When a patient starts dialysis, there’s a lot of information for them to absorb. And it’s natural to have lots of questions: How will life change? Can I still do things I like to do? What if I need help?

It may take time to adjust to new routines and schedules, but many people on dialysis continue to do their day-to-day activities. Below are some common questions and answers about living with dialysis.

What should people on dialysis know about meal planning?

Patients on dialysis usually need to follow a special diet, watching their intake of carbohydrates, protein, potassium, sodium, phosphorus, and other vitamins and minerals. They also need to be careful about their fluid and calorie intake.

Patients on dialysis usually need to follow a special diet

A dietitian who specializes in kidney health can provide specific details and make suggestions for planning and preparing meals. The dietitian can also recommend adjustments if a patient has diabetes, high cholesterol, or another medical condition.

Modifying a diet can be challenging at first. But many patients eventually fall into a routine and discover new ways to prepare and enjoy food. For example, enhancing your meal with a variety of spices can add a delightful burst of flavor, offering a healthier and more aromatic alternative to salt. Other steps, like using fresh or frozen vegetables instead of canned products (which tend to have more salt), are easy to do.

Can people on dialysis go out to eat?

Yes. It may take some planning, but people on dialysis can still enjoy dining out. It’s important to follow the dietary guidelines set forth by a kidney dietitian. Diners shouldn’t hesitate to ask servers questions about how dishes are prepared and whether substitutions can be made.

Can people on dialysis exercise and stay fit?

Yes. Physical activity can boost a person’s mood and energy, improve their blood pressure, and help maintain their strength. So it’s important to keep exercising.

However, dialysis patients should talk to their doctor before starting any fitness program. A doctor can recommend types of exercise that are most appropriate for a person’s situation. They can also discuss how intense a workout should be, what to watch for while exercising, and how to get the most out of a fitness program.

For example, a doctor might recommend taking a 30-minute walk every other day. Or they may advise against heavy weightlifting.

If there are any changes to a person’s dialysis schedule or medicine, it’s best to talk to a doctor before resuming exercise.

Can people on dialysis still travel and go on vacation?

Absolutely, although it does take some special preparation. Some people start planning months in advance of their planned trip to make sure all their medical considerations are taken into account.

Patients should discuss their travel plans with their health care team to make sure everything is in place well in advance. Before the trip, they may have a checkup to make sure they are healthy enough to travel.

Patients on hemodialysis can arrange to have their treatments at a dialysis center in the location they’re traveling to. Medical records and information about any special requirements will need to be transferred to the new center beforehand.

Patients should also make sure they have copies of their medical information with them at all times. They should bring enough medication to last throughout the trip, plus some extra doses in case there are travel delays. Taking written prescriptions is also a good idea.

People on peritoneal dialysis should make sure they have plenty of supplies, which may be shipped to the destination beforehand. If needed, travel-sized cyclers are available. Patients should also ensure that there will be a clean place to do their exchanges.

How might dialysis change work, volunteering, and other activities?

People on dialysis may need to change their schedule so they can fit dialysis into their everyday lives. For example, a person on hemodialysis may need several hours during the day, several times a week, to receive treatment at a dialysis center. One who undergoes peritoneal dialysis may need time and a clean, private place to do dialysis exchanges.

Dialysis patients should not hesitate to let their employers know if they need accommodations. Employers should also know what to do if there is an emergency.

Some people take a break from work or other activities when they start dialysis so that they can get used to their new routine. Others decide to work part time.

How might dialysis affect mental health?

The mental health impact of dialysis can be profound. Patients are adapting to a changed lifestyle as well as learning lots of important information about their diet and activities. It’s natural to feel overwhelmed at times. It’s also natural to feel frustration, anger, sadness, and anxiety. People may worry about being a burden on their loved ones, and they may miss the way their lives used to be.

Staying involved with activities as much as possible, spending time with friends and family, having fun, and doing relaxation exercises are all ways to cope. Patients may also consider joining a support group with others who are going through dialysis. Seeing a therapist is another option.

In summary

Living with dialysis represents a significant shift in lifestyle, but it doesn't have to be a barrier to enjoying a fulfilling life. With proper planning, dietary adjustments, and open communication with healthcare professionals, patients can continue to dine out, stay active, travel, and participate in work or volunteer activities. Adapting to this new routine may pose challenges, but it also opens opportunities for personal growth, discovering new hobbies, and connecting with others in similar situations. It's crucial to acknowledge the mental health aspects as well, seeking support from friends, family, support groups, or professional counseling. Remember, while dialysis is a part of your life, it doesn't define who you are. With resilience, adaptability, and a positive outlook, you can lead a rich and rewarding life while managing your health effectively.

Resources

American Psychological Association

“Living well on dialysis”
(October 31, 2019)
https://www.apa.org/topics/chronic-illness/dialysis

Dialysis Patient Citizens Education Center

“Dining Out”
(no date)
https://www.dpcedcenter.org/staying-healthy/nutrition/dining-out/

“Nutrition”
(no date)
https://www.dpcedcenter.org/staying-healthy/nutrition/

National Kidney Foundation

“Coping with Symptoms While on Dialysis”
(August 12, 2014)
https://www.kidney.org/news/coping-with-symptoms-while-on-dialysis

“Filtering Dialysis Myths from Facts”
(no date)
https://www.kidney.org/atoz/content/myths

“Nutrition and Hemodialysis”
(2015)
https://www.kidney.org/atoz/content/nutrihemo

“Nutrition and Peritoneal Dialysis”
(Reviewed by the Council on Renal Nutrition: April 2019)
https://www.kidney.org/atoz/content/nutripd

“Staying Fit With Kidney Disease”
(no date)
https://www.kidney.org/atoz/content/stayfit

“Travel Tips: A Guide for Kidney Patients”
(no date)
https://www.kidney.org/atoz/content/traveltip

“Working With Kidney Disease: Rehabilitation and Employment”
(no date)
https://www.kidney.org/atoz/content/working