Renal vitamins contain B vitamins and a limited dose of vitamin C to help replace losses related to dialysis in those with end stage renal disease. The B vitamins, also called the B-complex, are a combination of eight water soluble vitamins: Read more…

The amount of fluid weight gained depends on how much fluid is consumed, how often a dialysis patient has the dialysis treatment (daily versus 3 times a week), and if their kidney is still able to remove water through urine. Some dialysis patients do not urinate at all and others still urinate because they have residual urine output.

Individual goals for weight gain between dialysis treatments must be determined by the nephrologists, and may vary based on small or large body size and other considerations.

The goal for an average sized hemodialysis patient is to keep fluid weight gain at or below 1 kilogram (kg) (2.2 pounds) each day. This equals a 2 kg (4.4 pounds) fluid weight gain when there are 2 days between treatments and 3 kg (6.6 pounds) fluid weight gain when there are 3 days between treatments.

Here is a guideline that can be used to determine how much fluid contributes to weight gain:

2 cups liquid = 32 ounces = 480 ml = 1 pound or 1/2 kilogram fluid weight

4 cups liquid = 64 ounces = 960 ml = 2 pounds or 1 kilogram fluid weight

Melting Ice Cream Cone Any food that is liquid or will melt at room temperature counts as fluid. These can be divided into visible fluids (includes anything a person drinks) and hidden fluids (foods that appear as solids, but are liquid at room temperature). For people with kidney disease following a prescribed fluid restriction, all the items below are counted as fluid:

Visible fluid

• All beverages
• Alcoholic drinks
• Coffee, tea
• Juice, juice drinks, lemonade
• Milk, milk substitutes, liquid creamer
• Nutrition drinks
• Soup
• Soft drinks
• Sports drinks
• Water

Hidden fluid

• Gelatin
• Gravy
• Ice chips or cubes
• Ice cream
• Popsicle
• Sherbet
• Sorbet
• Watermelon also contains lots of fluid

Dialysis patients are instructed to take their renal vitamin once a day. For hemodialysis patients, renal vitamins are taken after dialysis. The reason is that vitamins B and C are water soluble and easily removed from the blood during dialysis if the vitamin is taken before the treatment.

If forgetting to take the renal vitamin is a problem, try to make a habit by taking it at the same time each day.

People on dialysis take a special renal vitamin preparation that contains B vitamins with extra folic acid and a limited amount of vitamin C. There are several reasons why dialysis patients take renal vitamins:

• to replace vitamins removed during each dialysis treatment
• the dialysis diet is inadequate in vitamins due to limits on fruits, vegetables and foods like milk, whole grains, nuts seeds and legumes
• a limited variety of foods and poor appetite contributes to nutrient deficiencies
• adequate amounts of folic acid, vitamin B12, and vitamin B6 are required to make red blood cells and prevent anemia
• vitamin deficiencies increase risk for infection

Examples of renal vitamins are Dialyvite®, Nephrocaps®, Nephrovite®, Nephplex®, and Renaltab®. Some brands require a prescription and others are available over the counter. Kidney doctors or renal dietitians usually make recommendations on which renal vitamin to take.

Most people on hemodialysis limit high potassium foods to keep blood levels from going too high. Potassium is a mineral that helps muscles and nerves work properly, and it helps regulate the heartbeat and blood pressure. In kidney failure, potassium from the diet builds up in the body. If the level goes too high the heart slows and could stop beating.

Dialysis removes potassium from the body and between treatments potassium builds up again. By following a dialysis diet which limits high potassium foods, hemodialysis patients can keep potassium in a safe range during the 2 to 3 days between their dialysis treatments.

Those with end stage renal failure on daily dialysis treatments, like peritoneal dialysis or daily hemodialysis, may not require a potassium restricted diet. Since the treatments are daily, potassium does not build up to high levels.

Information about individual potassium requirements are provided to dialysis patients by their doctors and dietitians. In addition to following a kidney-friendly meal plan, they can limit high potassium foods like banana, melon, nectarine, orange or orange juice, milk, yogurt, potato, spinach, tomato and tomato products, winter squash, nuts and seeds, dried beans and peas, avocado and chocolate.