You can send your questions or inquiries to our dietitian, Ms. Beyza, via email at dyt@rentek.com.tr

Nutrition plays an important role in managing chronic conditions such as end-stage renal disease (ESRD). Lifestyle changes that include proper nutrition, sufficient physical activity, and smoking cessation are closely related to blood pressure and blood sugar levels, making them essential for managing chronic kidney failure.

Among ESRD treatment options, nutrition is especially important during hemodialysis. This is because, although hemodialysis helps remove uremic toxins from the body, it can also lead to the loss of beneficial nutrients such as proteins, vitamins, and minerals. Therefore, adequate intake of energy, protein, salt, sodium, potassium, phosphorus, and water is essential.

In the early stages of chronic kidney disease, strict dietary restrictions are recommended. However, once dialysis treatment begins, the diet can become more flexible. In general, there are four key elements patients need to pay attention to: salt, potassium, phosphorus, and fluid management.

Fluid intake is adjusted according to the patient's urine output. For example, the recommended daily fluid intake for a hemodialysis patient is:

Urine amount + 750–1000 ml

(Note: This total includes fluids from both drinks and food.)

Another key component is sodium (salt). The daily sodium intake should be less than 2–4 grams. To meet this requirement:

- Choose salt-free bread

- Add only a small pinch of salt to your meals

Phosphorus is another mineral that must be limited. Its main sources include:

- Meat products (especially smoked or fermented)

- Dairy products

- Egg yolks

- Seafood

- Legumes and nuts

- Packaged foods (such as biscuits, crackers, chocolate, wafers, and chips)

Note: Inorganic phosphorus in processed foods is more easily absorbed by the body, so be sure to read food labels carefully.

Since meat products are rich in both protein and phosphorus, dialysis patients must be cautious. Unlike the pre-dialysis stage, once a patient begins hemodialysis, protein intake is no longer restricted. Recommended sources of protein include:

- Beef, lamb, chicken, duck, turkey

- Soybeans

- Egg whites or whole eggs

Potassium is another mineral that must be controlled. Potassium requirements vary depending on the individual's blood potassium levels, but for dialysis patients, 2–3 grams per day is usually recommended.

Almost all foods contain potassium, but key sources include:

- Fruits

- Vegetables

- Legumes

- Seeds and nuts

General recommendation:

Dialysis patients may consume 2 servings of fruit and 1 serving of vegetables daily.

- 1 serving of fruit = one handful

- 1 serving of vegetables = 4–5 tablespoons

Try to avoid raw leafy greens, dried fruits and vegetables, and orange/yellow produce which contain more potassium.

To reduce potassium content in foods like potatoes, carrots, or squash, peel and slice them, soak in warm water for 2 hours, rinse, and then cook. This method also applies to legumes.

Remember: Diet plans must be personalized. A nutrition plan supervised by a dietitian during dialysis can significantly improve survival rates and overall quality of life.

At our center, individuals who receive dietitian consultation are informed about all aspects of nutrition throughout their treatment.

Our goal is to create lasting improvements in eating habits and to support a healthy lifestyle.