Many Chronic Kidney Disease (CKD) patients who take dialysis are discouraged from eating during their treatment, whether home or in-center. It has been suggested that eating during your treatment can cause hypotension (low blood pressure), risk of choking, infection, diabetes concerns and phosphorus control challenges.
However, meals are routinely recommended for dialysis outpatients in most European countries, both at home and in-center. In fact, Dr. Kalantar Zadeh, Renal & Urology News Medical Director for Nephrology, said that German dialysis patients eat invariably during their dialysis treatments and have higher serum albumin and they have greater survival than their American counterparts. In the past, meals during dialysis were routine in the United States as well.
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Often patients may end up skipping meals altogether. This can lead to malnutrition causing relatively low serum albumin and fat or muscle wasting which is "by far the strongest death risk factor compared with any other condition," according to a 2013 study published by the National Kidney Foundation. Also, a recent Harvard study found that "people who regularly skipped breakfast had a 27% higher risk of having a heart attack than those who ate a morning meal." These findings suggest that not eating breakfast contributes to people being hungry later and eating larger meals which forces the body to process a larger amount of calories in a short period of time. This should be alarming for those with CKD because they are already predisposed to having serious Cardiovascular events such as heart attacks and strokes. So not eating during dialysis and overeating afterward because you are hungry could cause serious long term issues.
Hence, although dialysis clinics may not serve meals to their patients due to staff burden and financial constraints, KidneyBuzz.com recommends that you discuss with your Healthcare Team the possibility of eating during dialysis to avoid the tremendous downside. If it is approved and you decide to eat during treatment, opt for a higher protein content and lower phosphorus and potassium content meal. Do not forget to take your phosphorus binders after you eat. This simple addition may make your dialysis session more bearable as well as improve your health.
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Kalantar-Zadeh, Kam, MD,MPH, PhD. "Why Not Meals During Dialysis?"Http://www.renalandurologynews.com/. Renal And Urology News.
Kalantar-Zadeh K, Ikizler TA. "Let Them Eat during Dialysis: An Overlooked Opportunity to Improve Outcomes in Maintenance Hemodialysis Patients." National Center for Biotechnology Information. U.S. National Library of Medicine.
Stobbe, Mike. "Skipping Breakfast May Increase Heart Attack Risk."Http://www.usatoday.com/. The Associated Press/USA Today.