CKD vs Hemodialysis diet?

[KelliC_NKF]

What are the key differences between a diet for a CKD4 (not on dialysis) patient, and one who is on hemodialysis?

[KatyWilkens]

Great Question!

The diets for someone with CKD stage 4 and not on diaylsis is quite different from the diet for some one with stage 5 who is on dialysis, but there are some similarities too.

Both groups should limit their intake of salty foods, and sodium. A good limit is about 1,500 mg a day. That is actually a good limit for everyone in the USA, and will be healthy for you and your family too! So take a look at labels and try to limit most entrees to 400 mg of sodium. If you need recipes, NKF has great recipes on their website. In general, following a low salt diet is easier if you do most of your own cooking.

Where the diets differ, can be in the areas of protein, potassium and phosphorus.

People with stage 4, not on dialysis, may be recommended to limit their protein intake somewhat. This is because protein waste products don't get filtered out in your urine as they normally would.

A good rule is less than 1 ounce of meat/fish/chicken/eggs/dairy for every 10 kilograms you weigh, up to 100 kg. You might need to convert your weight in pounds to killograms, just divide by 2.2.

For example, a woman who weights 140 pounds, divided by 2.2 would weight 63 killograms, and at 1 ounce of protein/10 killograms, she should have a bit less than 6 ounces of protein a day, more like 4-5 ounces.

Someone on dialysis needs more than that, probably about 8-10 ounces/day, even more if they are on peritoneal dialysis.

Potassium restiction or increase, really depends on your individual kidney function and medications. With CKD it is a good question to ask your doctor, "? Should I limit my potassium or not?"

For people on hemodiallysis, most of them will need to at least be aware of high potassium foods, and limit them somewhat. A good goal is about 2.5 cups of fruits and vegies a day, and limiting to one half cup serving of high potassium fruit or vegies.

It's good to remember that milk, beans, nuts are also sources of high potassium and phosphorus. But again, it depends on your diet and your budget, and your cooking skills and what you like to eat.

Finding a good renal dietitian to help you with an individual plan is the best bet, they can tailor your diet to your laboratory values and your needs.

[KelliC_NKF in reply to KatyWilkens]

@Dixidude39

[KelliC_NKF]

NKF recipes can be found here: foodcare.com/myfoodcoach/si...

[Dixidude39]

Thank you, Kelli. I have cut and pasted your answer for the diet section of my 3-ring kidney binder. I am about to open your link foodcare.com.