Diet & Nutrition

In Home Hemodialysis Diet and Nutrition Information

Dialysis removes the majority of the wastes and toxins that build up in your body. By closely following your diet and eating the right foods, you can maintain optimal health and avoid some complications.

Diet recommendations are individualized and based upon your remaining level of kidney function, body size, race, gender, blood test results, and any other medical problems you may have. Although every renal diet has some basic similarities, do not follow the dietary recommendations of another patient.

As a home hemodialysis patient, you will be assigned to a dietitian who will work directly with you and your family to plan meals and guide you on the right food choices. Your dietitian will meet with you at least once a month to go over results from laboratory blood tests and adjust your diet accordingly.

There are several guidelines to follow:

  • Follow your recommended plan when choosing what to eat at all of your meals.
  • Use only the foods listed on your diet plan and in the amounts shown.
  • Do not add new foods until you talk with your dietitian.
  • Read food labels carefully.
  • Prepare and serve food without adding salt, salt substitutes or other salty seasonings.
  • Measure your food and fluids accurately.

In planning your diet, your dietitian will help you get the right amount of calories and pay particular attention to the right amount of:

Protein “” Proteins are critical to build and repair tissues such as muscles, bones, and skin and to resist infections. Proteins, however, leave behind a waste product call urea that is removed by the kidneys. Your dietitian will carefully regulate your diet to ensure the right amount of protein is in your meals.

Sodium “” Sodium, or salt, is used in the body to control blood pressure, balance fluids and control muscle contractions. But if there is too much sodium, you will become thirsty and your body will retain more fluid. This can cause swelling, high blood pressure, and shortness of breath. It’s vital to limit your sodium intake to avoid these potential problems.

Potassium “” Potassium is a mineral that helps to keep nerves and muscles working properly. Both high and low levels of potassium can cause serious health problems. The kidneys help balance potassium levels in the body. In patients with kidney failure, potassium levels are regulated through dietary choices. Most patients undergoing hemodialysis need to limit their intake of high potassium foods because potassium builds up in the body between dialysis treatments. There are fewer restrictions with home hemodialysis versus in-center hemodialysis because you undergo treatments more frequently.

Phosphorus “” Phosphorus, along with calcium, works to keep your bones healthy and strong. When kidneys fail, phosphorus builds up in the blood, causing a drop in calcium levels. Both of these can cause weak bones, damaged blood vessels, and heart disease. Your phosphorus level will be controlled by food choices as well as medications, if necessary. Phosphorus is found in almost all foods, but is especially high in dairy products, cheese, dried beans, liver, nuts, and chocolate.

Fluids “” When your kidneys don’t function, your body can’t control the build up of fluids. Excess fluids can cause swelling, shortness of breath, and high blood pressure. Keep in mind that fluids include any food or beverage that is liquid at room temperature, such as ice, frozen desserts, and gelatin. Your fluid level is set by your doctor and is based upon your urinary output and the amount of fluid that can easily be removed during dialysis. You will be asked to measure your body weight both before and after dialysis treatments.


Kidney disease and dialysis change the amounts of vitamins your body needs. Your special diet also may limit some food groups that normally would provide important vitamins. Your doctor will prescribe vitamins, but be sure to take only those supplements that are ordered. Some vitamins and minerals may be harmful to your health if you are on dialysis. Check with your dietician before taking other vitamins.

Diabetes and Your Diet

If you already are on a special diet because of diabetes, your dietician will combine this with your renal diet.

Dining Out

You don’t have to stop visiting family members, friends, or your favorite restaurant while on dialysis. You will, however, need to learn how to make smart meal choices that are in line with your recommended dietary guidelines. Talk with your dietitian about how to read restaurant menus to determine if particular foods are allowed in your diet plan.

Emergency Meal Planning

In the event of an emergency or power outage, you need to be prepared to follow a limited diet if a dialysis treatment has to be missed. Your dietitian can provide you with a three-day emergency meal plan that includes both a grocery list and recommended servings for each meal. Remember to regularly check for expiration dates and to rotate your emergency food stock.