One Day Dialysis Diet Breakfast: 3 Egg Whites 1 Slice White Toast 1 Tbsp Unsalted Butter ½ C Blueberries 1 C Soymilk 1/8 Tsp Table Salt Morning Snack: 2 Tbsp Creamy Peanut Butter 1 Small Apple ¼ C Water Lunch: 3 Ounces Whole Wheat Spaghetti 2 Tbsp Unsalted Butter (mix into spaghetti) 2 Ounces Grilled Turkey Breast 1 Tbsp Olive Oil (rub on turkey and grill) ½ Tsp Dried Basil 1 Chocolate Covered Ice Cream Bar with Nuts ½ C Water Afternoon Snack: ½ C 2% Cottage Cheese ½ C Sliced Strawberries Dinner: Dessert: 4 Ounces Broiled Top Sirloin ¼ Tsp Minced Garlic 2 Tbsp Unsalted Butter ½ C Cooked and Drained Asparagus ½ Tsp Dried Rosemary 1 Tbsp Olive Oil (use to cook asparagus) 2 Tbsp Lemon Juice (use to cook asparagus) 2/3 C Brown Rice ¾ C Sugar Free Lemonade 1 Slice Cherry Pie 2 Tbsp Whipped Topping
Meal Food Serving Size Breakfast Morning Snack Lunch Dialysis One Day Menu Calories Protein (g) Water (g) Phosphorus Potassium Egg Whites 3 50 11 3 3 3 164 White Toast 1 slice 64 2 7 23 29 130 Butter, 1 Tbsp 102 0 3 3 3 2 unsalted Blueberries ½ C 42 1 62 9 57 1 Soy Milk 1 C 132 8 216 127 289 125 Table Salt 1/8 Tsp 0 0 0 0 0 295 Creamy 2 Tbsp 188 8 1 115 208 145 Peanut Butter Small Apple 1 Apple 77.5 127 16 159 1.5 Water ¼ C 0 0 59 0 0 2 Whole 3 Ounces 105 5 57 75 37 3 Wheat Spaghetti Turkey 2 Ounces 107 16 36 119 163 36 Breast With Skin Olive Oil 1 Tbsp 126 0 0 0 0 0 Butter, 2 Tbsp 203 0 5 7 7 3 unsalted Dried Basil ½ Tsp 2 0 0 2 18 0 Chocolate 1 Each 171 2 23 62 129 50 Covered Ice Cream Bar With Nuts Water ½ C 0 0 118 0 0 5 Sodium
Afternoon Snack Food Serving Size Calories Protein (g) Water (g) Phosphorus Potassium Sodium 2% Cottage ½ C 97 13 91 184 94 373 Cheese Strawberries, ½ C 27 1 75 20 127 1 sliced Dinner Top Sirloin 4 Ounces 291 30 64 227 371 61 Steak, Broiled Dried ¼ Tsp 2 0 0 0 10 0 Minced Garlic Butter, 2 Tbsp 203 0 5 7 7 3 unsalted Asparagus, ½ C 20 2 83 49 202 13 cooked and drained Dried ½ Tsp 2 0 0 0 6 0 Rosemary Olive Oil 1 Tbsp 126 0 0 0 0 0 Lemon Juice 2 Tbsp 7 0 28 2 31 0 Brown Rice 2/3 C 144 3 95 108 56 7 Sugar Free ¾ C 5 0 177 23 2 7 Lemonade Cherry Pie 1 Slice (1/6 304 2 54 34 95 288 of an 8 pie) Whipped 2 Tbsp 30 0 6 6 12 0 Topping TOTAL: 2600 kcal 106 g Protein 1481 g Water 1241 mg Phosphorus 2243 mg Potassium 1716 mg Sodium
Potassium What is potassium? Potassium is a mineral that is found in a wide variety of foods. It is necessary for muscle contraction, nerve impulses and is important in maintaining a regular heartbeat. How is potassium affected in dialysis patients? Normally, your kidneys keep safe levels of potassium in the blood. When they are not functioning properly potassium can build up and be very harmful to your health. If your potassium becomes too high it can cause an irregular heartbeat or a heart attack. Some symptoms that potassium levels are too high include tingling, numbness and weakness. Talk to a doctor immediately if you have any of these symptoms while you are on dialysis. What is a safe level of potassium in my blood? Your potassium blood level should be tested regularly. Work with your doctor and dietitian to find the proper potassium intake to maintain a safe potassium level. If it is 3.5-5.0 You are in the SAFE zone If it is 5.1-6.0 You are in the CAUTION zone If it is higher than 6.0..You are in the DANGER zone How do I control my potassium levels? Potassium is regulated primarily through what you eat. Food high in potassium should limited and intake should be monitored closely. Portion sizes are important to pay attention to because almost all foods have some amount of potassium in them. Having too large of a portion size can turn a low potassium food into a high potassium food. Certain cooking techniques can help reduce the amount of potassium in your food. Leaching is a process that pulls the potassium out vegetables food before you eat them. Ask your dietitian for tips on how to leach potassium out of some of your favorite foods. What can I eat while on a potassium restriction? The main sources of potassium are whole foods like fruits and vegetables. Pay attention to serving sizes of these foods and be familiar which ones are low and high sources of potassium. Refer to the back of this sheet for a list of potassium containing foods.
High Potassium Foods Potassium Content >300 mg Fruits Small Banana, 1 467 mg Cubed Cantaloupe, 1 C 461 mg Raisins, 1/2 C 598 mg Orange Juice, 8 fl oz 496 mg Tomato Juice, 1 C 535 mg Medium Avocado, ½ 450 mg Medium Potato, with skin, ½ 422 mg Meats and Protein Cooked Pinto Beans, ½ C 400 mg Cooked Lentils, ½ C 365 mg Baked Salmon, 3 oz 345 mg 2% Milk, 1 C 377 mg Yogurt, 6 oz 398 mg Raisin Bran Cereal, 1 C 362 mg Medium Potassium Foods Potassium Content 150-300 mg Fruits Orange, small, 1 237 mg Peach, medium, 1 193 mg Apple, small, 1 159 mg Asparagus, cooked, 1 C 288 mg Carrots, fresh, ½ C 177 mg Zucchini, cooked, ½ C 173 mg Meats and Protein Lean Beef, cooked, 3 oz 224 mg Peanut Butter, 2 Tbsp 214 mg Roasted Turkey, dark meat, 3 oz 259 mg 2% Cottage Cheese, 1 C 217 mg Ricotta Cheese, ½ C 154 mg Brown Rice, cooked, 1 C 155 mg Cinnamon Raisin Bagel, 3 ½, 1 155 mg Low Potassium Foods Potassium Content <150 mg Fruits Small Grapes, 10 93 mg Blueberries, ½ C 63 mg Strawberries, ½ C 138 mg Cucumber Slices, ½ C 88 mg Iceberg Lettuce, 1 C 87 mg Green Beans, frozen, ½ C 85 mg Meats and Protein Egg, 1 55 mg Vanilla Ice Cream, ½ C 131 mg American Cheese, 1 oz 79 mg Cheddar Cheese, 1 oz 28 mg Oatmeal, cooked, 1 C 130 mg Breadstick, 1 12 mg White Bread, 1 slice 25 mg
What is phosphorus? Phosphorus Phosphorus is an important mineral in your bones and teeth. It works with calcium to make them healthy and strong. Phosphorus is also in every cell in the body and is important for making energy. What does it mean for patients on dialysis? When kidneys function normally, they can remove phosphorus from the blood. In patients with chronic kidney disease, their kidneys cannot remove the phosphorus from the blood and it begins to build up in the body. When there is too much phosphorus in the blood it begins to take away calcium from bones and teeth making them weak and painful. It also causes a build-up of calcium in other parts of the body where it shouldn t be, for example in the heart and lungs. Phosphorus levels must be controlled to protect a patient s health. How do I control my phosphorus levels? Phosphorus can be controlled three ways in the body: dialysis, diet and medication. Dialysis can remove some phosphorus but it can build up again before your next treatment. If diet and medication are used properly they can reduce the amount of phosphorus that builds up between dialysis treatments. Working closely with your doctor and dietitian will help you understand what diet to follow and how to use your medication. What medications control my phosphorus levels? A phosphate binder is a medicine that is taken with meals and snacks. It reduces the amount of phosphorus your body absorbs when food is eaten. Phosphate binders can come in pills, chewable tablets, and powders. Patients should only take the phosphate binder that is prescribed to them by their doctor or dietitian. What can I eat to control my phosphorus levels? Phosphorus is found in most foods. and milk products have especially high levels of phosphorus. Meats, grains, and some vegetables are also high in phosphorus. By limiting or avoiding these foods in the diet it will help control phosphorus levels in the body. Patients should work closely with their dietitian to learn the best food and meal options. Turn the page over to see common food options that have high, medium and low levels of phosphorus in them.
High Phosphorus Food >120 mg Products: Cheddar Cheese, 1 oz Cottage Cheese, 2 % fat, ½ cup Ice Cream, 1 cup Milk, 2% fat, 1 cup Cheese, mozzarella, 1 oz Yogurt, plain, nonfat Meats and Proteins: Chicken, 3 oz Turkey, 3 oz Ham, 3 oz Fish, salmon, 3 oz Ground Beef, cooked, 3 oz Fast Food Hamburger, 1 Chicken Nuggets, 6 pieces Fried Chicken, 1 drumstick Kidney Beans, ½ C : Macaroni, 1 C Beverages: Hawaiian Punch Medium Phosphorus Foods 70-120 mg Meats and Proteins: Egg, 1 Tofu, regular, ½ cup Peanut Butter, 2 Tbsp : Potato baked with skin, 1 Peas, ½ C Spinach, 1 C Beverages: Tropicana Fruit Punch Low Phosphorus Foods <70 mg : Cooked White Rice, 1 C Dinner Roll, 1 Whole Wheat Bread, 1 slice White Bread, 1 slice Fruits: Apple, 1 small Banana, 1 small Blueberries, 1 C Peaches, 1 C : Iceberg Lettuce, 1 C Carrots, 1 C Corn, ½ C Zucchini, ½ C Beverages: Cola, 12 oz Mountain Dew, 12 oz Tropicana Lemonade, 12 oz Nestea Honey Lemon Green Tea, 12 oz Phosphorus Content 146 mg 170 mg 202 mg 232 mg 131 mg 385 mg 155 mg 173 mg 210 mg 252 mg 165 mg 284 mg 132 mg 304 mg 252 mg 126 mg 173 mg Phosphorus Content 96 mg 120 mg 92 mg 115 mg 84 mg 92 mg 90 mg Phosphorus Content 43 mg 14 mg 65 mg 23 mg 10 mg 17 mg 30 mg 11 mg 16 mg 64 mg 60 mg 21 mg 46 mg 53 mg 38 mg 0 mg
Sodium What is sodium? Sodium is a mineral found in many foods and makes up a major part of table salt. It helps maintain fluid balance in the body. How is sodium affected in dialysis patients? When the kidneys are damaged extra sodium builds up and keeps extra water in the body. Excess fluid causes swollen ankles, high blood pressure and shortness of breath. Eventually too much fluid in the body can cause an enlarged heart. Too much fluid also causes more discomfort during dialysis treatments. The more fluid retained in the body means more fluid removed during dialysis. By reducing sodium in the diet it decreases thirst and helps patients maintain proper fluid balance. How do I control my sodium intake? Sodium in the diet can be reduced in the diet by changing cooking methods and reading nutrition labels. Here are some helpful tips to reduce sodium in your diet: Cook with herbs and spices instead of salt Do not add salt to your food Limit the use of canned, processed and frozen foods Choose foods that have reduced sodium or are low in sodium Compare food labels of various products of the same food to find the lowest sodium item Do not choose foods with more than 500 mg of sodium per serving Beware of salt substitutes because they are high in potassium Avoid foods with sodium in the first five ingredients What can I eat while on a sodium restriction? The main source of sodium in the diet is from processed foods and added salt. By eating whole foods and using herbs and spices instead of salt a wide variety of flavorful foods can still be enjoyed. Refer to the back of this handout to see a list of sodium containing foods. Work closely with your dietitian for further tips and a recommendation of what your sodium intake should be.
High Sodium Foods Tomato Sauce, canned, 1 C Scalloped Potatoes, home prepared, 1 C Corn, canned, 1 C Meats and Protein Bacon, cured, 3 slices Frankfurter, beef, 1 frank Ham, sliced, 2 slices Shrimp, fast food, breaded and fried, 6-8 shrimp American Cheese, processed, 1 oz Ricotta cheese, 1 C Cottage Cheese, 1 C Cornbread, 1 piece Cinnamon Raisin Bagel, 4 bagel Pita Bread, 1 6 pita Kellogg s Raisin Brain, 1 C Medium Sodium Foods Frozen Chopped Spinach, w/out salt, 1 C Canned Sweet Potato, 1 C Peas, frozen, 1 C Meats and Proteins Sausage, pork and beef, 2 links Fried Chicken, 1 thigh Egg, poached, 1 Salmon, dry heat, 3 oz Milk, 1%, 1 C Soymilk, original, 1 C Yogurt, plain, 8 oz Cheerios, 1 C English Muffin, 1 muffin Mutli Grain Bread, 1 slice Low Sodium Foods Fruits Pineapple, canned, 1 C Orange Juice, 1 C Blueberries, 1 C Cherry Tomato, 1 Corn, 1 ear Raw Spinach, 1 C Meats and Proteins Steak, beef, 3 oz Pork Loin Ribs, 3 oz Trout, 3 oz Peanut Butter, smooth, 1 Tbsp Ice Cream, Vanilla, ½ c Whipped Topping, 1 Tbsp White Rice, long grain, 1 C Instant Oats, 1 packet Taco Shells, baked, 1 medium Sodium Content >250 mg 1284 mg 821 mg 730 mg 439 mg 513 mg 603 mg 1446 mg 356 mg 308 mg 479 mg 467 mg 358 mg 322 mg 259 mg Sodium Content 100-250 mg 190 mg 135 mg 115 mg 209 mg 248 mg 149 mg 114 mg 107 mg 125 mg 175 mg 171 mg 248 mg 109 mg Sodium Content <100 mg 3 mg 2 mg 1 mg 1 mg 1 mg 24 mg 37 mg 49 mg 52 mg 73 mg 53 mg 4 mg 4 mg 87 mg 52 mg