You may be familiar with the idea that there are certain nutrients you need to pay attention to while receiving dialysis, which include protein, fluid, sodium, potassium, and phosphorus. Protein is an extremely important part of the diet while on dialysis. Protein has many functions, such as helping us build and maintain muscle, fight infections, heal wounds, and support our immune system.
The main sources of protein include:
Animal products, such as dairy, eggs, chicken, turkey, fish, beef, pork, lamb, or game meat.
Plant sources of protein including soy, nuts, beans, lentils, and whole grains.
Protein is important because it can be pulled out of the blood during dialysis sessions, and this can leave you feeling tired, weak, and your body unable to function properly. That is why your dialysis dietitian should always address your protein levels in your blood.
You may hear that “high quality” proteins from animal sources are the best to eat while on dialysis because they have the most impact on your blood protein levels. However, it is still definitely possible for you to follow a vegetarian diet, and not eat animal foods, while on dialysis. Whether you are a vegetarian for health, cultural, ethical, or ecological reasons, or it is just your taste preference, there is a way to achieve a vegetarian diet with end stage kidney disease.
The most common vegetarian diets:
Lacto-ovo vegetarian - eat dairy products like milk, cheese, yogurt, butter, and eggs
Lacto-vegetarian - eat dairy products like milk, cheese, yogurt, and butter, but not eggs
Pescatarian – the above mentioned dairy and eggs, as well as fish
Vegan - do not consume any animal products whatsoever, including dairy products, eggs, and fish.
While you may think animal proteins are the only source of protein out there, that’s actually not true! There are many high protein foods from plant sources that are safe for people on dialysis to eat.
High protein foods from plant sources include:
Soy products
Meat substitutes
Beans and lentils
Nuts and nut butters
Dairy products
Whole grains
Track your blood protein levels
The main thing to consider when following a vegetarian diet is to be sure you are in fact, eating enough protein. It is important to review your blood protein levels with your dialysis dietitian every month to make sure you are eating enough protein. When looking at your blood test results, you can find this out by looking at your serum albumin levels, a low level may indicate that you are not eating enough protein.
Like people who do not follow a vegetarian diet, continue to work closely with your dietitian and watch your monthly labs to see if any or your labs are abnormal, and if there is anything in your diet that may be contributing to those lab values.
What to do if your protein levels are low
If your protein is low when following a vegetarian diet, a good strategy is to try to eat a vegetarian source of protein with every meal and snack, if possible.
If you need a little more protein (which is also possible for people who eat meat as well), you can incorporate plant-based protein supplements made from rice, hemp, and pea proteins.
Plant-based protein supplement examples:
Orgain
Vega Sport Premium
Garden of Life protein powders
Kind Protein bars
Go Macro Bars
ZonePerfect
Orgain bars.
Keep track of your sodium, potassium and phosphorus intake
While plant-based protein supplements are typically safe to eat while on dialysis, they may contain more sodium, potassium, and phosphorus, especially processed foods like meat substitutes. It’s important that you continue to read food labels and pick foods that are lower in sodium (less than 300 mg/sodium per serving).
Also, nuts, beans, and legumes are higher in phosphorus and potassium. If those lab values are higher, talk to your dietitian about increasing your phosphate binders with meals and snacks, and try to select fruits and vegetables that are lower in potassium, as well.
To help limit sodium, phosphorus, and potassium, try to avoid processed and pre-packaged foods as much as possible, like:
Canned soups
Refined grains - white bread, white pasta, white rice, high sugar cereals
Snack foods like potato chips, flavored popcorns
Sweet desserts like cakes, pastries, cookies
Sugar sweetened beverages like sodas
Benefits of a Vegetarian Diet
A vegetarian diet can come with many health benefits, especially for people on dialysis:
Can lower blood pressure
Can lessen protein loss in the urine
Plant based proteins reduce the workload of the kidney
Vegetarian diet can increase overall fiber intake, which helps with constipation as well as blood sugar control in people with diabetes
Lowers inflammation due to higher intake of vitamins and minerals
Lowers overall risk for heart disease
There is no singular vegetarian diet that is recommended for people on dialysis, so it is important to consult with your dialysis dietitian to ensure you are getting enough protein and that you aren’t overdoing it with your potassium, sodium, and phosphorus intake. Keep in mind that just because animal sources of protein are considered “high value proteins,” does not mean that you should not or cannot fully embrace a plant-based vegetarian lifestyle.
Resources:
CKD Diet: How Much Protein is the Right Amount? National Kidney Foundation.
Protein Supplements for Dialysis Patients. Plant Powered Kidneys.
What is a Plant Based Diet, and Is It Good for Your Kidneys? National Kidney Foundation.
Key benefits of plant based proteins in your kidney-friendly food plan. American Kidney Fund.
Note: The OneTrackHealth mobile application allows you to determine if you are within your set test reference ranges for blood tests such as albumin which is discussed in this article.
The OneTrackHealth app includes five default blood tests (Albumin, Calcium, Hemoglobin, Phosphorus and Potassium) that are regularly monitored for people with chronic kidney disease on dialysis with the standard recommended blood test result ranges* to make it easier for you and your care partner to keep track of your health goals.
* References used to determine the default test type ranges are included in The Blood Test Results Help Guide located in the OneTrackHealth app. We provide basic reference ranges for your educational purposes and recommend that you consult with your licensed healthcare provider/nephrologist for your specific reference ranges. The OneTrackHealth mobile and web app is customizable, you can add new tests and change the default tests reference ranges via the test edit tool. We recommend consulting with your physician to determine the appropriate ranges for you when adding or editing test result ranges.
