Recipes for hemodialysis patients

[Pan]

What advice do you have for making tasty food that's low in potassium, sodium, phospherous, and water content (e.g., eating thick soups from time to time is OK, but no thin soups)? This is for a loved one who has always enjoyed delicious food and has so far found that the advice of nutritionists tends to be directed toward a very bland and boring diet that some Americans like, but he doesn't. Phospherous can be covered some with a pill called "Phoslo" which binds with phospherous, but there's no pill that binds with potassium, so the overall consumption of that nutrient really has to be low (i.e., a combination of foods heavily weighted toward low-potassium items, with moderate amounts of moderate-potassium foodstuffs and low amounts of high-potassium things). The USDA National Nutrient Database for Standard Reference is a really useful site for finding out the amounts of nutrients in foodstuffs. Reports on foodstuffs covering only one nutrient can also be found here (warning: PDF file downloads). As an example, the PDF on potassium shows that orange juice, grapefruit juice, white beans, dates, raisins, and baked potatoes are very high in potassium, while white rice, lettuce, and carrots are among the items very low in potassium. (One does have to watch out for differences in the "common measure" given for different items in the PDFs.)

I look forward to all the wondrous creations I'm sure you'll come up with!

[KatieLoeb]

Michael:

My mom was a hemodialysis patient for the last several years of her life. The diet I tried to get her to stick with was really just decent healthy eating. Lean proteins in moderation, lots of fresh veggies, good whole grains, pasta and whatever would fill her up quickly when she came home afterward. Cook with lots of fresh herbs and find salt free spice mixes (like Mrs. Dash, the Trader Joe's 21 Seasoning Salute, etc.) and use cooking techniques that add moisture to the food (like braising and thick stews) but aren't purely liquid like a broth based soup would be. Helps keep the thirsties and dehydration away since actual beverage consumption is so closely monitored.

Dialysis is a draining procedure, both literally and figuratively, and to say it takes a lot out of you would be both an understatement and perversely true. She was exhausted when she came home on those days. Many times it was all she could do to climb the stairs and go to bed.

I wish you the best of luck with your loved one's care and treatment. Keeping their diet interesting will help make this transition a lot easier I'm sure.

[Patrick S]

Pan,

I'm so glad you started this thread. My mother started dialysis 2 days after Christmas. Right now she is on hemodialysis via a shunt, but next week she is having a peritnoeal port implanted. I look forward to trying to come up with some low-K desserts!

[rooftop1000]

All I really know about the subject is anecdotal...I used to have a client that asked for a sample of the soup every time he came in...couldnt have a whole one.

But I found a book...

http://www.amazon.com/exec/obidos/search-h...0015274-2313413

Tracey

[Eden]

Great topic. I have a friend who was recently diagnosed & is currently only focused on controlling the phosphorus, so I have tried to make meals that limit the phosphorus content: less meat, cream rather than milk etc.

Here's one of the meals I served recently bearing the phosphorus content in mind. (may not be appropriate for your case since I have no idea on the potassium content) I can't remember other specific dishes at the moment, but will share as they come to me or as I make new ones.

And good luck to everyone going through this, and the friends & family supporting them!

[Pan]

Patrick, the diet for peritoneal dialysis patients is very different than for hemodialysis. For example, potassium is not nearly as much of a problem. The thing you have to watch out for with peritoneal dialysis is overhydration in the belly, but that's more a hazard of the treatment than anything dietary (and you have to be very careful to avoid any contamination that could cause peritonitis, but that's not food-related at all). I hope that methodology works for your mother. On average, it has a better survival rate than hemodialysis, but averages aren't the same as the experiences of an individual.

Katie, the low potassium aspect of the diet is really important. In the words of the nephrologist, high potassium can lead to sudden death.

[KatieLoeb]

Patrick, the diet for peritoneal dialysis patients is very different than for hemodialysis. For example, potassium is not nearly as much of a problem. The thing you have to watch out for with peritoneal dialysis is overhydration in the belly, but that's more a hazard of the treatment than anything dietary (and you have to be very careful to avoid any contamination that could cause peritonitis, but that's not food-related at all). I hope that methodology works for your mother. On average, it has a better survival rate than hemodialysis, but averages aren't the same as the experiences of an individual.

Katie, the low potassium aspect of the diet is really important. In the words of the nephrologist, high potassium can lead to sudden death.

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Michael:

Sorry - I didn't mean to ignore that, I guess it just wasn't as much of an issue for my mom since the foods that are high in postassium weren't really part of her diet anyway. She wouldn't drink juices at all because she just wasn't drinking a lot of fluids and she was never a big fan of dried fruits anyway. She ate beans but in very small quantities very infrequently, and always colored beans like red or black. She did miss bananas though. In addition to her failed kidneys she also had a heart condition and high blood pressure so was always a proponent of low-sodium cooking and eating. That's where the salt free seasonings came in handy.

My mother's doctors tried to switch her over to peritoneal dialysis at one point but it was never very successful for her. Lots of issues with having to do it herself and problems with the port. She finally went back to hemodialysis after a short while and although she hated having to go to the hospital three days per week, she felt better on her non-treatment days so it was the lesser of two evils.

[Pan]

I wasn't offended, Katie, and I appreciate all the responses so far.

I don't have a list of high-potassium foods in front of me, but some of the nightshades are high-potassium, for example, with tomatoes being the biggest problem (no tomato sauce). Also, many spices are high in potassium. Blessedly, tamarind and lime juice are low in potassium.

[Pan]

All I really know about the subject is anecdotal...I used to have a client that asked for a sample of the soup every time he came in...couldnt have a whole one.

But I found a book...

http://www.amazon.com/exec/obidos/search-h...0015274-2313413

Tracey

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Thanks for those search results, Tracey. Does anyone know if any of those books have tasty, non-bland recipes in them?