Understanding the Diet a Dialysis Patient Should Be On in an Emergency

Over 550,000 Americans with End-Stage Renal Disease rely on dialysis, making emergency preparedness a critical concern. Understanding what is the diet a dialysis patient should be on in an emergency is vital for preventing life-threatening complications like fluid overload or dangerous mineral imbalances when regular dialysis is disrupted. This emergency plan is a temporary measure, not a substitute for medical treatment.

Quick Summary

This guide details a temporary, low-protein, low-sodium, and low-potassium diet for dialysis patients during emergencies when regular treatments are missed. It covers essential food choices, fluid management, and safe food handling practices for power outages to mitigate health risks.

Key Points

• Restrict Fluids: During an emergency, limit fluid intake to less than 16 ounces (2 cups) daily to prevent dangerous fluid overload.

• Control Electrolytes: Avoid high-potassium foods (bananas, oranges) and high-sodium items (salt, processed meats) to prevent heart complications and fluid retention.

• Choose Shelf-Stable Foods: Stock low-sodium, low-potassium canned goods, white bread, and unsalted crackers that don't require refrigeration.

• Manage Protein and Phosphorus: Temporarily reduce protein and phosphorus intake by limiting dairy, nuts, and dark sodas to minimize waste buildup.

• Practice Food Safety: Use refrigerated foods first during a power outage, and discard any food left unrefrigerated for more than four hours.

• Prioritize Low-Potassium Fruits: Canned applesauce, peaches, pears, and mandarin oranges are safer choices than fresh fruits for emergency consumption.

• Utilize High-Calorie Sweets and Fats: Use hard candies, honey, or unsalted margarine to maintain energy without adding unwanted minerals.

Emergencies such as natural disasters, power outages, or pandemics can cause disruptions to routine medical care, including dialysis treatments. A missed or delayed dialysis session means the kidneys cannot adequately filter waste products and excess fluid from the blood. Adopting a specific, temporary emergency diet is crucial for minimizing the buildup of toxins and fluid until treatment can be restored. This article provides a comprehensive overview of that diet, safe food storage practices, and general emergency preparedness steps.

Key principles of the emergency dialysis diet

The primary goals of an emergency diet for a dialysis patient are to control the intake of fluids, sodium, potassium, and phosphorus.

Limiting fluid intake

During an emergency, fluid restriction becomes even more stringent than a patient's normal fluid allowance. Excess fluid can lead to dangerous fluid overload, causing shortness of breath and high blood pressure. Patients are typically advised to limit intake to less than 500 cc (16 ounces or 2 cups) per day. This includes all liquids, such as water, coffee, juice, and foods that are liquid at room temperature like ice cream and soup.

Controlling sodium and potassium

Since high sodium intake increases thirst and fluid retention, and high potassium levels can cause dangerous heart rhythm problems, controlling these minerals is paramount. This means avoiding table salt, salty snacks, processed meats, and many dairy products. Salt substitutes should also be avoided as they often contain high levels of potassium. High-potassium foods like bananas, oranges, and potatoes must be limited.

Reducing phosphorus and protein

During a missed dialysis period, it is also important to limit phosphorus and protein intake. While protein is normally encouraged for dialysis patients, temporary restriction during an emergency helps reduce waste buildup. Similarly, limiting phosphorus-rich foods like dark sodas, nuts, and dairy products helps prevent dangerously high levels.

Stocking your emergency kit: What to include

Having a dedicated emergency food supply is non-negotiable. It should consist of shelf-stable, low-sodium, low-potassium foods that require minimal or no preparation.

• Fluids: Bottled or distilled water is essential for drinking and preparing any powdered mixes. Freeze extra bottles of water to keep food cold longer in a power outage.
• Carbohydrates: Opt for white bread, unsalted crackers, plain cereals (like puffed wheat or rice), white rice, or unsalted pasta. These provide calories without excess potassium or phosphorus.
• Proteins: Choose low-sodium canned meats like tuna, chicken, or salmon. Unsalted peanut butter and eggs (if refrigeration is available) are also good choices.
• Fruits: Canned low-potassium fruits like peaches, pears, applesauce, fruit cocktail, or mandarin oranges are excellent choices. Be sure to buy them packed in juice or light syrup and drain the liquid.
• Sweets and Fats: Hard candies, jelly beans, marshmallows, honey, jelly, and unsalted margarine or oil can be used to add calories.
• Equipment: Keep a manual can opener, disposable plates and utensils, and a refrigerator thermometer in your kit.

Food safety during a power outage

If the power goes out, proper food storage is critical to prevent foodborne illness, especially for immunocompromised individuals. Refrigerated food is generally safe for up to 4 hours, and frozen food for up to 48 hours if the freezer is kept closed. Use refrigerated and frozen items first before transitioning to your shelf-stable emergency kit. Throw away any perishable food that has been at an unsafe temperature for too long.

Emergency Diet for Dialysis Patients: Sample 3-Day Plan

Meal	Day 1	Day 2	Day 3
Breakfast	Unsalted cereal with 1/2 cup evaporated milk (mixed with distilled water) and a 1/2 cup canned pineapple.	Unsalted cereal with 1/2 cup evaporated milk (mixed with distilled water) and 1/2 cup canned pears.	Unsalted cereal with 1/2 cup evaporated milk (mixed with distilled water) and 1/2 cup mandarin oranges.
Lunch	Low-sodium tuna sandwich on white bread with a small amount of unsalted mayonnaise. Side of 1/2 cup canned peaches.	Peanut butter and jelly sandwich on white bread. Side of 1/2 cup canned fruit cocktail.	Low-sodium chicken sandwich on white bread with a small amount of unsalted mayonnaise. Side of 1/2 cup canned pineapple.
Dinner	Low-sodium canned chicken or turkey on white bread with unsalted crackers and a low-potassium juice box.	Low-sodium canned tuna on white bread with a side of unsalted crackers and a low-potassium juice box.	Low-sodium canned chicken or salmon on white bread with a side of unsalted crackers and a low-potassium juice box.
Snacks/Desserts	Hard candies, marshmallows, or graham crackers with jelly.	Jelly beans or vanilla wafers.	Hard candies or marshmallows.

Alternative strategies and considerations

• Hydration tricks: To manage thirst, some patients find that chewing gum, sucking on hard candy (counted in fluid limits), or freezing a small amount of approved fruit juice into ice cubes can help.
• Cooking methods: If some cooking is possible, boiling and draining high-potassium vegetables like potatoes can help reduce their mineral content.
• Diabetic considerations: For dialysis patients with diabetes, it's crucial to manage blood sugar carefully. Keep glucose tablets or hard candies on hand for low blood sugar, but avoid high-potassium juices like orange juice. Sweet snacks mentioned in the emergency plan should be used cautiously.
• Outbound link: For more detailed information on emergency preparedness for dialysis patients, you can consult the National Kidney Foundation's guide.

Conclusion: Prioritize preparedness

An emergency situation can be frightening, especially for dialysis patients who rely on regular treatments to live. However, careful planning and assembling a dedicated emergency food kit can provide peace of mind and significantly mitigate health risks. The key to a successful emergency diet is strict adherence to fluid, sodium, and potassium restrictions using only shelf-stable, low-mineral foods. While this diet is a temporary bridge, it is a life-saving measure that can help manage dangerous waste buildup and maintain stability until regular dialysis can be resumed. Always inform emergency personnel of your condition and dietary restrictions if you need medical attention during a crisis. Early preparation is the best defense against unforeseen disruptions to your health and well-being.

Frequently Asked Questions

What is the most important thing for a dialysis patient to limit in an emergency?

The most important things are fluid intake, and foods high in potassium and sodium. Restricting these is critical to prevent dangerous fluid buildup and heart problems.

Can I use a salt substitute during an emergency?

No, you should not use salt substitutes. Many contain potassium chloride, which can be extremely dangerous for a dialysis patient with compromised kidney function.

How do I manage my thirst with fluid restrictions?

To manage thirst, try sucking on a hard candy, chewing gum, or freezing a small portion of your daily allowed juice into ice cubes. Avoid salty foods, which increase thirst.

Which canned fruits are safest for an emergency diet?

Safe canned fruits include applesauce, peaches, pears, mandarin oranges, and fruit cocktail, as they are typically low in potassium. Remember to drain the liquid before eating.

What should I do with food in my refrigerator during a power outage?

Eat the food in your refrigerator first, as it will only stay safe for about four hours without power. The freezer will hold food for one to two days if kept closed.

Are canned beans okay for an emergency diet?

Most canned beans are high in phosphorus and potassium and should be avoided. Small portions of thoroughly leached vegetables, if possible, are a better option.

What kind of water should I use during an emergency?

Always use bottled or distilled water for drinking and preparing any food items or drinks during an emergency to ensure it is clean and safe for consumption.