Prior to beginning dialysis, you might have already watched sugar or sodium intake. After your kidneys begin to fail, your doctor begins to watch the phosphorus, potassium, protein, calcium, and sodium bicarbonate in your blood. Most of these levels are managed by diet. Labs are taken monthly on the same day. Our labs are always on the second Monday of the month. In our unit, the nutritionist, physician’s assistant, and doctor review different aspects of our lab work, but any of these specialists will explain all of the results if you ask.
Nutritionists offer practical advice, answers
Our unit has had three nutritionists in three years, but the last two are well-qualified and understand the difficulty of managing a renal diet. Fortunately both talk as advisors and don’t treat us as irresponsible or unruly children. Our nutritionists offer education and are glad to answer questions. If they don’t know the answers, they are quick to research answers. Below and in the next few weeks, I will share insights about the lab tests I referred to above. Depending on your health and lab results, you might encounter other challenges, as well. Please share those insights with our community here.
Phosphorus poses challenges
Most foods and many beverages contain the mineral phosphorus. Coffee, chocolate and nuts are especially high in phosphorus. But if you manage your diet, an 8 oz. cup of coffee daily and a teaspoon of peanut butter a few times each week is generally OK. Unhealthy kidneys do not effectively process phosphorus out of the blood. Dialysis helps but is not sufficient. One nurse told me that if I crave a phosphorus-filled food, eat it on a dialysis day before dialysis because the treatment will help remove the some of the excess mineral.
Too much phosphorus can leach calcium from the bones, making them weak and causing calcium to make its way into the skin. Hard white specks or larger pieces rise to the surface of the skin. This unsightly condition reveals a serious imbalance in the body.
Your nutritionist can provide lists or charts of foods high and low in phosphorus, but here is a short list of each.
|American cheese||1 oz. mozzerella or brie cheese|
|Brownie||Rice crispie treat or lemon square|
|Colas, pepper-type beverages||Flavored seltzer water, ginger ale, root beer|
|Dried fruit||Grapes, medium plum|
|Ice cream, pudding (dairy products)||Sorbet Popsicle|
|Nuts, peanuts||No-salt pretzels or no-salt popcorn|
|Oatmeal||Grits, Cream of Wheat|
|Peanut butter & jelly sandwich||Light cream cheese (2 Tbsp.) and jelly|
Source: “Fill Your Plate! A World of Tasty Recipes for the Kidney Community”, ©2011 Fresenius Medical Care Holdings, Inc.
Phosphorus called other names
Phosphorus lurks in processed foods, but you can recognize terminology that reveals what to avoid. Several ingredients have forms of phosphate, which is phosphorus connected with another element. Avoid foods with names like these on the nutrition labels.
* sodium tripolyphosphate
* sodium hexametaphosphate
* trisodium triphosphate
When reading labels, select foods that contain less than 5% of the daily value (DV) or 50 mg. or less of phosphorus.
Fresh meats and fruits generally have lower amounts of phosphorus than frozen or prepared meats or dried fruit. Cooking from “scratch” ingredients instead of boxed meals or mixes also lowers phosphorus intake. Refrigerated biscuits, for example, are high in phosphorus. Made at home from the basic ingredients, breads have less phosphorous.
Phosphorus blockers help
Phosphorus blockers absorb the mineral and stop it from entering the blood. Some of us take one with each meal and snacks. Others take three with each meal. Countless combinations exist, and your doctor will advise you on dosage and necessary changes.
A few varieties of phosphorus blockers can be prescribed. Some add calcium. Some can cause side effects. Both descriptions of each phosphorus blocker and a free downloadable cookbook of autumn recipes for dialysis patients are available here.
Sign up to get our dialysisgal.com posts. Next week you’ll find more ways to watch your diet and keep your kidneys happy!
The renal diet is difficult and sometimes unsatisfying, but dialysis patients in your clinic and recipes written for kidney patients can help you feel healthier and happier. Luckily, many of the recipes are simple and quick! Try some of the recipes referenced above and let us know what you think.
If you or someone you care about is facing dialysis, share your experiences and concerns. This is a forum for learning and inspiration where we can ask questions and be honest with others in the same situation. Share your experiences, challenges, and questions about dialysis with us.