Understanding How much sodium can you have while on dialysis?

October 13, 2025 •

4 min read

For individuals with kidney failure undergoing dialysis, excessive sodium intake can cause dangerous fluid buildup between treatments, leading to high blood pressure, swelling, and increased thirst. It is critical for patients to understand how much sodium can you have while on dialysis and how to manage it effectively.

Quick Summary

A renal dietitian typically recommends limiting sodium per day for dialysis patients, with many needing a stricter limit. Sodium restriction helps control fluid gain, blood pressure, and thirst. Managing intake involves avoiding high-sodium processed foods, reading food labels carefully, and using salt-free seasonings.

Key Points

Daily Sodium Target: Dialysis patients are typically advised to limit sodium intake per day, with many needing a stricter limit based on individual health needs.
Control Fluid Buildup: High sodium intake causes fluid retention, leading to uncomfortable swelling, high blood pressure, and stress on the heart.
Avoid Processed Foods: Most dietary sodium comes from processed, packaged, and fast foods, not just the salt shaker. Read food labels carefully.
Flavor with Herbs and Spices: Use herbs, spices, lemon juice, and other salt-free seasonings to add flavor to food without increasing sodium intake.
Manage Thirst Effectively: Limiting sodium is the most effective way to control thirst. Sucking on sour candy or ice cubes can also help manage dry mouth.
Consult a Professional: Work with your renal dietitian to determine the ideal sodium and fluid targets for your specific condition and type of dialysis.

Why Limiting Sodium is Crucial on Dialysis

For those with kidney failure, the body can no longer effectively regulate sodium and fluid balance. This means that excess sodium consumed in the diet will cause the body to retain fluid. This fluid retention, or volume overload, is one of the most dangerous complications for dialysis patients. The extra fluid can lead to serious health problems, including:

High blood pressure, which is a major risk factor for cardiovascular disease.
Swelling in the hands, feet, and ankles (edema).
Shortness of breath due to fluid accumulating around the heart and lungs.
Discomfort during dialysis sessions, such as muscle cramps and drops in blood pressure.

By controlling sodium intake, patients can reduce fluid weight gain between dialysis sessions, lower their blood pressure, and manage thirst, which is often a significant challenge.

Recommended Daily Sodium Intake for Dialysis Patients

While the general population is advised to limit sodium, the restriction is even more critical for dialysis patients. Most kidney health organizations recommend that dialysis patients limit their sodium intake. However, many patients may require a stricter restriction depending on their individual blood pressure and fluid retention levels. A renal dietitian is the best resource for determining a personalized target.

It is important to remember that one teaspoon of table salt contains a substantial amount of sodium, which may exceed the daily limit for many patients. This emphasizes the need to look beyond the salt shaker and be aware of sodium in processed foods, which is the primary source for most people.

Hemodialysis vs. Peritoneal Dialysis

The required sodium intake can vary slightly depending on the type of dialysis received.

Hemodialysis (HD): Since HD is typically performed three times a week, patients must be very careful with their sodium and fluid intake between treatments. A high-sodium diet makes fluid buildup more likely, leading to a more challenging and uncomfortable dialysis session.
Peritoneal Dialysis (PD): PD is performed daily, so patients often have a more liberal fluid and sodium allowance. However, careful monitoring is still necessary to avoid excessive fluid gain and to preserve any remaining kidney function. High sodium intake is also associated with a greater risk of high blood pressure and negatively affects the peritoneal membrane.

Spotting Hidden Sodium in Food

Many foods that don't taste salty are loaded with sodium. Becoming a savvy label reader is one of the most effective strategies for controlling sodium intake. The following table compares common high-sodium foods with healthier, lower-sodium alternatives.


High-Sodium Choices	Low-Sodium Alternatives
Processed Meats: Bacon, sausage, deli meats, hot dogs	Fresh Meats: Plain, unsalted chicken, fish, or pork
Canned Foods: Soups, vegetables, beans with added salt	Rinsed Canned Foods: Canned goods rinsed well before cooking. Fresh or frozen vegetables.
Packaged Mixes: Macaroni and cheese, ramen noodles, gravy mixes	Homemade Mixes: Make sauces and side dishes from scratch using low-sodium ingredients.
Convenience Meals: Frozen dinners, fast food, restaurant meals	Home-Cooked Meals: Use fresh ingredients to control all seasonings and flavors.
Condiments & Sauces: Soy sauce, ketchup, teriyaki sauce, salad dressings	Salt-Free Seasonings: Herbs, spices, lemon juice, vinegar.
Salty Snacks: Chips, pretzels, salted nuts, salted crackers	Unsalted Snacks: Air-popped popcorn, unsalted nuts, fresh fruit.
Processed Cheese: Most cheese products are high in sodium	Low-Sodium Cheese: Look for reduced-sodium varieties or use smaller portions.

How to Reduce Sodium and Control Thirst

Managing a low-sodium diet requires mindful eating and strategic food preparation. Here are practical tips to help you succeed:

Ditch the Salt Shaker: Stop adding salt at the table and in cooking. Your taste buds will adapt over time.
Use Salt-Free Flavorings: Replace salt with herbs, spices, lemon juice, lime juice, onion powder, or garlic powder. Be cautious with "salt substitutes," as they often contain potassium, which can be dangerous for dialysis patients.
Rinse Canned Foods: For canned vegetables or beans, rinsing them thoroughly can help remove a significant amount of sodium.
Prioritize Fresh Foods: Whenever possible, choose fresh or frozen produce, which are naturally low in sodium.
Control Portion Sizes: Even low-sodium items can add up if you consume too much. Always be mindful of serving sizes.

To manage the thirst that a lower sodium diet can cause, try these tips:

Suck on sour candy or lemon slices to stimulate saliva.
Keep beverages ice-cold for a more refreshing effect.
Rinse your mouth with mouthwash or cold water (but do not swallow).
For hemodialysis patients, tracking your fluid allowance is crucial. Your dietitian can help you determine the right amount for you.

Conclusion

Managing sodium intake is a cornerstone of a healthy and successful dialysis journey. The typical target involves limiting sodium per day, with many needing to aim for a stricter intake based on individual needs. The key to success lies in understanding the dangers of fluid overload, identifying hidden sodium in processed foods, and mastering flavor alternatives to reduce reliance on salt. With careful planning and communication with your renal care team, including a dietitian, you can effectively manage your sodium intake and improve your overall well-being. By controlling your sodium and fluid, you can make your dialysis treatments more comfortable and reduce the risk of serious complications, putting you in better control of your health.

For more detailed information, consult the National Kidney Foundation's resources on hemodialysis and diet.

Disclaimer: This information is for general knowledge and should not be taken as medical advice. Consult with a healthcare professional before making any dietary changes or before starting any new supplement regimen.

Frequently Asked Questions

The primary risk is fluid retention, which can cause high blood pressure, swelling in the ankles and hands, and fluid buildup around the heart or lungs.

High sodium intake makes you feel more thirsty, which can make it very difficult to stick to your daily fluid restriction. Limiting sodium is key to managing thirst effectively.

Yes. Patients on PD often have a more liberal diet due to daily treatments, while HD patients, with less frequent treatments, often need stricter fluid and sodium control to prevent fluid overload between sessions.

Hidden sodium is common in processed and packaged foods, canned goods, processed meats like deli meat and bacon, fast food, and many condiments and sauces.

No, salt substitutes are not safe for most dialysis patients. They often contain high levels of potassium, which can also be dangerous when the kidneys are not functioning properly.

You can use a variety of herbs and spices, as well as lemon juice, lime juice, and different types of vinegar. Preparing food from scratch and using fresh ingredients helps control sodium levels.

Beyond reducing sodium, try sucking on sour candies or frozen fruit like grapes, chewing gum, or rinsing your mouth with cold water or mouthwash without swallowing.