Dietitian Service
The Vital Role of Nutrition in Dialysis
In the treatment of chronic kidney failure, a high-tech dialysis machine and a good physician alone are not enough; one of the most inseparable and critical parts of dialysis is medical nutritional therapy (Dietitian Service). Electrolytes such as potassium, phosphorus, sodium, and excessive fluid, which a healthy kidney removes from the body, accumulate in the blood in case of kidney failure and can cause life-threatening risks between sessions.
As Bali Dialysis Center, our full-time “Nephrology and Dialysis Dietitian” specialist monitors each of our patients one-on-one to support the treatment and prevent potential complications. The nutrition of a patient undergoing dialysis involves completely different disciplines from that of a healthy person, or even a pre-dialysis stage patient.
Individualized (Personalized) Nutrition Planning
For each patient who registers at our center, our dietitian takes a detailed nutrition history (anamnesis). Our patient’s age, dry weight target, accompanying diseases (such as Diabetes, Hypertension, Cholesterol, or Gout) and monthly laboratory biochemistry test results are evaluated.
- In line with this evaluation, calorie, carbohydrate, and most importantly protein needs are calculated, and special diet lists completely integrated into the patient’s eating habits and taste are created.
- During the dialysis process, amino acids (protein building blocks) are also discarded from the body along with blood, so dialysis patients are ensured to consume high and biologically strong quality protein (meat, eggs, fish, etc.). Our dietitian adjusts this ratio within medical limits.
Fluid and Electrolyte (Potassium, Phosphorus) Control Education
The amount of fluid that dialysis patients should take between two dialysis sessions (approximately 48 or 72 hours) is severely restricted. Not only water; tea, soup, fruit juice, and even the fruit itself cause edema (fluid overload) by putting a direct load on the heart and lungs in patients without urine output.
During each visit, our dietitian teaches our patients:
- Fluid Restriction Tips: Practical methods such as sucking on ice, lemon drops, and consuming salt-free/unsalted spices to quench the feeling of thirst.
- Potassium Control: Education on how to stay away from high potassium foods such as bananas, apricots, melons, potatoes, and nuts to prevent high potassium levels in the blood that create a risk of cardiac arrest, or how the potassium of these foods can be reduced by the method of pouring out the boiling water.
- Phosphorus and Salt: To stop osteoporosis, vascular calcification (calcification), and skin itching, foods containing phosphorus such as milk, cheese, ready-made/packaged processed foods and acidic beverages such as cola are carefully explained in the forbidden list. The effect of sodium (salt) consumption on raising blood pressure and causing thirst is adopted by the patient with graphics.
In-Center Treats and Regular Follow-up
Bali Dialysis Center offers low-phosphorus and sodium treats/breakfasts containing personalized “light sandwiches, special cheese, or diet biscuits” formulated by the institution’s physician and dietitian themselves to stabilize our patients’ blood pressure or blood sugar fluctuations during the session.
When laboratory results arrive at the end of each month, our dietitian goes to the patient’s chair and reads their report card. For patients whose albumin levels have decreased, protein supplements are provided; for patients whose potassium has increased, diet tightening and education repetition are performed; family relatives (patient spouses/children) are told how to cook the right meal. At our center, diet service is not just a piece of paper, but a dynamic coaching process sustained for life.
