Amount of salt intake for hemodialysis patients

[jo]

Can hemodialysis patients add a little bit of salt to their daily food? How much of salt intake per day is too much if dialysis is done three times a week? Are there any recommendations for salt substitutes if hemodialysis patients had to completely avoid adding salt?

[Bill Peckham]

Most salt is already in the foods you buy, the salt you add typically makes up much less than 10% of your daily sodium intake. This is true of most restaurant food and any food from the grocery store that has a shelf life.

There are sources that will give you a number 1,500 to 2,000 mg/day is usual for someone with no kidney function. Those are convenient numbers since they are about the numbers of calories /day people need to stay nourished. When you read the label on packages of the foods you buy, avoid any foods where the mg of sodium per serving is greater than the calories per serving. At the end of the day you'll come out alright but don't skip meals because you're worried about avoiding this or that, it as or more important to get enough calories than it is to avoid sodium. How is your appetite?

As far as substitutes there are many ways to add flavor to food without falling back on salt. Actually cutting back on your salt intake will increase your taste sensitivity, which makes cutting back on salt easier - a virtuous cycle. What sort of foods do you enjoy? What are your salty pleasures?

[kristina]

I am not on dialysis yet, but I have avoided any salt intake for many years...
... and there is not one grain of salt in my household to be seen anywhere...
Interestingly enough, I won't lack any salt, despite the fact that I eat completely healthy
with fresh vegetables only and fresh fruit every day of the year and nothing else...
... I  have even baked my salt-free bread myself for many years...
... Recently  I have been told by a medic, that there is some sort of "natural salt" in most fresh vegetables...
... and whenever I have my blood checked, I am told that my salt-intake shows that I am certainly
on a very low side of any salt-intake, but it is still within acceptable natural low limits...
...I was always surprised about this fact, because I honestly  can say that I do not have any salt intake at all
and I never ever eat any readymade food and I even cook and bake all my food myself without using any salt ever...

[Michael Murphy]

From what I can see it's not the dietary impact of salt that's the major problem but the fact that a increase of salt in the diet usualy means a increase in fluid intake.  Salt makes you thirsty.

[kristina]

     I was told by one nephrologist and a medical Professor in 1971, that any salt-intake would be very bad for my fragile kidney function ...
... and that is the reason why I have avoided any salt-intake ever since ... (my fragile kidneys still function without any help after all these years...)

                            ... Perhaps medical opinions of nephrologists in this matter has changed over the years...?

[JW77]

Can hemodialysis patients add a little bit of salt to their daily food? How much of salt intake per day is too much if dialysis is done three times a week? Are there any recommendations for salt substitutes if hemodialysis patients had to completely avoid adding salt?

They can if they really 'want to'  not the same as needing to.

Most good quality fresh fruit and veg includes enough natural sodium for a healthy diet. For those on heamodialysis off the shelf substitutes such as Lo-Salt are NOT recommended as they are potassium based salts. Not a good thing if your on thrice weekly heamo.

The RDA in many countries is about 1 full teaspoon a day.  The main issue with adding salt to food for heamodialysis patients is it makes you thirsty, leading to drinking more, leading to fluid overload with the potential to damage the heart.

Hope this is useful:)


Most kidney cookbooks recommend using herbs, dried or fresh to season and flavour dishes that may seem plain.

Eating Well With Kidney Failure, a Practical Guide and Cookbook
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Eating Well for Kidney Health, Expert Guidance and Delicious Recipes
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Eating Well, Living with Kidney Disease
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Truly Tasty, over 100 recipes created by Irelands Top Chefs for Adults Living with Kidney Disease
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Get to know your herbs, :http://www.thekitchn.com/quick-guide-to-every-herb-and-spice-in-the-cupboard-108770 and you won't need salt.  Cumin is great on grilled chicken with a yogurt marinade for instance.


Over processed and so called fast foods tend to be high in salt, and much mass produced fresh food may have lower nutritional levels but you should still get adequate salt.

[jeannea]

I believe the Mrs Dash products are salt free and potassium free. They use herbs and spices. There is no set amount of salt for a dialysis patient. It depends on your disease and the function you have left. You could experiment with a little extra salt to see if you retain more fluid or need to drink more. Don't overdo it with your experimenting.

[MatheaFord]

You probably need to adjust more to the "true" taste of foods that don't have salt in them.  We have an adjustment period when you remove salt from your diet that causes everything to taste bland.  This is why seasoning is good, but you probably miss the salty taste.  Not sure how long it has been for others, it took me about 2 weeks when I stopped adding salt to foods to adjust to the taste.  Strong flavorings like lemon, lime, curry, and tabasco are good ways to add a little flavor without salt.  Nu salt, and other white salt substitutes are made of potassium chloride and should not be used in kidney failure.

The problem when you start adding a "little" salt is that it starts to add up. 

[Rerun]

I use Mrs. Dash and black pepper on most everything. 

             

[Sugarlump]

Some salt is okay. In fact too little salt can cause cramps on dialysis.
I have discovered through the dietician that because the UK government have brought in new lower salt level guidelines for food, a lot of food manufacturers
are lowering their salt levels and adding potassium chloride instead (lo salt) which is worse for us dialysis patients.
You have to read the ingredient labels very carefully when you buy things these days, especially things like crackers or crisps or biscuits.
And hidden phosphates as well.

It's a minefield.