The kidney is the core organ for metabolizing waste and regulating electrolyte balance in the human body. However, due to severe renal impairment, dialysis patients rely on dialysis to replace part of their kidney function.
Diet management, as an important auxiliary measure for dialysis treatment, directly affects patients' nutritional status, incidence of complications, and quality of life.
"Precisely supplement nutrition and strictly control load"
It refers to the dietary management that dialysis patients need to follow, which aims to meet their physical needs while minimizing the pressure on their kidneys.
1. Protein management: Balancing sufficiency and quality
Protein management is the core of dialysis diet, requiring a balance between "adequacy" and "quality". During dialysis, patients experience protein loss, and insufficient intake can easily lead to muscle atrophy and decreased immunity; excessive intake can produce more metabolic waste such as urea nitrogen, increasing the residual burden on the kidneys.
It is recommended that dialysis patients control their daily protein intake at 0.8-1.0 grams per kilogram of body weight, with a proportion of high-quality protein not less than 50%. High-quality protein is rich in essential amino acids, easy to absorb, and produces fewer metabolic wastes. Common sources include eggs, milk, lean meat, fish, and shrimp. For example, consuming 1 egg + 200 milliliters of milk + 50 grams of lean meat per day can meet basic needs. It is necessary to avoid plant proteins such as beans, nuts, and soy products, which have low absorption and utilization rates and can easily increase metabolic burden.
2. Management and control of sodium, potassium, and phosphorus: building a strong defense against complications
After the kidney loses its function of regulating electrolytes, disorders of sodium, potassium, and phosphorus are prone to cause severe complications: sodium retention leading to edema, hypertension, and heart failure; hyperkalemia inducing arrhythmias and even posing life-threatening risks; and hyperphosphatemia triggering calcium and phosphorus metabolism disorders, resulting in osteoporosis and vascular calcification.
Sodium: Keep daily intake within 2-3 grams (approximately 1 teaspoon of salt), and avoid preserved foods, processed meats, pickles, and condiments such as soy sauce and oyster sauce. Cooking methods should primarily be steaming, boiling, stewing, and cold mixing, using vinegar, lemon juice, and spices as substitutes for salt to enhance flavor.
Potassium: Patients undergoing hemodialysis should not consume more than 2000 milligrams of potassium per day, while patients undergoing peritoneal dialysis may have a slightly higher intake. Strictly limit or avoid high-potassium foods such as bananas, oranges, potatoes, and spinach, and prefer low-potassium ingredients such as apples, pears, and cucumbers.
Phosphorus: Control daily intake to 800-1000 milligrams, and avoid animal organs, seafood, meat broth, and processed foods. Although milk and eggs contain phosphorus, they are high-quality proteins and can be consumed in moderation. If necessary, follow the doctor's advice to take phosphorus binders.
3. Water management: Strictly control water storage to prevent overload
Excessive fluid accumulation during the dialysis interval can increase cardiac load and make blood pressure control more difficult. Daily water intake should strictly follow the formula: the previous day's urine output plus 500 milliliters (non-apparent water loss).
Avoid drinking liquids such as soup, Congee, juice, and tea. When eating fruits, prefer those with less water content and control the portion. You can reduce the desire for water intake by drinking slowly in small sips, using a graduated water cup to measure the amount, and drinking water before meals. If you experience edema or a weight gain of more than 5% of your dry weight between dialysis sessions, it is necessary to inform your doctor promptly for protocol adjustments.
4. Supplement energy + regular prescription adjustment: balance nutrition and adaptability
Patients undergoing dialysis require a daily caloric intake of 30-35 kcal/kg of body weight, primarily consisting of carbohydrates and moderate amounts of fat, to avoid protein breakdown for energy due to insufficient calories.
Meanwhile, regular monitoring of blood routine, electrolytes, liver and kidney functions should be conducted, and dietary plans should be adjusted under the guidance of doctors or clinical dietitians based on the test results and dialysis type.
Chen Wen, the director of the Nephrology Department at Hainan Chengmei Hospital, stated that dietary management for dialysis patients is not merely about avoiding certain foods, but more about scientific combination and precise regulation. He reminded that many kidney disease patients experience relapse due to negligence in dietary details. Only by closely integrating dietary management with dialysis treatment and medication can we effectively maintain nutritional balance, reduce complications, and improve quality of life.
Expert Introduction
Chen Wen, Director of Nephrology Department
Chief Physician, Professor, Master's Supervisor
Outstanding Experts with Outstanding Contributions in Hainan Province
Leading talent in Hainan Province
Key experts directly connected with the Provincial Party Committee and Provincial Government of Hainan Province
Medical expertise
Specializes in primary glomerular disease, IGA nephropathy, lupus nephritis, hypertensive nephropathy, uric acid nephropathy, and diabetic nephropathy; especially in the diagnosis and treatment of critical and complex diseases in nephrology, as well as clinical pathological diagnosis and treatment; proficient in the indications, diagnosis, and treatment of complications of hemodialysis and peritoneal dialysis; proficient in the establishment of temporary and long-term vascular dialysis access, peritoneal dialysis access, and the management of complications.