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Frequently Asked Questions and Dialysis
1. What do the dietitians do?
A dietitian is a food and nutrition expert. When you start dialysis, you need to start watching the foods that you eat because certain foods can harm you. Your dietitian will meet with you to discuss and recommend many food choices that go along with your prescribed diet. They will also review your lab work with you and help you adjust your diet to improve your lab results.
2. Do I need to be on a special diet? Do I need to watch how much fluid I drink?
Most people on dialysis will have to watch their diet more carefully. Your dietitian may recommend you avoid and/or increase specific types of foods. For example, if your protein is low on your lab report, then your consumption of foods high in protein will need to increase and your dietitian can explain how much you need. Other foods that may affect your lab results include foods high in phosphorus, calcium, potassium, and/or sodium. Your dietitian may recommend that you avoid and/or limit some of these foods. Your dietitian may also suggest that you limit your fluid intake. Your restrictions are very individualized and are dependent on your other medical conditions and/or your remaining kidney function.
3. Will dialysis cause me to lose weight?
When you start dialysis, the scales may show that you are losing weight. However, your weight loss may simply be caused by the loss of fluid that dialysis pulls off. Fluid may have built up over time because your kidneys could no longer do this job sufficiently. You also may lose a little weight when you start dialysis because the build up of toxins in your blood (from your kidneys not working well before starting dialysis) can reduce your appetite. So, when you first start dialysis you may notice that you are not eating as well as usual. It can take a few weeks of dialysis (to remove all the "built up" or excess toxins from your blood) until you start feeling better and your appetite improves or returns to normal.
4. Can I still go out to eat?
Absolutely, but remember your diet and fluid limitations. Most fast food and sit-down restaurants add salt while preparing your food. Always avoid adding salt to your food at the table. Ask your dietitian for suggestions regarding proper food choices when eating out.
5. Can I still drink pop? Energy drinks? Alcoholic beverages?
Certain types of pop/soda can be high in phosphorus. All cola (both diet and regular) contains phosphorus and should be limited (1 can per day recommended) and/or avoided. Dr. Pepper/Mr. Pibb and some bottled iced tea also contain some phosphorus and should be treated just like colas. Citrus and other flavored sodas contain very little or no phosphorus and are fine to drink (ie. Root beer, Lemon-lime, Orange, Grape, etc...). Limit wine and/or mixed drinks to no more than one small glass per day. Beer contains phosphorus and should be limited (1 can per day recommended) like colas. All energy drinks (ie. Redbull) and/or sports drinks (ie. Gatorade) should be avoided at all costs due to their added vitamins, minerals, and herbs that dialysis does not remove and will build up in your blood.
6. Can I still take my vitamin, mineral, and/or herbal supplements?
When you begin dialysis your doctor and/or dietitian will prescribe a specific multi-vitamin for people on dialysis to take daily. All other vitamin, mineral, and herbal supplements should be avoided, unless recommended by your nephrologist and/or renal dietitian. If you are still taking other supplements not prescribed by your nephrologist and/or dietitian, please let them know right away.
7. I am vegetarian. Will this be ok for me when I start dialysis?
You can follow a vegetarian diet on dialysis, but it may take some extra effort to make sure that you are eating enough protein. Many vegetable protein sources are also very high in potassium and/or phosphorus, which most people need to limit on dialysis. The best sources of protein come from meat and other animal products. Those who are lacto-ova vegetarians may eat enough protein from dairy products and eggs. Vegans will find it very hard to consume an appropriate amount of protein from vegetable sources, without an excessive intake of potassium and/or phosphorus.
8. I am diabetic. Will my blood sugar be difficult to control when on dialysis?
Actually, most diabetics who have begun dialysis have found that their blood sugar is now easier to control. This does not mean that it will be ok for diabetics to increase their sugar intake and to stop taking insulin/oral diabetic pills when starting dialysis. It is still very important to control your blood sugar levels when on dialysis in order to prevent further complications related to poor blood sugar control. If choosing peritoneal dialysis, you may need to monitor your blood sugar often due to the dextrose that is infused into the peritoneal dialysis solution.
9. Why do I have a bad taste in my mouth?
Before dialysis is recommended by your Nephrologist, many toxins can build up in your blood because your kidneys do not work properly anymore. This build up of toxins can cause you to have a metallic taste in your mouth. This will usually go away once you start dialysis, but may return if you continuously miss treatments and/or cut your prescribed treatment time.
10. Why is my hair falling out?
This is a debatable question. Hair is primary comprised of protein. Some kidney specialists believe it is caused by loss of protein. When you start to develop kidney disease your body will start to "dump" protein into your urine, which causes less protein to be in your blood. Furthermore, many people who are not on dialysis yet are recommended that they start limiting their protein intake in order put less "stress" on their remaining kidney function. This may be the start of hair loss. Once people start dialysis, they need to eat a lot of protein. Dialysis itself will remove some protein from the blood. Others researchers believe that hair loss in people on dialysis is related to plain old "stress" on the body from the dialysis process in itself.
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