Nutrition
Kidney disease & dialysis
The most individual diet in medicine — it changes with your stage, your bloods and whether you are on dialysis. Never self-prescribe it.
What you are aiming for
- Control potassium and phosphate within the range your team sets
- Keep to your individual fluid allowance
- Get enough protein — needs rise substantially once on dialysis
- Limit sodium to protect blood pressure and thirst
Build meals around
- Protein at each meal on dialysis: eggs, fish, chicken, meat, tofu — quantity as prescribed
- Lower-potassium vegetables: cabbage, green beans, cauliflower, peppers, onions, cucumber
- Lower-potassium fruit: apple, berries, grapes, pineapple, pawpaw in measured portions
- White rice, pasta, bread and maize meal as controlled carbohydrate sources
- Boiling and discarding the water for potatoes and root vegetables to reduce potassium
Limit or avoid
- High-potassium foods when potassium is high: bananas, oranges, potatoes, tomatoes, beans, avocado, dried fruit
- Phosphate additives — processed meats, cola, processed cheese, baked goods (look for 'phos' on labels)
- Salt and salt substitutes — potassium-based substitutes are dangerous here
- Fluid above your allowance, including soup, ice and jelly
- Starfruit, which is toxic in kidney failure
Meal timing
- Take phosphate binders with the first mouthful of food, not afterwards.
- Spread protein through the day rather than one large evening meal.
- Plan fluid across the day; save some allowance for the evening when thirst peaks.
Portions
- Protein and fluid targets are individual — use the numbers your renal dietitian gives you.
- Measure fluids in a marked jug so you can see the day's allowance disappearing.
- One portion of a permitted fruit at a time, not several.
A sample day
- BreakfastWhite toast with egg; apple; measured tea
- LunchChicken with white rice and boiled cabbage and carrots
- SnackRice cakes with a little butter; measured squash
- DinnerFish with pasta and green beans; tinned pears (drained)
Common myths
“A kidney diet means eating less protein at every stage.”
Before dialysis protein may be moderated; once on dialysis, protein needs go up. The advice reverses.
“Herbal remedies are safe because they are natural.”
Many herbal products are high in potassium or directly nephrotoxic. Check every one with the renal team.
Treatment-related challenges
- Constant thirst — use ice chips, frozen grapes, sour sweets, lemon slices and mouth rinses.
- Poor appetite on dialysis days — eat well on non-dialysis days and use prescribed supplements.
- Diabetes plus kidney disease requires an individually reconciled plan.
See a registered dietitian if
- · Always — renal nutrition should never be self-managed
- · After any change in potassium, phosphate or albumin results
- · When starting dialysis, or after a transplant
Afya Companion offers education and self-help support. It does not diagnose, treat or replace care from your doctor, nurse, psychologist or dietitian. If something in your health changes, speak to your care team.