabasco
• Basil
• Oregano
• Tarragon
• Cinnamon
• Nutmeg
• Ginger
• Pimento
• Black pepper
• Anything without sodium or salt

Spices not permitted
• Onion salt
• Garlic salt
• Soy sauce
• Oyster sauce
• Fish sauce
• Anchovies
• Capers
• Bouillon
• Anything with MSG
• Ketchup
• Steak sauce
• Regular salad dressing 

You may eat
• Sugar
• Honey
• Jelly
• Jam
• Mints
• Hard candy
• Chewing gum
• Syrup

You may not eat
• Ham
• Sausage
• Corned beef
• Potato chips
• Cheese (except cream cheese)
• Beans or legumes
• Canned soups
• Desserts made with milk
• Yogurt
• Ice cream or sherbet
• Oatmeal
• Pizza
• Liver
• Nuts
• Chocolate
• Sardines
• Chinese food

Low Protein Diabetic Diet for the Predialysis Patient

Beverages or liquids allowed
• Water or carbonated water
• Juices without sugar
• Unsalted broth
• Coffee or tea

Beverages or liquids not allowed
• Milk
• V-8 juice
• Tomato juice
• Colas
• Milkshakes

Spices permitted
• Vinegar
• Lemon or lime
• Dry mustard
• Onions
• Garlic cloves or powder
• Parsley
• Tabasco
• Basil
• Oregano
• Tarragon
• Cinnamon
• Nutmeg
• Ginger
• Pimento
• Black pepper
• Anything without sodium or salt

Spices not permitted
• Onion salt
• Garlic salt
• Soy sauce
• Oyster sauce
• Fish sauce
• Anchovies
• Capers
• Bouillon
• Anything with MSG
• Ketchup
• Steak sauce
• Regular salad dressing

You may not eat
• Sugar
• Honey
• Jelly
• Jam
• Mints
• Hard candy
• Chewing gum
• Syrup
• Ice cream or sherbet
• Oatmeal
• Milk
• Ham
• Sausage
• Corned beef
• Potato chips
• Cheese
• Beans or legumes
• Canned soups
• Desserts made with milk
• Yogurt
• Pizza
• Liver
• Nuts
• Choolate
• Sardines
• Chinese food 

What is the difference between a hemodialysis and predialysis diet?

Hemodialysis
• Protein intake of 1.2 g/kg per day
• Sodium intake of 2 grams per day
• Potassium intake of 2 grams per day
• Phosphorus intake of 1 gram per day
• Fluid intake (depending on urine output) of around 5 cups per day

Predialysis
• Protein intake of 0.6 g/kg per day
• Sodium intake of 2 to 3 grams per day
• If protein intake is low, phosphorus intake will be low.
• High calorie intake from carbohydrates and polyunsaturated fats
• No potassium or fluid restriction

Peggy Harum, RD, LD is a renal dietitian from Miami. Ms. Harum has worked with AAKP for many years in developing dietary resources for kidney patients.

The information contained herein is intended for educational purposes only. It is not intended and should not be construed as the delivery of medical care. Persons requiring diagnosis or treatment, or those with specific questions, are urged to contact their local healthcare provider for appropriate care.

This article originally appeared in the November 2004 issue of aakpRENALIFE, Vol. 20, No. 3.

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