How much sodium should someone on dialysis have?

October 20, 2025 •

4 min read

According to the National Kidney Foundation, many patients with kidney disease on dialysis need to limit their sodium intake to help control blood pressure and prevent fluid buildup. A typical recommendation for someone on dialysis is to aim for a daily sodium intake of less than 2,000 mg, though this can vary based on individual health needs. Managing exactly how much sodium should someone on dialysis have is a critical aspect of their treatment plan.

Quick Summary

Sodium intake for dialysis patients is crucial for managing fluid balance and blood pressure. Recommendations generally suggest restricting daily intake to less than 2,000 mg, which helps reduce thirst and discomfort. Avoiding processed foods and reading labels are essential steps for effectively controlling sodium levels and minimizing related complications.

Key Points

Daily Intake Goal: Aim for less than 2,000 mg of sodium daily, though the precise amount should be determined by a healthcare provider based on individual health needs.
Primary Risk: Excess sodium leads to fluid retention, which can cause high blood pressure, fluid overload, and stress on the heart.
Manage Thirst: Limiting sodium reduces thirst, making it easier to stick to prescribed fluid restrictions.
Read Labels: Look for low-sodium or no-salt-added products. A quick check of the nutrition label is vital for controlling intake.
Avoid Processed Foods: Processed and fast foods are a major source of hidden sodium; preparing meals from scratch is the best way to control salt content.
Flavor with Spices: Use herbs, spices, lemon juice, or salt-free seasoning blends to add flavor to meals instead of relying on salt.
Consult a Dietitian: A registered dietitian specializing in kidney health can help create a personalized and safe meal plan.

Why sodium restriction is so important for dialysis patients

For individuals with healthy kidneys, the kidneys regulate the balance of sodium and fluids in the body. When kidney function declines and dialysis is necessary, this regulation process is significantly impaired. The extra sodium that is consumed but not removed by the kidneys or dialysis treatment causes fluid to build up in the body.

Excess sodium and fluid retention can lead to a number of serious health complications for dialysis patients, including:

High blood pressure: The increased fluid volume puts pressure on blood vessels, forcing the heart to work harder. Uncontrolled hypertension can lead to further damage to the kidneys and heart.
Fluid overload: Extra fluid can accumulate in various parts of the body, leading to swelling (edema) in the hands, feet, and ankles.
Congestive heart failure: Severe fluid buildup can put a dangerous strain on the heart, potentially causing it to enlarge and weaken over time.
Shortness of breath: Fluid can collect in the lungs, a condition known as pulmonary edema, which makes breathing difficult.
Increased thirst and discomfort: High sodium intake triggers excessive thirst, causing patients to drink more fluids and making it harder to adhere to their fluid restrictions.

Daily sodium recommendations for dialysis patients

While a generalized goal for sodium intake on dialysis is less than 2,000 mg per day, it is crucial to consult with a doctor or registered dietitian to determine the right target for your specific health situation. Factors such as the type of dialysis, residual kidney function, blood pressure, and individual fluid management needs can all influence the exact recommendation.

Here’s a breakdown of general guidelines for different types of dialysis:

Sodium intake for hemodialysis patients

General guideline: Many hemodialysis patients are advised to limit their sodium to no more than 2,000 mg daily. This helps control fluid gain between sessions and manage blood pressure.
Home hemodialysis: Patients on more frequent, daily home hemodialysis might have different fluid and sodium targets. Due to more regular dialysis, the need for extreme sodium and fluid restriction can sometimes be less severe, but it is still carefully monitored by the care team.

Sodium intake for peritoneal dialysis patients

General guideline: A similar target of less than 2,300 mg per day is often recommended for peritoneal dialysis (PD) patients. However, some PD patients might have higher daily protein needs, which can be linked to higher sodium intake, so careful management is essential.
Monitoring and education: PD patients are often taught how to track their dietary intake and identify hidden sources of salt to maintain appropriate balance.

Table: Low-sodium food swaps for dialysis patients


Food Category	High-Sodium Examples	Low-Sodium Alternatives
Protein	Deli meats, hot dogs, sausage, canned meat	Fresh lean meat, poultry, or fish; unsalted eggs; tofu
Canned Goods	Regular canned vegetables, beans, soups	Low-sodium or no-salt-added canned options (rinsed thoroughly); fresh or frozen produce
Condiments	Ketchup, soy sauce, steak sauce, pickles	Vinegar, lemon juice, herb blends (potassium-free), salt-free seasonings
Snacks	Chips, pretzels, salted nuts, crackers	Unsalted popcorn, unsalted nuts, fresh fruits or vegetables
Ready-made Meals	Frozen dinners, fast food, restaurant meals	Homemade meals using fresh ingredients, controlling all seasoning

Tips for controlling your sodium intake

Reducing sodium requires more than just putting away the salt shaker. Much of our daily sodium comes from processed and restaurant foods. Here are effective strategies for lowering your intake:

Become a label reader: Check food labels for sodium content. Look for products with 5% or less of the Daily Value (%DV) for sodium. Be cautious of products with a %DV of 20% or more.
Choose fresh foods: Opt for fresh fruits, vegetables, and lean meats whenever possible. These are naturally low in sodium.
Cook at home: Preparing meals from scratch gives you complete control over how much sodium you add. Use herbs, spices, garlic, onion, and lemon juice to add flavor instead of salt.
Rinse canned goods: If you must use canned vegetables or beans, rinse them thoroughly under running water to wash away some of the excess sodium.
Ask at restaurants: When dining out, request that your meal be prepared without added salt. Ask for sauces and dressings on the side.
Beware of salt substitutes: Many salt substitutes contain potassium, which can be dangerous for kidney patients. Always check with your healthcare team before using any.

Conclusion

For those on dialysis, managing sodium intake is a cornerstone of effective disease management. It directly impacts fluid balance, blood pressure, and overall cardiovascular health. The general recommendation of restricting sodium to less than 2,000 mg per day serves as a critical starting point, but personalized guidance from a renal dietitian or healthcare provider is essential for finding the right balance. By being diligent about food choices and cooking methods, patients can significantly improve their quality of life and reduce the risk of serious complications. Always work closely with your healthcare team to create a nutrition plan tailored to your needs. For more information and resources on dialysis nutrition, visit the National Kidney Foundation's website.

Outbound Link: National Kidney Foundation: Sodium and Your CKD Diet

Frequently Asked Questions

Sodium restriction is necessary because damaged kidneys cannot effectively remove excess sodium and fluid from the body. This causes fluid to build up, leading to high blood pressure, swelling, and increased strain on the heart, which can cause significant discomfort and health issues.

For many dialysis patients, a sodium intake of less than 2,000 mg per day is recommended. However, this can be individualized based on the patient's specific health condition, blood pressure, and the type of dialysis treatment they receive.

Instead of salt, use a variety of herbs, spices, garlic, onion, and lemon juice to add flavor to your meals. You can also experiment with salt-free seasoning blends. Cooking with fresh ingredients and preparing meals from scratch also helps control sodium levels significantly.

No, most salt substitutes are not safe for dialysis patients because they contain potassium chloride instead of sodium chloride. Since dialysis patients often have difficulty processing excess potassium, using these substitutes can be dangerous. Always consult your doctor before using any salt substitutes.

When reading food labels, check the % Daily Value (%DV) for sodium. Look for foods with 5% DV or less per serving. Be mindful that foods labeled 'reduced sodium' still contain some salt, so compare the values to a no-salt-added version. Avoid foods with a %DV of 20% or higher.

A higher sodium intake increases your thirst, causing you to drink more fluids. For dialysis patients with fluid restrictions, this makes managing fluid balance very difficult and can lead to dangerous fluid overload.

The general recommendation is similar, typically under 2,000 mg daily for hemodialysis and under 2,300 mg for peritoneal dialysis (PD). However, the specifics can vary based on the patient's unique health profile and the treatment protocol. A dietitian can provide the most accurate, personalized advice.