Timing is everything
By June Martin, RD, CDE
We spend a lot of time talking to dialysis patients about what to eat. But did you know that when you eat matters, too? When we talk about conventional hemodialysis treatment taking 4 hours, 3 times per week, we don’t take into account how much effort, energy and time goes into preparing for dialysis. For some patients, it’s a whole-day affair.
Skipping meals on dialysis days
Studies have shown that most patients eat less on the days they dialyse; often entire meals are skipped. Even more concerning is that the hemodialysis treatment itself is catabolic: it can cause the body to break down muscle or use up energy stores. Even more concerning – as some studies have shown – is that this catabolic effect can last for hours after dialysis.
So when you combine a decrease in nutrition intake with an increase in nutrition needs, you end up with a recipe for malnutrition, muscle wasting and weight loss.
Why should you care?
There are many reasons to want to avoid malnutrition. We know that malnourished dialysis patients don’t do as well, end up in hospital more often and have a reduced quality of life. Sometimes I hear patients say to me – “I’ve been trying to lose weight for years and now I’m doing it without trying!” The concern with unintentional weight loss is that it is often primarily muscle or lean tissue loss – not the kind of weight most people want to lose. This kind of weight loss can lead to losing strength and endurance. And regaining muscle takes a lot of work.
Timing of meals
It’s important to get enough nutrition EVERY day (including dialysis days). This means eating the meal before your treatment and (if allowed at your unit) having a high-protein snack on dialysis. Multiple studies have shown that taking a high-protein oral nutrition supplement during dialysis can help reduce the catabolic effect of dialysis. The same would be true for a high-protein snack, like one of our Frittata Muffins. It’s important to check with your dialysis clinic about rules around eating in the unit, and there are always some patients who can’t tolerate a large meal while dialysing. If you can’t eat while on dialysis then make sure to have a high-protein meal as soon as possible afterwards.
What about PD patients?
Peritoneal dialysis patients have dialysis every day so they tend to have a more consistent dietary intake. But that’s not to say nutrition isn’t important! It’s critical that you get enough protein each and every day and your protein needs may be even higher than those of hemodialysis patients. Make sure to talk to your dietitian to be sure that you’re getting enough protein each and every day. Enjoy high-protein recipes from Spice It Up! to help you meet your needs!
Make it personal!
Talk to your dietitian to help develop a personalized nutrition plan designed around your dialysis therapy, timing of treatments and your individual dietary needs.