Getting Enough Nutrition for People with Kidney Disease

By Mary Jo Dahms, RD, LD

Often, a person on dialysis has a hard time eating enough calories and protein because of a loss of appetite, difficulty chewing, being too tired or just too lonely to prepare meals.

As important as eating is, mealtime and meal preparation often get pushed aside when you are not feeling well. But research has shown that poor nutritional status is the strongest predictor of illness and death for someone on dialysis. A well-nourished body is better able to fight off infection, and good nutrition is essential in the fight.

Here are some tips to help improve your intake:

  • Try preparing meals ahead of time and freezing them in individual portions, so when you’re too tired to cook, you can take one out and heat it up. Ask your dietitian about lower sodium frozen meals that you could use on occasion.
  • Eat with family members or friends. If this isn’t an option, try watching TV or reading while you eat.
  • Rest before you eat; this will provide you with more energy at mealtime.
  • Try eating smaller meals more frequently, such as six small meals instead of three large ones.
  • Try foods that require little or no preparation.  For example, you might try tuna (packed in less salt or rinsed) on crackers, deli roast beef or turkey on white bread or crackers. Use applesauce as a quick fruit choice. Try baby carrots or frozen vegetables heated in the microwave.
  • If you have difficulty chewing meats, try softer ones such as ground beef, fish, eggs or canned tuna or chicken rinsed of salt. Cottage cheese in limited amounts is also a good source of protein (ask your dietitian how much would be acceptable to eat).
  • Use dips and sauces to add flavor and moisture if swallowing is difficult. Watch the sodium content, but a little mustard, margarine, mayonnaise, cocktail, sweet and sour, taco, barbecue, lemon or garlic sauce may be just what is needed.
  • If you find you lose your appetite once the meal is prepared, try eating cold foods instead of hot foods. Often, the aroma of hot foods can make a person feel sick to their stomach; cold foods give off less of an aroma than hot foods. 
  • If you have questions regarding your calorie or protein intake, ask your dietitian; they will be able to offer additional suggestions.
  • Ask your dietitian about nutritional supplements you could use. Your dietitian may also have recipes available for preparing your own supplements. Below is a recipe for a high protein shake you can make at home.
  • Use the microwave, if you have one. The microwave will cut down on your cooking time and won’t heat up the whole house especially in the summertime.

Here is an easy-to-prepare microwave recipe:

Lemon Chicken with Vegetables

Makes 4 portions.

Serving size 1 breast half + ¾ cup vegetables

Ingredients:

  • 1 cup julienne green peppers
  • 1 cup julienne red peppers
  • 1/2 cup green beans
  • 1/2 cup thinly sliced carrots
  • 1 pound chicken breast halves (skinless, boneless)
  • 2 tablespoons lemon juice
  • 3/4 teaspoon dried thyme leaves
  • 3/4 teaspoon black pepper

Preparation:

  1. In an 8" square baking dish, place peppers, beans and carrots. 
  2. Arrange chicken breast halves over vegetables.
  3. Sprinkle evenly with lemon juice.
  4. In small bowl, combine thyme and black pepper. Mix well.  Sprinkle evenly over chicken and vegetables.
  5. Cover with plastic wrap. 
  6. Microwave on high for 10-12 minutes, rotating dish a half turn after 5 minutes, if you do not have a rotating microwave.

Nutrients per serving:

  • Calories: 166
  • Protein: 27 g
  • Carbohydrate: 7 g
  • Fat: 3 g
  • Cholesterol: 70 mg
  • Sodium: 81 mg
  • Potassium: 399 mg
  • Phosphorus: 211 mg
  • Calcium: 36 mg
  • Fiber: 1.9 g

Renal and Renal Diabetic Food Choices:

  • 3-1/2 meat
  • 1-1/2 vegetable, low potassium

 

Single Serving High Protein Shake 

Recipe by dietitian Cheryl Colwell, MS, RD, LD.

Makes a single serving (1-1/4 cup)

Ingredients:

  • 1/2 cup fruit juice (apple-cranberry)
  • 4 ounces Eggbeaters® or similar liquid eggs (These are pasteurized and safer to use than raw eggs.)
  • 1/4 cup sherbet, very soft (lime)

Preparation:

  1. Mix fruit juice and Eggbeaters® together.
  2. Mix sherbet into juice mixture.
  3. Drink as beverage or scoop into a dish or ice cube trays to freeze.

 

High Protein Shake 

Makes 8 servings (1-1/4 cup each)

Ingredients:

  • 32 ounces fruit juice 
  • 32 ounces Eggbeaters®
  • 1 pint sherbet, very soft

Preparation:

  1. Mix juice and Eggbeaters® together.
  2. Mix sherbet into juice mixture.
  3. Freeze as whole mixture or scoop into dishes or ice cube trays to freeze.

Nutrients per serving:

  • Calories: 181
  • Protein: 13 g
  • Carbohydrate: 30 g
  • Fat: 1 g
  • Cholesterol: 4 mg
  • Sodium: 228 mg
  • Potassium: 291 mg
  • Phosphorus: 64 mg
  • Calcium: 66 mg
  • Fiber: 0 g

Renal and Renal Diabetic Food Choices:

  • 2 meat
  • 1 fruit, low potassium
  • 1 high calorie

Carbohydrate Choices:

  • 2