Essential Precautions Every Dialysis Patient Should Follow for Better Health

Your kidneys are essential organs in the urinary system. These bean-shaped structures are located beneath your ribcage, one on each side of your spine. They remove toxins from your blood, sending back clean, nutrient-rich blood to your circulatory system. The waste and extra water become urine, which moves from the kidneys to the bladder. Furthermore, your kidneys help regulate your blood pressure.

In kidney failure, the kidneys cannot effectively filter blood, leading to a build-up of waste and toxins in the bloodstream. Dialysis performs the role of the kidneys by eliminating waste products and excess fluid from the blood.

Who requires dialysis?

Individuals with kidney failure, also known as end-stage renal disease (ESRD), often require dialysis. Various injuries and health conditions, such as high blood pressure, diabetes and lupus, can harm the kidneys and result in kidney disease.

Some individuals experience kidney issues without any clear cause. Kidney failure can either be a chronic condition or occur suddenly (acute) following a serious illness or injury. In such cases, kidney failure may resolve as the person recovers.

Types

There are two ways types of dialysis, namely:

Haemodialysis: During haemodialysis, a machine takes blood out of your body, filters it through a dialyser (which acts like an artificial kidney) and then sends the cleaned blood back into your body. This process usually lasts between 3 and 5 hours and is typically done in a hospital or a dialysis centre three times a week.

Peritoneal dialysis: With peritoneal dialysis, small blood vessels in the abdominal lining (peritoneum) help filter blood using a dialysis solution. This solution is a cleansing liquid made up of water, salt and various other additives.

Dialysis patient symptoms

You might encounter various symptoms that are often reported by individuals undergoing dialysis. Nevertheless, there are strategies to help manage these symptoms by adhering to your treatment plan and promptly informing your healthcare team about any sudden changes. Given below are some common challenges faced by those on dialysis:

• Dizziness
• Light-headedness
• Fatigue
• Nausea
• Vomiting

Food for dialysis patients (Dialysis patient diet chart)

A well-balanced dialysis patient diet that includes the appropriate amounts of protein, calories, fluids, vitamins and minerals is essential for dialysis patients or those with end-stage kidney disease to maintain their health, as their kidneys are not functioning at full capacity.

Your dialysis centre provides access to a renal dietitian who can assist you in meal planning. A renal dietitian is specially trained to address the dietary and nutritional needs of individuals with kidney disease.

Here is some important information about the right diet for dialysis patients.

• Right amount of calories: For overall health and well-being, taking appropriate calories (energy) is very important. The energy required for each individual is different according to their age, gender, body size, medical conditions and physical activities. Consultation with the dietician or your healthcare provider is essential to know the contribution of the calories (carbohydrates) by the dialysate used. Peritoneal dialysis patients should reduce their intake of calories in order to avoid excess intake of calories, as dialysate contains calories.  
• Sodium: It is a mineral present in salt (sodium chloride) and is commonly used as a seasoning for various foods. However, it is one of the first minerals to reduce in a renal diet, as it directly affects your body’s ability to retain water.
• Potassium: When your kidneys are not functioning well, potassium can accumulate in your bloodstream. This build-up can alter your heart’s rhythm and may even result in a heart attack.  
• Potassium is primarily present in fruits and vegetables, along with milk and meats. It is important to steer clear of specific fruits and vegetables and to restrict the intake of others. Examples of food containing high potassium contents are bananas, orange, avocado, tomatoes, dried beans, pumpkins, nuts, etc.
• Phosphorous: Phosphorus is another mineral that can accumulate in your blood if your kidneys are not functioning correctly. When this occurs, calcium may be drawn from your bones and can start to deposit in your skin or blood vessels. This can lead to bone disease, increasing your risk of fractures. Dairy products are the primary source of phosphorus in our diet. However, some vegetables and grains also provide this essential mineral. Limit the intake of phosphorous-containing dairy products, vegetables, grains and foods. Foods like dried beans, leafy greens, broccoli, mushrooms, Brussels sprouts, bran, wheat cereals, oatmeal and granola are good sources of phosphorus as well.
• Proteins: Proteins play a crucial role in building and repairing muscles. Patients undergoing dialysis need to consume more protein because some protein is lost during the process. Not getting enough protein can result in weight loss, muscle wasting and a decreased ability to fight infections, ultimately leading to malnutrition. High-protein content foods include meat, poultry, fish, yoghurt, milk, cheese, etc.
• Fluid: Due to reduced kidney function, dialysis patients often exhibit diminished urine output. Therefore, it is crucial for them to carefully monitor and restrict their fluid intake. Excess fluid can accumulate in the body, leading to symptoms like shortness of breath, high blood pressure and swelling in the legs. The recommended fluid intake for dialysis patients can vary depending on their urine output.

How do dialysis patients die?  

Cardiovascular disease is recognised as the primary cause of death in dialysis patients, with sepsis and infections following closely behind. Additional causes of mortality include withdrawal from dialysis, diseases of the circulatory system, endocrine, nutritional and metabolic disorders, genitourinary diseases and neoplasms.

Conclusion

When your kidneys are not functioning well, it is essential to adjust your diet and manage your fluid intake. While your dietary needs may differ based on the type of dialysis you undergo, most dialysis patients generally need to restrict sodium, phosphorus and potassium in their meals. Consulting with your kidney dietitian is crucial to help you understand which foods are suitable for you and which ones to avoid.