Foods for Diabetic Hemodialysis Patients

Diabetics face a daily challenge when it comes to food. Blood sugar management is critical, and can be difficult even when all the "right" choices are made, leaving diabetics open to a wide range of complications, including kidney failure. All dialysis patients live with dietary restrictions, but these can be doubly burdensome to diabetics. Patients should consult with a dietitian for specific diet recommendations.

Basic Kidney Function

• When the body is working normally, food is digested in the stomach and intestines, and the blood picks up the nutrients and transports them to the body cells. Waste materials from the cells is then transported by the blood to the kidneys, which filter out the waste to be excreted in the urine. When the kidneys stop working, the waste remains in the bloodstream and continues to circulate in the body, causing uremia. You feel tired and week, and your hands and feet swell. If left untreated, uremia can cause seizures, coma or death.

Fluids

• Because the amount of loss of function varies between individual patients, your dietitian will provide you with a specific guideline for the amount of fluid you can have each day. Remember that beverages aren't the only source of fluid; foods like soup or Jell-O, as well as many fruits and vegetables, also contribute to your fluid intake. Follow fluid guidelines carefully, since the buildup of fluid between dialysis sessions can affect blood pressure and your heart.

Phosphorus and Potassium

• Many foods contain the minerals phosphorus and potassium. When the kidneys fail, excess minerals are not removed from the bloodstream and can cause health problems. Too much phosphorus can weaken bones by pulling calcium from them. Milk, cheese, dried beans, peas, cola and nuts are high in phosphorus, and will need to be limited. Potassium plays a role in muscle contraction and heart rate. Too much potassium can cause weakness and fatigue, difficulty breathing and heart palpitations. Your dietitian will instruct you to limit foods high in potassium, such as bananas, avocados and kiwis.

Carbohydrates

• For diabetics, carbohydrates are an important dietary component. Part of good blood sugar management includes not watching only total carbs, but maintaining a routine. Eat roughly the same amount of carbohydrates are each meal, and eat meals on a regular schedule. Most diabetic meal planning systems involve counting carbohydrate servings, with approximately 15 grams of carbs in each serving. A good starting point is eating three servings of carbs at each meal, although your dietitian may adjust that up or down according to your individual needs. Fruits like apples, plums, tangerines, grapefruit and some berries are carb sources that are also low in potassium and phosphorus. Starches that are low in potassium and phosphorus include white bread, rice, noodles, pasta and unsweetened dry cereal.

Proteins

• Protein is very important to patients on dialysis, but it is important to choose proteins wisely. All proteins break down into urea, a waste product, although some result in more waste than others. High-quality proteins produce less weight, and include lean cuts of meat, poultry, fish and eggs. Seafood is generally allowed, but should not be boiled in high-sodium seasonings. Cottage cheese is a high-quality protein, but because of its high sodium content, the amount of it you eat should be limited. Avoid hig-sodium processed meats like lunch meat, bacon, sausage and hot dogs, as well as most cheeses, nuts and dried beans.