What is Sodium?

Sodium is one of the widespread and essential elements on Earth. It is commonly found as sodium chloride (dietary salt). It has a lot of functions to maintain day to day functions in the body. LIke

1. Maintain the neural transmission.
2. Regulating blood pressure.
3. Maintain Acid-base balance. 

However, the excess amount of sodium may give rise to a lot of problems for humans. Such as;

1. uncontrolled blood pressure.
2. Leg and body swelling.
3. Difficulty in breathing. 

Therefore it is recomend to use low sodium diets for hemodialysis patients.

Recommended daily limit of Sodium intake

Most of our meals contain salts. It is estimated that the average American eats around 3500mg of salts each day. But both American Heart Association and the Food and Drug Administration recommended taking around 2300mg of salts (1Teaspoon) per day. However, the American heart association further suggests that it is better to reduce daily intake to less than 1500mg or even less(500mg).

Problems associated with high sodium in CKD patients

Chronic Kidney Disease patients often fail to maintain most of the kidney functions. They fail to remove excess fluids from the body. Also, they fail to maintain Sodium-Potassium balance in the body. Additionally, most of them fail to regulate blood pressure. 

High blood pressure is one of the causes of kidney failure. It also worsens kidney damage. Unless CKD patients maintain blood pressure adequately, there will be fast deterioration of kidneys. 

Therefore it is essential to maintain blood pressure during illness. However, excessive sodium intake may damage this blood pressure control. Therefore it is necessary to reduce dietary sodium intake in all Chronic kidney disease patients, including dialysis patients. 

Patients with End-Stage Kidney Failure are facing difficulties in fluid excretion. As a result, they accumulate water in the body. These fluids are distributed all around the body—legs, lugs, abdomen, etc.

Even hemodialysis may fail to reduce these fluids from the body when you take a high sodium diet.  

Importance of Low Sodium diet in hemodialysis patients

When you get renal failure, we often advise reducing dietary sodium intake to control blood pressure. Because a low sodium diet will prevent the unnecessary increase of blood pressure, this will preserve the kidneys in the long run. 

However, when you progress to End-stage kidney failure, you need to reduce dietary sodium further. This will reduce the unnecessary accumulation of fluids in the body. 

Also, high sodium amount in the blood can drastically change your blood pressure during hemodialysis. Therefore it is essential to take a low sodium diet for hemodialysis patients. 

How to select a low sodium diet as a hemodialysis patient

Although we are not fully aware, there are ways to reduce sodium intake in our diet as a hemodialysis patient. 

1. Often select fresh fruits, vegitables, etc.
2. Prepare your food by yourself.
3. Look at the amount of sodium levels in each food item. 
4. Identify foods that contain hidden sodium and avoid them.
5. Use alternative natural flavors for your food items.
6. Reduce the portion size of your sodium-containing foods. 
7. Ask no- salt / fewer salts in your foods in restaurants. 

Importance of taking support from your dietician

As a patient undergoing hemodialysis, you can use all the above methods to reduce dietary sodium. However, your dietitian can help you make a proper low sodium diet that adjusts to your needs.

He will initially counsel you on the importance of a low sodium diet as a hemodialysis patient. Also, he will assess your current nutritional state and food habits. Then he can determine your sodium levels. After all, you can discuss your diet plans according to your most preferable foods. 

As a patient with CKD patient, your long term target should be to live longer with less complications. low sodium diet for hemodialysis patients is unavoidable factor in this issue. Therefore you have to meet your dietician and take necessary diet plan and proceed it to progress longer. Additionally you often have to get review your diet plan each 3- 6 months by your dietician.

Reference:

1. Sodium in Your Diet, US food and Drug Administration
   
2. How much sodium should I eat per day?, American Heart Association
   
3. Chazot C, Collonge C, Charra B. Diététique hyposodée chez le patient dialysé: mythe ou réalite? [Low sodium diet for dialysis patients: myth or reality?]. Nephrol Ther. 2007 Sep;3 Suppl 2:S137-40. French. doi: 10.1016/s1769-7255(07)80022-8. PMID: 17939970.