What Not to Do During Dialysis: Essential Diet and Lifestyle Precautions

October 10, 2025 •

4 min read

Adherence to a restricted diet is a cornerstone of effective dialysis treatment, with non-adherence being linked to higher mortality rates. For patients and caregivers, answering the question, 'What not to do during dialysis?' is key to preventing complications and maintaining well-being.

Quick Summary

This guide covers critical dietary and lifestyle restrictions for dialysis patients, including limiting fluid intake and avoiding high-sodium, high-potassium, and high-phosphorus foods to prevent dangerous electrolyte imbalances.

Key Points

Strict Fluid Limits: Control your fluid intake closely to prevent dangerous fluid buildup, swelling, and heart strain between treatments.
Monitor Sodium Intake: Excess sodium makes you thirsty and causes fluid retention and high blood pressure; avoid processed foods, fast food, and salty snacks.
Manage Potassium Levels: Limit high-potassium foods like bananas and potatoes to prevent dangerous, irregular heart rhythms.
Limit Phosphorus Intake: Reduce consumption of foods high in phosphorus, such as dairy and cola, and take prescribed binders to protect bone and cardiovascular health.
Avoid Hidden Additives: Many processed foods and drinks contain phosphorus and potassium additives; always read ingredient labels carefully.
Never Skip Treatments or Medications: Adhere strictly to your dialysis schedule and medication regimen to prevent dangerous build-up of toxins and fluid.
Do Not Use Unapproved Supplements: Do not take over-the-counter supplements or herbal remedies without a doctor's approval, as they can be harmful for people with kidney disease.
Consult a Renal Dietitian: Work with a specialized dietitian to create a personalized, safe, and effective eating plan tailored to your specific needs.

Dialysis is a life-sustaining treatment for end-stage renal disease, but its effectiveness depends heavily on the patient's discipline outside of treatment sessions. When the kidneys fail, they can no longer properly balance minerals and remove excess fluid and waste products from the body. A significant part of a dialysis patient's health management is adhering to a strict nutritional plan, often developed in consultation with a renal dietitian. This involves not just knowing what to eat, but more importantly, understanding what not to do during dialysis.

The Critical Importance of Fluid Restriction

Excessive fluid intake is one of the most common and dangerous mistakes dialysis patients can make between treatments. Since failing kidneys produce little or no urine, extra fluid stays in the body, leading to serious complications such as high blood pressure, fluid accumulation in the lungs (pulmonary edema), and strain on the heart.

To control fluid intake, it's essential to understand what counts as a fluid. Beyond water, this includes any food that is liquid at room temperature, such as soup, ice, popsicles, ice cream, and gelatin. The best way to manage fluid gain is by monitoring your weight and controlling your sodium intake, as sodium makes you thirsty. Your healthcare team will provide a specific daily fluid goal, which is essential to follow for your individual needs.

High-Sodium Foods to Strictly Avoid

Sodium is a key driver of thirst, and excessive intake can make adhering to fluid restrictions nearly impossible. High sodium levels also contribute to high blood pressure, adding further stress to the cardiovascular system.

To minimize sodium, patients should avoid or limit:

Processed and packaged foods: Deli meats, canned soups, instant meals, frozen dinners, and packaged snacks like chips and crackers are often laden with sodium.
Salty condiments: Ketchup, mustard, barbecue sauce, soy sauce, and salad dressings.
Restaurant and fast food: These are typically very high in sodium, and controlling the amount of salt is difficult.
Salt substitutes: Most of these products contain potassium chloride and are not safe for dialysis patients.

Cooking at home with fresh ingredients allows for better control over sodium levels. Patients should opt for herbs, spices, and lemon juice to flavor food instead of salt.

Avoiding High-Potassium Foods for Heart Health

In healthy individuals, kidneys regulate potassium to ensure a steady heartbeat. However, impaired kidney function can lead to high potassium levels (hyperkalemia), causing muscle weakness, irregular heartbeat, and potentially fatal cardiac arrhythmias.

Foods to avoid or limit due to high potassium content include:

Certain fruits: Bananas, oranges, cantaloupe, dried fruits (dates, raisins, apricots).
Certain vegetables: Potatoes, tomatoes, cooked spinach, avocados.
Other sources: Dairy products, nuts, seeds, and salt substitutes.

To manage potassium, a renal dietitian might suggest smaller portions of higher-potassium foods or preparation methods like leaching (shredding or dicing potatoes and boiling them in water). For some peritoneal dialysis patients, potassium restrictions may be less strict, but this is decided on an individual basis.

Limiting High-Phosphorus Intake for Bone Strength

When phosphorus levels become too high, the body pulls calcium from the bones to compensate. This can lead to weakened bones, pain, and itching. High phosphorus levels also contribute to vascular calcification, which increases the risk of heart disease.

Foods high in phosphorus to avoid or restrict include:

Dairy products: Milk, cheese, and yogurt.
Processed foods and meats: Many packaged and processed items, including lunch meats, have added inorganic phosphates for preservation.
Certain beverages: Cola and dark-colored sodas, as well as chocolate-based drinks.
Beans and nuts: These are naturally high in phosphorus.

Dialysis patients often take phosphate binders with meals and snacks, which help prevent the absorption of phosphorus. Checking labels for "PHOS" additives is also vital.

Mistakes Beyond the Diet to Avoid

Beyond food and fluid, other habits can jeopardize a dialysis patient's health. Neglecting these can have serious consequences.

Skipping medications or treatments: Adherence to the prescribed dialysis schedule and medication regimen is crucial for survival. Missing sessions can lead to dangerous buildups of waste products.
Taking unapproved supplements: Many over-the-counter vitamin, mineral, or herbal supplements contain ingredients that are harmful to those with kidney failure. Always consult your healthcare provider before taking any supplement.
Ignoring a healthy lifestyle: While dialysis is life-sustaining, it is not a cure. Maintaining a healthy weight, exercising regularly, and managing conditions like diabetes and high blood pressure are all part of a proactive approach to kidney health.
Overusing pain relievers: Some pain medications can be hard on the kidneys and should only be used as directed by a physician.

High-Risk Foods vs. Kidney-Friendly Alternatives


Nutrient	High-Risk Foods (to avoid/limit)	Kidney-Friendly Alternatives	Notes
Sodium	Processed meats, fast food, canned soups	Fresh poultry, homemade meals, herbs & spices	Follow the sodium recommendations from your healthcare provider
Potassium	Bananas, oranges, potatoes, tomatoes, salt substitutes	Apples, berries, cauliflower, cucumbers	Leaching can reduce potassium in some vegetables
Phosphorus	Dairy products (milk, cheese), cola, nuts, chocolate	Rice milk, non-dairy creamer, small portions of protein	Take binders with meals containing phosphorus as prescribed
Fluid	Excessive water, coffee, tea; ice cream, soup	Portion-controlled water, sucking on small ice cubes	Adhere to the fluid limit provided by your medical team

Conclusion

Successfully managing life on dialysis requires an unwavering commitment to a tailored nutritional plan. Ignoring restrictions on fluid, sodium, potassium, and phosphorus can lead to severe, and in some cases, life-threatening complications. It is not merely about enduring a bland diet but about making informed, conscious choices that protect your health and support the effectiveness of your treatment. Regular consultation with your nephrology team and renal dietitian is the best path to navigating these dietary and lifestyle changes effectively. For additional resources and support, consider visiting the National Kidney Foundation's website.

Frequently Asked Questions

Dialysis patients should avoid or limit high-potassium foods such as bananas, potatoes, oranges, tomatoes, avocados, and dried fruits to prevent dangerous heart problems.

Fluid restriction is crucial because failing kidneys cannot remove excess fluid, leading to dangerous fluid overload, swelling, high blood pressure, and potential heart problems.

To reduce sodium, avoid processed and fast foods, use fresh ingredients, rinse canned foods, and flavor meals with herbs, spices, and lemon instead of salt.

Excess phosphorus can cause calcium to be pulled from bones, leading to weakening and itching. It also contributes to vascular calcification and an increased risk of heart disease.

Alcohol consumption should be limited or avoided entirely, as it can worsen kidney function, interfere with medications, and contribute to dehydration.

Most salt substitutes contain high levels of potassium, which is dangerous for dialysis patients. You should not use them unless specifically approved by your doctor.

Over-the-counter supplements can contain vitamins or minerals that are harmful to people with kidney failure. Always consult your healthcare provider before taking any supplements.

Processed meats like hot dogs and deli meat should be avoided as they are very high in both sodium and phosphorus additives, which are harmful for kidney patients.