This information will help you choose foods to keep you well on dialysis. You may also be given some extra information if needed. Your dietitian may change the advice in the future if your health, blood tests or appetite changes.
You will be able to talk to your dietitian regularly about your eating. You can contact your dietitian at any time. See the bottom of the page for contact details.
These are high protein foods. They are essential:
Before starting dialysis, you may have been advised to eat smaller portions of protein foods. Now your body is losing some protein during dialysis. You need to eat extra protein foods to replace what you are losing.
Try to eat protein foods at two meals every day. Speak to your dietitian if you are struggling to manage these.
Milk, cheese, yoghurt and fortified soya milk are great sources of protein and calcium. They also contain a lot of phosphate.
Phosphate levels in the blood may be high when the kidneys are not working properly; this can increase your risk of heart disease, cause weak bones and itching. Your dietitian will advise if you need to limit these foods to lower phosphate levels in the blood. See phosphate section below for more information.
These foods give us energy.
Try to include one serving at every meal.
Wholegrain varieties are high in fibre. Fibre helps to keep your bowels healthy and prevent constipation. Constipation can prevent your dialysis from working well.
Try to choose these wholegrain foods:
You may have been advised to always boil potatoes, yam, cassava and plantain; this reduces the potassium. Your dietitian will advise you if you still need to do this.
Eat at least five portions of a variety of fruit and vegetables per day.
You may have been advised not to eat some fruit and vegetables because your potassium levels in the blood have been high. Your dietitian will advise you if you still need to do this.
Foods high in fat and/or sugar include pastry, fried foods, cakes, biscuits and chocolate.
If your appetite is good and you want to manage your weight and eat to keep your heart healthy, you could:
Fluid mainly comes from liquids you drink.
When most people start dialysis, they are still passing urine. Fluid is removed from the body by dialysis and by passing urine.
Many people find that after a while on dialysis they pass less urine; they begin to rely on dialysis to remove most of the fluid.
If you are drinking more fluid than can be removed, you will become fluid overloaded (oedema). The extra fluid puts a strain on your heart and lungs. It is often difficult to remove extra fluid by dialysis.
Signs you are overloaded are:
You will weigh yourself before and after dialysis sessions. The change in weight from the end of one session to the beginning of the next is mainly fluid. Your doctor, dialysis nurse or dietitian can advise you on your ideal maximum weight gain between dialysis sessions.
If you are gaining too much fluid your doctor, dialysis nurse or dietitian may advise you to limit the fluid you drink.
Tips if you need to have less fluid:
Your dietitian can give you more ideas to help.
Eating less salt can help you to feel better. Reducing salt helps your dialysis remove fluid, can improve your blood pressure and make you feel less thirsty.
Most of the salt we eat comes from processed and ready prepared foods.
Tips to reduce salt:
Your dietitian can give you more help to reduce the salt you eat.
Potassium is a mineral found in many foods. It helps our nerves, muscles and heart to work properly. Our kidneys usually control the level of potassium in the blood. Extra potassium is passed out in the urine.
Dialysis removes potassium but levels can build up between sessions, especially if you start to pass less urine. Your levels of potassium in your blood will be checked regularly.
The target range for potassium in your blood is 3.5 – 5.9mmol/l. A high level of potassium can be dangerous, as it can affect your muscles and heart.
Your dietitian will advise if you need to eat less potassium to keep your blood levels safe.
These are foods and drinks higher in potassium:
Only limit high potassium foods if you have been advised to.
If you have diabetes, you may have been recommended to eat more fruit, vegetables and nuts. Your dietitian can advise you on appropriate quantities and help you choose lower potassium options.
Phosphate levels in the blood can be high when the kidneys are not working properly; this can increase your risk of heart disease, weaken your bones and cause itching.
Dialysis is poor at removing phosphate from the blood. Your levels of phosphate in your blood will be checked regularly.
The target range for phosphate in your blood is 0.8 – 1.5mmol/l. If your levels are high, eating less phosphate can protect your bones and heart, and help you feel less itchy.
High phosphate food and drinks include:
Other high phosphate foods such as dairy products, milk, fish and meat are good sources of protein and other nutrients. Some recommended portion sizes are below.
Your dietitian can guide you on how many portions to have per day or per week. For most people 2 servings per day of dairy foods and up to 6 eggs per week will limit the amount of phosphate you’re eating.
If you are already following a low phosphate diet your dietitian will advise if you need to continue. Only limit high phosphate foods if you have been advised to.
To help control phosphate levels, some people may be prescribed tablets called phosphate binders. Your dietitian will advise on the best way to take these to make sure they work well.
If yes, the following information may help.
Eating well is important to help you feel better and cope with dialysis.
Some of these foods are high in salt, sugar, phosphate and potassium which may not be in line with the diet you have previously been advised to follow. If you have diabetes or you are limiting potassium or phosphate, speak to your dietitian for more information.
Water soluble vitamins are lost during the dialysis process.
Your GP can prescribe a multivitamin tablet (Renavit) suitable for people with kidney disease; this helps to replace the vitamins lost during dialysis.
Renavit contains a beef product so if you are unable to take this, we can recommend an alternative.
You will need to take Renavit after your dialysis session (three times a week for most people).
You are recommended to discuss any other vitamin, mineral, herbal or fish oil supplements with your dietitian or doctor before taking; some can be harmful for kidney patients.
Some people find it more difficult to eat well on dialysis days. This can be due to lack of time and being away from home.
Many people take a packed lunch or snack with them to dialysis. This can be particularly helpful if you have diabetes, or if your appetite is poor.
Eating during your dialysis session can help you get nourishing food even on busier dialysis days.
Many people want to eat food that is more environmentally friendly. Below are some ideas you could consider.
An easy-to-use online service that allows you to monitor your own blood test results. You can find out more and register to use it at https://patientsknowbest.com/register/
Information on kidney disease and food written by the kidney dietitians at North Bristol NHS Trust
Kidney Care UK diet and lifestyle information including recipe books to download
Kidney Patient Guide diet information including menus and recipe books to download
Website of the Edinburgh Renal Unit and contains useful dietary information
Webinar on importance of protein for people on haemodialysis
Kidney Care UK practical advice to help you reduce your weekly food shopping bill while maintaining a nutritious and kidney friendly diet
Contact your dietitian if you need further help.
© North Bristol NHS Trust. This edition published March 2023. Review due March 2026. NBT003498.
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