Lifestyle Changes to Manage End-stage Renal Disease (ESRD)

Changing some habits will keep you as healthy as possible. Here are some steps you can take to help control problems that happen with ESRD.


You will need to keep track of what you eat and drink. The amounts may differ depending the course of treatment. A dietitian will work with you to make sure what you eat is healthy. You may need to watch:

  • Protein—Too much protein harms the kidneys. Foods rich in protein include meats, poultry, fish, and eggs. Your care team will tell you how much you can have each day. Protein needs may change with your care plan.
  • Sodium—Makes blood pressure higher. It also increases the amount of fluid in the body. Reduce sodium from both foods and fluids. Look for the amount of sodium on food labels.
  • Potassium—High potassium levels can cause heart problems. Reduce potassium-rich foods such as potatoes, bananas, or avocados.
  • Phosphorus (phosphates)—A buildup of phosphorus can lead to weaker bones. Phosphorus is found in many foods. This makes it harder to limit. Your doctor may have you take a phosphate binder. They block phosphates from being absorbed into the body.
  • Fluids—A buildup of fluid causes blood pressure to go up. This makes the heart work harder. It can also make it harder to breathe. Your care team will tell you what range you need to stay in.

Calories give your body energy. But, you may not feel hungry during ESRD treatment. Calories can be added with healthy fats or certain sweets. If you have diabetes, you may need to limit the amount of sugar added to your diet. Talk to your dietitian before making changes.

Control Blood Glucose and Blood Pressure

Diabetes and high blood pressure put extra strain on your kidneys. Keep to your diet plan to help with these problems. Your doctor may also want you to take medicine to keep them under control.

Supplements and OTC Medicine

Certain herbal supplements and OTC medicine can cause more harm to the kidneys. Talk to your doctor about all the medicines and supplements you take.

Seek Support

ESRD is a life-changing event that can be hard to handle. It is important to rely on family, friends, and other people in your life. Talk to a therapist or join a support group. They can help you better cope with your emotions.

Comfort Measures

Some people with ESRD choose not to start dialysis. Comfort measures will help keep your quality of life. It is realistic to think about end-of-life planning. Considerations include:

  • Choosing home or hospice care
  • Financial decisions
  • Advance directives—includes legal issues, like wills, hospital orders for your care, and power of attorney for medical care and finances
  • Insurance coverage

Your care team will refer you to a trained professional to guide you through this process.


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Eating & nutrition for peritoneal dialysis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: Updated August 2018. Accessed July 22, 2019.
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Nutrition and kidney failure. National Kidney Foundation website. Available at: Accessed July 22, 2019.
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Last reviewed June 2019 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 10/4/2019

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