Renal Diet

What do I need to know about fluids?

You need to watch how much you drink. Any food that is liquid at room temperature also contains water. These foods include soup, jello, and ice cream. Many fruits and vegetables contain lots of water, too. They include melons, grapes, apples, oranges, tomatoes, lettuce, and celery. All of these foods add to your fluid intake.

Fluid can build up, causing swelling and weight gain. The extra fluid affects your blood pressure and can make your heart work harder. You could get serious heart

trouble from overloading your system with fluid. Control your thirst. You can keep your fluids down by drinking from smaller cups or glasses. Freeze juice in an ice cube tray and eat it like a popsicle. (Do not forget to count the popsicle in your fluid allowance!)

Potassium is a mineral found in many foods, especially milk, fruits, and vegetables. It affects how steadily your heart beats. Healthy kidneys keep the right amount of potassium in the blood to keep the heart beating at a steady pace. Potassium levels can rise between dialysis sessions and affect your heartbeat. Eating too much potassium can be very dangerous to your heart. It may even cause death.

You can remove some of the potassium from potatoes and other vegetables by peeling them, then soaking them in a large amount of water for several hours. Drain and rinse before cooking.

High-potassium foods:

Phosphorus is a mineral found in many foods. If you have too much phosphorus in your blood, it pulls calcium from your bones. Losing calcium will make your bones weak and likely to break. Also, too much phosphorus may make your skin itch. Foods like milk and cheese, dried beans, peas, colas, nuts, and peanut butter are high in phosphorus.

Most people on dialysis are encouraged to eat high-quality protein. The better nourished you are, the healthier you will be. You will also have greater resistance to infection and recover from surgery more quickly. Protein helps you keep muscle and repair tissue. In your body, protein breaks down into a waste product called urea. If urea builds up in your blood, you can become very sick.

Some sources of protein produce less waste than others. These are called high-quality proteins. High-quality proteins come from meat, fish, poultry, and eggs (especially egg whites). Getting most of your protein from these sources can reduce the amount of urea in your blood.

Meat, fish, and chicken are good sources of protein. A regular serving size is 3 ounces. This is about the size of the palm of your hand or a deck of cards. Try to stick to lean (low-fat) meats that are also low in phosphorus. If you are a vegetarian, ask about other ways to get your protein. Low-fat milk is a good source of protein. But milk is high in phosphorus and potassium.

Sodium is found in salt and other foods. Most canned foods and frozen dinners contain large amounts of sodium. Too much sodium makes you thirsty. Then, if you drink more fluid, your heart has to work harder to pump the fluid through your body. Over time, this can cause high blood pressure and congestive heart failure.

Try to eat fresh foods that are naturally low in sodium. Look for products labeled low sodium. Do not use salt substitutes because these contain potassium.

Reprinted with permission from the National Institute of Diabetes and Digestive and Kidney Diseases

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