What can someone on dialysis eat?

Start with the individual plan

Eating during dialysis is not a fixed list of forbidden foods. The kidney team and renal dietitian discuss the amount of sodium, potassium, phosphorus, protein, energy, and fluids according to tests, type of dialysis, residual urine, medications, weight, and nutritional status.

The KDOQI 2020 Nutrition Guideline emphasises that nutritional assessment and intervention should be individualised, not based on a single number or general list.

Four important questions

1. Potassium: Does the current blood result require changing a particular food or portion? Do not remove fruit and vegetables indiscriminately.
2. Sodium: Does salty food increase thirst and fluid accumulation? Review labels and avoid salt substitutes containing potassium chloride without team approval.
3. Phosphorus: Does the phosphorus-binding medication need to be taken with a meal as prescribed? Do not stop it or change its timing without the team.
4. Protein and energy: How do you maintain nutrition and muscles while respecting blood results? Hemodialysis may increase the need for an appropriate protein plan.

Portions and preparation matter

Mineral content may vary depending on serving size, type of food, brand and preparation method. Therefore, the word “low” does not mean that food is allowed without limits, nor does the word “high” mean that food is always forbidden. Ask your dietitian for examples related to your usual foods.

Alcohol is a separate topic

Alcohol should not be placed on a potassium chart alone. Its intake is related to fluids, medications, and general health condition, and may not be suitable for some patients. Discuss the matter openly with the kidney team and count any drink toward your fluid intake.

Sources

• KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update.
• NIDDK: Hemodialysis and dietary changes.