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"Dialysis Diet: Fruits for Thought"
Written by Syaidatun Yahya, Dietitian, National Kidney Foundation of Malaysia

Some ‘eat to live’; others ‘live to eat.’

Eating is something much celebrated, especially in a food haven like Malaysia. Eating – plays a vital role in our survival, and dialysis patient should not be spared from it. Although dialysis patients should adhere to certain food restrictions, they could opt for food choices which are more suitable and their diet intake in maintaining their health.

What about the variety of fruits available – can dialysis patients ‘eat all they can’? High potassium levels in blood tends to lead other complications such as body weakness, muscle cramps, breathing difficulty as well as irregular heartbeats. Thus, fruits with high potassium levels should also be avoided.

Fruits with High Potassium levels:- Bananas/ Oranges/ Durian/ Kiwi/ Langsat/ Mata Kucing etc

However, there are fruits that fit in the dialysis diet.
  • Pineapples, rich in VitaC!
Pineapple fits a low potassium diet with 125mg potassium for ¾ cup of serving. Pineapples have very low levels of sodium and phosphorus, but rich in vitamin C and provides 1 gram of fiber per serving. The good news is - it is fat-free, contain less than 1 gram of protein and around 15 grams of carbohydrates per serving!

  • Guavas, plentiful of fiber!
One whole guava contains around 100mg of potassium. It is also very high in fiber content and rich in vitamin C. When eating guava, it is better to peel-off the skin; eat them plain without any ‘Assam buoy’. Adding in ‘Assam buoy’ will increase the potassium content to a whopping 240mg!

  • Watermelons, careful with the excess fluids!
Watermelon is also allowed in a dialysis diet. Some are told to avoid watermelon, while some said it is acceptable in the dialysis diet. Thus, why the mixed message? Can a dialysis patient eat watermelon – or not?

Yes, watermelon is acceptable in the dialysis diet; in fact, the fruit has low levels of potassium – but we must control the portion size and fluid levels.

Watermelon is low in potassium, with around 120mg for a one cup of serving. However, watermelon contains a lot of fluid – the fruit is made up of 92 percent of fluid. For this reason, patient may exceed their fluid goals if they consume watermelon in a large amount. For dialysis patient on fluid restriction, watermelon is limited to only one cup per day. For dialysis patient with *interdialytic weight gain concern, watermelon should be counted as a replacement for fluid.

To sum up, dialysis patients should eat fruits which are suitable for them; at the same time keeping an eye on the portion size. We should understand and learn about the knowledge on fruits restriction so that we can offer our support for dialysis patients and not neglecting them.

*interdialytic weight gain: amount of weight gain in between dialysis session; example if on Monday after dialysis patient weighs 60kg and Wednesday before dialysis patient weighs 64kg, that is 4kg of interdialytic weight gain
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