Diet and Nutrition

Nearly all foods contain some potassium, including healthy ones like fruits, vegetables, and dairy. If you have kidney disease, you need to control your intake of these foods. That could mean avoiding some fruits and vegetables altogether, or it may just mean reducing the amount of high potassium foods you eat.

If you have kidney disease, it is very important that your calcium and phosphate balance is checked and managed correctly. Your healthcare team will request regular blood tests to check you calcium and phosphate levels.

Treatment of calcium and phosphate imbalance is designed to:

• prevent phosphate levels increasing in your blood
• maintain calcium levels
• reduce the release of parathyroid hormone
• prevent bone disease caused by loss of calcium

See our calcium and phosphate balance fact sheet for more information.

‘Fluids’ refers to any foods that are liquid when they’re at room temperature – that includes ice cream, yoghurt, and ice cubes. Fluid is also contained in foods like cooked pasta and rice, salad ingredients, soup, and watermelon.

Some people on dialysis may need to limit their fluid intake, while others can have as much as they like. It’s usually people who are on peritoneal dialysis or more frequent home haemodialysis that can enjoy more freedom with their fluids.

A renal dietitian or your healthcare team can help you manage your fluid intake, including advice on how much you should drink each day.

If you’re on haemodialysis, it’s unlikely your protein intake will need to change. However, you’ll definitely need to address the amounts of potassium and fluid in your body.

The amount of potassium right for you depends on which type of dialysis you choose. While it’s more common to have to restrict your potassium intake on haemodialysis, some people on peritoneal dialysis have to increase their potassium intake. In these cases, a dietitian or health professional might recommend foods high in potassium, such as bananas. Be sure to check with them for professional advice suited to you.

People on dialysis will often have to avoid foods high in phosphate. This is especially the case for those undergoing haemodialysis, although often people use special tablets called phosphate binders to help with this. Those on peritoneal dialysis may also need to avoid high phosphate foods. The restrictions are usually far less strict, though.

Because of the restrictions placed on those with chronic kidney disease, you may find that you’re not getting the right vitamins and minerals from the food you eat. In this case, your doctor or dietitian might recommend certain supplements. For example, KidneyVital™ aims to provide key vitamins and trace elements that may be missing so you can live a more active life.

It’s important that you only take supplements that are prescribed, as some can interfere with your treatment and be incredibly harmful. You may find extra vitamins and minerals helpful if you experience any of the following:

• chronically poor or erratic eating habits
• reduced appetite
• nausea
• vomiting
• changes in taste
• food aversions
• undesirable weight loss
• food insecurity
• vitamin loss during dialysis.

It’s important that you talk to your dietitian or healthcare team to formulate a plan that works best for you.

When living with chronic kidney disease, managing what you eat and drink can be a challenge; however, your diet can also positively influence how you feel, and what other treatments you might need.

It is important to recognise that as kidney disease progresses your dietary needs will more than likely change. It is also important to recognise that every person with kidney disease is different and has different food preferences and dietary needs.

An Accredited Practising Dietitian experienced in kidney disease is the best person to speak to about what food and drinks are best for you. The Dietitian will assess what you are currently eating and advise if changes are needed.

Your GP or Nephrologist may make a referral to a renal dietitian. The Dietitians Association of Australia can provide names and contact details of local renal dietitians. Call 1800 812 942 or visit www.daa.asn.au and then ask your doctor to arrange a referral to your preferred dietitian.

For more information and to get the most out of your appointment with the Dietitian see our Nutrition and Kidney Disease fact sheet.