Ask me anything! : Hi, this is Katy Wilkens... - Kidney Dialysis

Kidney Dialysis

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Ask me anything!

Hi, this is Katy Wilkens, I am a renal dietitian who loves to help people with questions about the healthiest way to eat on dialysis. I have worked with people on dialysis for the last 38 years, and am happy to share my suggestions and ideas with you.

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AlexaHU6 years ago

Hi KatyWilkens, are there any foods you should try to eat when on dialysis?

KatyWilkens in reply to AlexaHU6 years ago

Hard question! In general patients probably should not eat when they are actually having a treatment. Your mother was right, it's like waiting an hour after you eat, before you go swimming, you don't want to stress your body doing too many things at once, you can get muscle cramps, vomiting, blood pressure dropping and other side effects.

KelliC_NKF in reply to AlexaHU6 years ago

You can find recipes that are right for you on the My Food Coach app: foodcare.com/myfoodcoach/si...

MaddieHUHealthUnlocked6 years ago

Hi KatyWilkens , I've heard that you should avoid dairy and wholegrain products when on dialysis treatment - why is that?

KatyWilkens in reply to MaddieHU6 years ago

Maddie,

Good question! Both dairy products and whole grain products have phosphorus. Unfortunatly, whole grains get a bad reputation. They are high in phosphourus, when compared to white bread, but the difference is not very big. A good goal for your phosphorus intake is about 800-1,000 mg/day. A slice of wheat bread has somewhere about 150-200 mg of phosphorus, and a slice of white bread has about 115-130. So, for about 70 mg of phosphorus, I would choose the whole wheat, because you get fiber and other vitamins along with the phosphorus, which is good for you.

Milk has about 350 mg/cup, so you can see that using a non-dairy milk, like Almond, or Rice milk, could save a lot more phosphorus in your diet.

KelliC_NKF in reply to MaddieHU6 years ago

For more information on phosphorus : kidney.org/atoz/content/pho... and dairy: kidney.org/atoz/content/dai...

AlexaHU6 years ago

One of our members has said she needs help on what to do for snacks and suppers for her husband. She says they are in the phase of learning everything about dialysis and having a terrible time changing their food intake. What would you suggest?

KatyWilkens in reply to AlexaHU6 years ago

Alexa, so great you are helping your members!

Change is hard. I would say to ask the doctor or dietitian, what the most important part of the diet is. It's probably limiting sodium, for most people. Setting priorities can help you focus on a goal. There is a lot to learn, not just the diet, so asking your health provider what is the most important can save a lot of stress.

KelliC_NKF in reply to AlexaHU6 years ago

For more tips, info and recipes on the dialysis diet visit: kidney.org/nutrition/Dialysis

Meghanrice6 years ago

Hi KatyWilkens, my 18 month old is on daily Peritoneal Dialysis and is fed mainly through a g-tube. We feed her a blenderized diet that has been created by her nephrology teams dietition. She has recently been having issues with a lot of phlegm and has been gaging and spitting up her feeds. She’s on Claritin for allergies as well as erythromycin to help with her slow motility.

Do you think she could be suffering from acid reflux as well? Could that cause the phlegm and gaging?

Do you know anything diet related that we could try to combat this issue if it is acid reflux? She was on a PPI for a while until I read about how they are causing KIDNEY DISEASE! I slowly took her off of it and she was doing great for about 2 months but then the spitting up started again. I would rather not put her back on them if we can try something with her diet that might help.

Thanks.

KatyWilkens in reply to Meghanrice6 years ago

Meghan,

Sounds like you have a super pediatric renal dietitian! So great she has worked up a blenderized diet for your child! I work with adults on dialysis, which is a really different world, and I can't answer your question with the detail you need.

You could check with your doctor about the proton pump inhibitor, since your child is on dialysis, it may not be affecting their kidney function at all. It is at least worth asking the question about. And talk to your RD about the issue, hopefully she/he will have some ideas.

KelliC_NKF in reply to Meghanrice6 years ago

For general information for parents of children with kidney disease visit: kidney.org/category/childre...

AlexaHU6 years ago

Another question from our members - is green fenugreek good for kidney failure patients?

KatyWilkens in reply to AlexaHU6 years ago

I wish it were that easy! Fenugreek and most herbs and seeds add flavor and taste to meals. Using most of these as medication has little to no science behind it. I would always encourage tasty meals, but the idea there is some 'magic food' that will help your kidneys just doesn't pan out, I wish it did.

KelliC_NKF in reply to AlexaHU6 years ago

For more information on herbal supplements and kidney disease visit: kidney.org/atoz/content/her...

YollyD_NKF6 years ago

What is the recommended amount of water a dialysis patient should intake?

KatyWilkens in reply to YollyD_NKF6 years ago

Yolly,

Great question, and one I know my patients always struggle with.

How much fluid is recommended depends on your kidney function, and how big you are. How much urine, if any, your kidneys put out on their own, is easy to figure out. Just measure your urine for one day. You don't have to save it, just measure how much you pee in one day. Most people on dialysis don't pee at all, that is typical.

A good rule is three 8 ounce cups a day, plus whatever your own kidneys get rid of in a day.Be sure and count all things liquid at room temperature, so soup, ice, icecream, jello, as well as liquids all count.

So three cups, (about 750 cc's) is not much. Try measureing the amount of liquid your coffee cup, drinking glass and bowls hold. That can help you estimate how much fluid you are taking in.

The best way to limit your fluid intake is to limit your intake of salty foods. Eating more than 1,500 mg of sodium a day is a sure way to make yourself thirsty.

If you are gaining more than 4% of your body weight between dialysis treatments, that is too much.

Dixidude396 years ago

I am CKD4 since my right ureter/kidney were removed in July 2016 due to cancer. My eGFR is 27-29. My nephrologist has prescribed a potassium binder called Veltassa. Because I qualify, the pharmaceutical company is providing it free. A side effect is constipation for which I take a daily dose of generic Benefiber. I believe Benefiber is a soluble fiber. Are CKD4 and 5 OK with a soluble fiber vs. foods with roughage like bran, etc.

Dixidude396 years ago

How do I find a renal dietitian who I can pay out-of-pocket to review my current diet and make recommendations to improve same? Is there an organization representing renal dietitians and/or certifying renal dietitians?

KatyWilkens in reply to Dixidude396 years ago

Sorry, I didn't see your question till just now....

If you go to the Acadamy of Nutrition and Dietetics, (AND), their website is EatRight.org.

In the top right hand side you see 'Find an Expert' in red. Click on that. You can search by zip code and specialty. I would expand the zip code, since there are not a lot of renal dietitians, and there might not be one in your area, but might be one in a zip code close to you.

Look for an RD or an RDN (Registered Dietitian or Registered Dietitian Nutritionist). If you are lucky, you might find someone with an CSR (certified renal specialist) they are certified by . But I don't have that certification, even though I have worked in renal for 38 years because the place I work doesn't require it, and doesn't pay me any more to have it, and it is expensive. So it doesn't neccesarily mean the person is any better, it just means they took the test.

You might also call the closest dialysis unit to you and ask to speak to their renal dietitian. Chances are that person has someone they refer to all the time, and they can give you a sound referral. Remember, just like doctors, there are dietitians you will hit it off with and others you won't find helpful, so if you are not getting your needs met, try someone else.

I applaud you for wanting to take good care of your health, and there are lots of studies showing that people who see a renal dietitian can put off, by several years, the need to go on dialysis, so definetly worth it to you!

Good luck!

Katy