Kidney failure (on dialysis)
Why do I need to change how I eat in kidney failure (on dialysis)?
Following a kidney-friendly food and fluid plan is very important for your health when you are in kidney failure and are on dialysis. In kidney failure, your kidneys cannot work the way healthy kidneys do to remove extra waste and fluid from your body.
Dialysis is a treatment that can help your kidneys filter waste and extra fluid from your blood. Some waste and fluid may still build up in your body, especially between dialysis treatments. Over time, the extra waste and fluid in your blood can cause heart, bone and other health problems.
To feel and do your best on dialysis, you will need to change how you eat and drink. In kidney failure, you may need to eat more protein, while limiting fluid, salt, potassium and phosphorus. This will help to control your blood pressure and prevent fluid retention (when too much fluid builds up in your body) between dialysis sessions.
It is very important to work with your doctor and dietitian to create and follow a kidney-friendly food and fluid plan to protect your kidneys.
How can I eat healthy in
kidney failure (on dialysis)?
Once you are on dialysis you will have a renal (kidney) dietitian as part of your care team. They will help you understand your new kidney-friendly food and fluid plan, as well as any changes they may need to make to it based on how well you are feeling and your lab results.
You will likely need to:
Eat more protein
Limit sodium (salt)
Limit fluids
Limit potassium and/or phosphorus
Protein
Limit sodium (salt), potassium and phosphorus
Fluid
Protein
Your body needs protein to build muscle, heal and stay healthy. When you are on dialysis, your protein needs may be higher, to make up for the proteins you lose during dialysis treatments. Dialysis removes some of your body’s blood proteins, so you will need to eat more protein to help make up for the amount you lose during your dialysis treatments. These proteins are important to help deliver important nutrients to the rest of your body. They also help your body fight infections.
Protein needs for people with kidney disease can vary widely depending on kidney function, body size, lab results, medicines and overall health status. For this reason, the daily protein recommendations listed here are a general reference and may not be appropriate for everyone with CKD. Review your individual needs and how much protein you should eat a day with your doctor and registered dietitian.
For general adult population: 0.8 g/kg body weight:
- About 56 grams of protein each day for a sedentary male who weighs 155 pounds.
- About 47 grams of protein each day for a sedentary female who weighs 130 pounds.
For active individuals: 1-1.2 g/kg body weight:
- About 70-84 grams of protein each day for an active male who weighs 155 pounds.
- About 59-71 grams of protein each day for an active female who weighs 130 pounds.
Get your protein from lean protein sources:
Eggs
Chicken
Fish
Turkey
Quinoa
Beans
Soy products (tofu, edamame, tempeh, soy milk, etc.)
Lean protein serving size and estimated amount of protein:
Food | Amount of Protein (grams) |
½ cup kidney beans | 7 grams |
1 large egg | 6 grams |
½ chicken breast | 29 grams |
Shrimp (3 oz, about size of palm) | 20 grams |
Ask your doctor and dietitian how much protein you should eat each day
Tips to eat more protein on dialysis:
- Aim to have a lean protein source at every meal.
- Keep high protein snacks on hand, like hard-boiled eggs or cottage cheese.
- Check food nutrition labels for protein content.
- Talk to your doctor or dietitian about adding protein supplements, like protein shakes or protein bars.
Sodium (salt)
You can find the amount of sodium in foods by checking the nutrition label. Sodium plays many important roles in the way our bodies function, but too much sodium can be harmful for people with kidney disease. When your kidneys are not working as well as they should, they may not be able to remove extra sodium from your body.
Having too much sodium in your body can make your body retain (hold onto) fluid, which makes your heart and kidneys work harder. Over time, this can raise your blood pressure and cause your kidney disease to get worse.
The amount of sodium found naturally in foods is enough to keep a healthy level in your body, but sodium is often added to many processed foods, foods we eat in restaurants and even the food we cook ourselves. This can lead to eating too much salt and cause too much sodium to build up in your body.
The recommended amount of sodium to consume can depend on your stage of kidney disease and your kidney function. In general, a healthy amount of sodium is 2,300 mg or less of sodium per day. This is equal to about 1 teaspoon of salt a day.
These foods and drinks usually have added sodium (unless marked as low-salt or low-sodium):
Soda and sports drinks
Ice Cream
Frozen dinners and snacks
Fast food and food from restaurants
Packaged snacks (chips, pretzels, nuts, etc.)
Bakery items (bread, bagels, pies, cakes, etc.)
Condiments (ketchup, salad dressings, hot sauce, soy sauce, etc.)
Canned and jarred foods (tomatoes, beans, corn, pickles, etc.)
Seasonings and spices with salt (garlic salt, celery salt, seasoned salt, taco seasoning, seafood seasoning, etc.)
Soda and sports drinks
Frozen dinners and snacks
Packaged snacks (chips, pretzels, nuts, etc.)
Condiments (ketchup, salad dressings, hot sauce, soy sauce, etc.)
Ice Cream
Fast food and food from restaurants
Bakery items (bread, bagels, pies, cakes, etc.)
Canned and jarred foods (tomatoes, beans, corn, pickles, etc.)
Seasonings and spices with salt (garlic salt, celery salt, seasoned salt, taco seasoning, seafood seasoning, etc.)
Ask your doctor and dietitian if they recommend that you consume less sodium in kidney failure (on dialysis).
Tips to limit added sodium:
- Carefully review labels and ingredients for salt substitutes or “No-Salt” seasonings. It’s important to note that some are made with potassium (like potassium chloride) and could raise your potassium to a dangerous level.
- Choose canned and jarred foods that say “no salt added” or “low sodium” on the package
- Choose no salt added snacks (unsalted or no-salt pretzels, etc.)
- Prepare and cook your meals from scratch using one of our kidney-friendly recipes, so you can control the amount of salt in your food
- Use fresh or dried herbs and spices to add extra flavor to your dishes, instead of salt
- Drink water instead of sports drinks or soda
- When eating out, ask your server for your food to be prepared without any added salt and ask for dressings on the side
- When eating out, choose baked, grilled or broiled dishes and consider splitting bigger entrees with someone
Fluid
When you are in kidney failure, you may need to limit your fluids to help you feel better and stay healthier. It can be challenging, but there are ways to do it.
If you are struggling with dry mouth, try some of these tips to help keep your mouth moist:
- Use sugar free gum, candies or mints
- Snack on frozen grapes, berries or pineapple chunks
- Suck on a lemon or lime wedge
- Use an alcohol-free mouthwash
- Keep good oral hygiene by brushing your teeth at least twice a day and going to your dental checkup every 6 months
When on dialysis, you may not urinate (pee) as much as you used to. Dialysis removes extra fluid from your body, so eating and drinking too much fluid can cause fluid to build up between your dialysis treatments. Fluid retention (when too much fluid builds up in your body) can be dangerous and cause problems, including:
- Swelling
- Trouble breathing
- High blood pressure
- Lung infections, like pneumonia
- Decreased blood proteins
- Heart failure
Ask your doctor and dietitian how much fluid you should have each day.
Remember, fluid is more than just the water you drink! Everything that turns to liquid at room temperature counts toward your daily fluid intake.
Ice
Soups and stews
Pudding
Ice cream, sherbet, sorbet, popsicles
All beverages (water, juice, soda, coffee, tea, milk, non-dairy milk, sports drinks, protein drinks, etc.)
Jell-O®, other gelatin products and gelatin substitutes (pectin, arrowroot powder, etc.)
Ice
Soups and stews
All beverages(water, soda, coffee, tea, milk,non-dairy milk, sports drinks, protein drinks, etc.)
Pudding
Ice cream, sherbet, sorbet, popsicles
Jell-O® other gelatin products and gelatin substitutes (pectin, arrowroot powder, etc.)
Tell your doctor right away if you have any of these signs of possible fluid retention:
- Swelling in your feet or ankles
- Trouble breathing or shortness of breath when:
- Walking a short distance (1-3 blocks)
- Lying flat on your back
Potassium
Potassium is found in most foods, and your body needs it for many reasons. When you are in kidney failure (on dialysis), it is important to keep a healthy level of potassium in your body. Potassium plays an important role in helping your muscles expand and contract. Your heart is a muscle, so keeping potassium at a healthy level helps to keep your heart beating the right way. Having too much potassium in your body is very serious and can even be deadly if not treated. Too little potassium may cause fewer bowel movements, or hard, dry, or difficult-to-pass stools, also known as constipation. Let your doctor and dialysis care team know if you are struggling with constipation.
Tips to lower your potassium levels:
- Choose water instead of sports drinks or sodas, which can have a lot of added potassium
- Prepare and cook one of our low-potassium kidney-friendly recipes, so you can control the amount of potassium in your food.
- Use a small plate (9-10 inches in diameter) to make your portion size look larger.
- Track the amount of potassium you consume each day in our potassium tracker.
Phosphorus
Phosphorus is found in many foods in the form of phosphates. Phosphorus is found naturally in some foods, but it is commonly added to foods to help preserve them.
Phosphorus helps your body build bones and teeth, gives you energy and makes up a part of DNA.
When in kidney failure (on dialysis), you need to limit how much phosphorus you eat. Too much phosphorus can make your bones brittle, raise your blood pressure, cause calcium deposits in your veins and organs and cause painful sores on your skin.
If you have dry, itchy skin (pruritus) from high phosphorus levels, scratching can make itching worse. Moisturizing daily with fragrance-free creams and following a kidney-friendly eating plan can help prevent dry, itchy skin as much as possible. Talk to your healthcare team to manage itchy skin.
Ask your doctor and dietitian how much phosphorus you should have each day.
Foods that commonly have added phosphorus:
- Lunch meat
- Hot dogs
- Pancake or biscuit mixes
- Fast food
- Tortillas
- Certain beverages, like cola and iced tea
- Other types of packaged foods
Tips to limit added phosphorus:
- Check ingredient labels for words that start with “phos” (“phosphate,” “phosphoric,” etc.) and limit foods with these ingredients.
- If you have been prescribed phosphate binders, take them before or at the beginning of your meals as instructed. Phosphate binders are medicines that pull extra phosphorus out of the foods you eat, which prevents your body from absorbing and having a buildup of extra phosphorus.
- In addition to phosphate binders, your doctor may also prescribe phosphate blockers to help get your phosphorus levels in a healthy range. Phosphate blockers are medicines that help remove extra phosphorus from the food you eat and block it from entering your bloodstream. These medicines are typically taken in the morning and at night.
Tips, webinars and videos
Salt and your kidneys
Fluid management & control
Ask a nephrologist
You need protein
What can I eat?
More tips to stay healthy in kidney failure (on dialysis)
Add an extra daily activity into your schedule
Go for a brisk walk after dinner or take the stairs instead of the elevator.
Go to all your regular checkups
Your doctor will monitor your kidney function and other conditions.
If you have diabetes or high blood pressure, take your medicines as your doctor instructed.
One of the best ways to keep your kidney disease from getting worse is to keep your diabetes or high blood pressure under control.
Keep a healthy weight
Talk to your doctor about a healthy weight for you and ways to manage your weight.
Add an extra daily activity into your schedule
Go for a brisk walk after dinner or take the stairs instead of the elevator.
Go to all your regular checkups
Our doctor will monitor your kidney function and other conditions.
Keep a healthy weight
Talk to your doctor about a healthy weight for you and ways to manage your weight.
If you have diabetes or high blood pressure, take your medicines as your doctor instructed.
One of the best ways to keep your kidney disease from getting worse is to keep your diabetes or high blood pressure under control.
More Kidney Kitchen Resources
View Guides ➔
View Videos ➔
View Articles ➔
Your support goes further with AKF
Your donation allows AKF to support people wherever they are in their fight against kidney disease – from prevention through transplant. For more than 50 years, we have fought on all fronts for millions of people impacted by kidney disease.
Donate today to support our work
