Calories & dialysis: the basics
Why are calories important?
An adequate energy supply is the basis for maintaining all bodily functions (e.g. heartbeat, breathing, circulation, etc.) smoothly. Unfortunately, it happens quite regularly that dialysis patients have problems with insufficient nutrition. This is logical, because if you have to eat a diet low in phosphates and potassium, proteins and calories often come off badly. But your body needs to be supplied with enough energy.
How many calories per day should I eat?
The rule of thumb for people on dialysis is 25-35 kcal per kg of your dry weight per day. A simple example: With a body weight of 70 kilos, this corresponds to a daily energy intake of 1,750-2,450 kcal. For patients under 60 kilos, you should always calculate with 35 kcal per day per kilo of your dry weight.
What are the signs of malnutrition?
Loss of appetite, fatigue and body weakness are typically the first signs of malnutrition. In addition, rapid weight loss of more than 5% of body weight in 3-6 months or a BMI (=body mass index) below 20 may indicate inadequate nutrition. If you notice that you have no appetite and therefore eat insufficiently for a longer period of time, you should definitely contact your doctor.
How can I make sure I am eating enough calories?
It is important that you do not simply torture yourself and do without eating when you are on dialysis. Dialysis does not mean that you have to fast - on the contrary! Instead, you should make sure that you find healthy foods that taste good to you.
By the way, you can also set a daily calorie guideline in the settings of your Miku app. This way you can easily check if you are eating enough calories despite a low phosphate and low potassium diet. Useful tools such as the phosphorus-protein-quotient in your nutrition search or creating a dialysis-specific nutrition diary will help you with the right information to support you according to your needs.
As a dialysis patient, you should make sure that you eat enough calories every day, despite your restrictions
Instead of foregoing certain foods completely, you should try to find foods that are beneficial and tasty for you
If you notice symptoms of malnutrition, such as loss of appetite, discuss this with your doctor as soon as possible
- Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, Fouque D, Friedman AN, Ghaddar S, Goldstein-Fuchs DJ, Kaysen GA, Kopple JD, Teta D, Yee-Moon Wang A, Cuppari L. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020 Sep;76(3 Suppl 1):S1-S107.
- Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis. 2001 Dec;38(6):1251-63. doi: 10.1053/ajkd.2001.29222. PMID: 11728958.