THESNOS - diet

The diet in dialysis

Proper nutrition is essential for people on dialysis.

It is a very important factor for their good quality of life and health. It is a very important factor for their good quality of life and health. Although there are some basic nutritional principles for all dialysis patients, the diet should be individualized according to the age, the comorbidities, and the activity of each patient individually.

Α. Energy needs
A normal person with an ideal body weight who does not work, needs 30-50 calories / kg of body weight daily, ie a 70 Kg person needs 2100 calories / day. A dialysis patient under the same conditions needs at least 35 calories / kg body weight Of course, those who work hard and those who are in a period of catabolic stress (fever, etc.) need more calories.

You should know that in addition to the calories you get through your food, when you do dialysis and your solution has a glucose content of 200 mg / dl, then you gain 400 calories from the glucose of the solution you take in each dialysis session.

Β. Total Proteins
When dialysis begins, the amount of dietary total proteins generally increases. Now your kidneys are not completely responsible for removing from your body the junk products that come from your food total proteins, so you can eat larger quantities. Also, do not forget that your needs for total proteins are now greater. It is estimated that you need 1-1.2 grams of total proteins per kilogram of your body weight and never less than 1 gram / kg of body weight per day.

C. Sodium and water
Sodium continues to be a very important part of your special diet. You may need to change the amount of sodium in your diet so far and this will depend on how much sodium your kidneys can excrete. On the other hand, good regulation of sodium in the diet is essential for maintaining good blood pressure. Basically 60-80 mmol sodium / day is a sufficient amount and is taken from food, when you do not put any salt in it.

The Controlling fluid intake becomes very important as the day approaches for dialysis to begin. When your kidneys cannot expel urine, the amount of fluid you take in daily should be reduced. Of course, getting the right amount of sodium quenches thirst. It is good to know that you are allowed to drink 500 ml of water (two full glasses) + as much water as your urine was in the previous 24 hours. In the summer, when you sweat a lot, you can of course drink 200-300 ml more water. You should also know that the amount of water contained in a daily diet is about 1 liter (water of food), without naturally including this amount of fluids taken in the form of water or beverages.

Fruit juices (oranges, lemonades), beer, cocoa, chocolate, Coca-Cola, and Nescafe are banned from various beverages and liquids because they contain potassium. Alcoholic beverages such as whiskey, brandy, ouzo, vodka, gin, raki, etc. are allowed in a limited amount, i.e. 1 to 2 drinks a day.


So, when your kidneys are not working, it is natural that they cannot get rid of the extra water and sodium (salt) that you have taken. For this reason, gaining weight in the intervals of dialysis, slowly creates edema (swelling) which appears low in the legs, face and of course in the abdomen, if the water that your body has retained is too much.

D. Potassium
Potassium regulation becomes more important in patients who need dialysis. As kidney function decreases, potassium accumulates faster in the blood and its levels rise dangerously. If potassium restriction was necessary for you when you are in the early stages of CKD, this issue is now a big and very important part of your diet.

However, you should know that potassium, as mentioned above, is responsible for the normal functioning of muscles and kidneys. Also remember that the heart is also a muscle and of course potassium can affect its function. Thus, potassium, which is normally filtered in the kidneys and excreted in the urine, can sometimes act as a “toxic poison”in patients with impaired renal function when blood levels rise.

E. Phosphorus
The amount of phosphorus you take in daily is part of your dialysis diet. Having normal levels of phosphorus in your blood can help prevent bone disease. As important as low phosphorus levels are in keeping bones in good condition, so important is the need for calcium supplementation. These two together (low phosphorus and high dietary calcium) are essential to prevent bone disease.

The best source of calcium and phosphorus is food and unfortunately, we have no way to increase the calcium in food without increasing the phosphorus (they are almost always together). So, most of the time to control the increased levels of phosphorus in the blood we are forced to take drugs that bind phosphorus in the intestine. However, we need to know which consumer foods contain a lot of phosphorus.

Consumer foods with a lot of phosphorus are:

  • All nuts and peanuts
  • Coca-Cola
  • Cereals, dried beans, lentils
  • Milk and cheese products
  • Soy products
  • Vitamins

A water-soluble vitamin supplement is most often needed in hemodialysis patients. Hemodialysis removes vitamins from the blood and thus their supplementation with exogenous administration is necessary.

Adaptation from “The Diet in Chronic Renal Insufficiency”, K. S. Mavromatidis, K I. Sombolos

Basic principles for regulating sodium intake from foods


1. Do not put a saltshaker on your table unless recommended by your doctor.

2. Do not use salt substitutes. These have potassium and of course will raise the levels of potassium in the blood. These have potassium and of course will raise the levels of potassium in the blood.

3. Canned foods are usually very high in sodium, so it is a good idea to check them before eating.

4. Avoid crackers, chips, and anything else that is definitely high in sodium.

5. Use fresh meat, poultry, and fish. Avoid smoked and salted meats or fish, as well as bacon. Avoid smoked and salted meats or fish, as well as bacon.