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  • Vegetarian on dialyisis: Protein without phosphorous & potassium ?

    I started on hemodialysis three weeks ago. Having been a lacto-ovo vegetarian for 35 years, and not wanting to resume eating meat or fish, I'm uncertain about the best way to get sufficient protein without too much phosphorous or potassium. Any suggestions? Thanks.

  • #2
    You would do best to consult with a renal dietitian on this one. I assume that your main protein sources in the past have been beans and cheese. I am sure that there must be some way around this, but it will be tricky and you should get professional advice. Be sure that the dietitian you talk to is a RENAL dietitian as a regular one may not have the specialized knowledge that you will require.
    To the stars through difficulty!


    • #3
      yeah, to stay a vegetarian on dialysis (especially on in-center hemo 3x a week, vs. another modality that might offer a slightly easier diet) you'll need a diet that's been specifically tailored with the guidance of a professional.

      however, if you want to research this yourself as well, here are some good links to start looking up stuff:

      this is the USDA's national nutrient database; it offers lists of the content of nutrients in pretty much every food imaginable. it's good for looking up the levels of protein, K, PO4, etc in foods:

      this website, nutrition data, offers pretty much the same thing, except you can look up one specific food to show it's entire nutritional content:

      here are some examples i found from the above sites of vegetarian protein options, some good, some not so good:

      Tofu – 98-110 mg PO4/ 120-144 mg K per serving (84 g)
      Morningstar farms “burger” crumbles – 174 mg PO4/ 178 mg K per cup
      Eggs: scrambled – 100 mg PO4/ 84 mg K per egg
      hard boiled – 85 mg PO4/ 67 mg K per egg
      baked beans, canned – 188 mg PO4/ 569 mg K per cup
      black beans, cooked – 241 mg PO4/ 611 mg K per cup
      chickpeas, canned – 216 mg PO4/ 413 mg K per cup
      pinto beans, cooked – 251 mg PO4/ 746 mg K per cup
      red kidney beans, canned – 233 mg PO4/ 658 mg K per cup
      soy beans: green, cooked – 284 mg PO4/ 670 mg K per cup
      mature, cooked – 421 mg PO4/ 886 mg K per cup

      Northwest Kidney Center's website gives you a "vegetarian" search option in looking through all their recipes:

      and, which has a whole host of learning modules for dialysis patients, has a good one on nutrition and fluids that covers protein intake; it gives some ideas and recipes for protein supplements:


      • #4
        Beans are a very poor choice and not included in the renal diet. This includes tofu since it is made from soybeans. It's going to be extremely difficult to get enough protein on a vegetarian diet. You definitely need to consult the renal dietician and get her to monitor you. Would you consider whey protein powder? You can mix it with fruit and rice milk and make a smoothie. The one I give my husband has 28g. of protein per serving.


        • #5
          It is typically possible to follow a renal diet as a vegetarian. There are a number of resources and hopefully you've searched the internet. What you will most likely find and learn is that you are able to replace the protein in a meat-based diet with non-meat sources of protein such as tofu, beans, etc. You just have to be very careful and aware of quantities. Protein foods like meat have phosphorus and potassium, so when you eliminate them, you will have an amount of phosphorus and potassium that you can include from the non-meat based protein foods.

          As with all patients, the amount of protein, phosphorus and potassium you are allowed to take in through your diet is individualized to your specific needs. The results of your monthly blood work will help determine this amount.

          Please ask the dietitian at your dialysis center for assistance. There are many materials available, including those from the AAKP.

          Best wishes as you work to make the renal diet work for you and your personal needs.
          The response of this moderator is not an attempt to address a specific condition. Please note that the discussion forums do not provide medical advice or professional opinions about specific conditions. The purpose of the discussion forums is to provide an opportunity for individuals to discuss end stage renal disease and related topics. The discussion forms are not a substitute for professional medical care. For questions or


          • #6
            Most grocery stores have an egg white powder you could add to foods, or whey powder is good too (I like unflavored whey as it can be added to a lot of different foods). Perhaps your dietitian would let you have cottage cheese, or mozarella cheese. How about egg beaters or egg whites to lettuce salad??


            • #7
              You can actually buy egg protein online and I have also seen and bought some rice protein at a local store.
              I have not used it lately- but you could try ordering rice protein online as it is easier to find there.


              • #8
                Protein Powder


                I was reading some of the comments about being a vegtarian. I am a transitioning semi octo vegetarian, I still eat chicken and fish and eggs but that is it. I lose protein durind pd dialysis so I "have to" replace what I lose by eating more protein. For a while I had a problem eating any type of meat but now my dietician gave me a protein powder called "Procel" it is an instant protein supplement that dissolves into food, beverage and snacks. I havent been using it since I have only had for a couple days but I tried a spoonful in a cup of soymilk and I couldnt tell it was in there. I had posted a thread about a book I purchased called "The complete guide to Whole Foods" recipes, and wholc food information--veggies, grains, dairy substitutes, etc. Includes main dishes, snacks, beverages, side dishes, lite meals soups and salads and desserts. It is a fabulous book. My goal is to become a vegetariam full time. I have lupus so I have researched alot about going on that diet and Im using the powder for foods I cook at home. I hope that helps, I know when I posted the book many users did not agree with my lifestyle since I require replacement of protein because Im on pd dialysis. I exercise 3-4 times a week and take yoga once a week and try and eat as healthy as possible. Im trying to diminish my lupus so that I can receive my fathers kidney. But I would definitely talk to your renal dietician about your options. Good luck....glad to know there are other vegetarians---
                SmiLe, LoVe, LiVe


                • #9
                  Had to look up Procel as never heard of it.
                  It is a whey protein powder.

                  I thought whey came from milk? not too sure (looks up in goooogle).

                  Whey protein is the name for a collection of globular proteins that can be isolated from whey, a by-product of cheese manufactured from cow's milk. It is typically a mixture of beta-lactoglobulin (~65%), alpha-lactalbumin (~25%), and serum albumin (~8%), which are soluble in their native forms, independent of pH. Whey has the highest Biological Value (BV) of any known protein.


                  I had this for rice protein before, it is good!

                  80% Protein Content!
                  Whole Grain Brown Rice
                  NutriBiotic Rice Protein is a great tasting vegetable protein free of the common food allergens normally associated with products such as soy, milk, egg, wheat and yeast. NutriBiotic Rice Protein is a highly soluble powdered formula that mixes easily into a glass of water or juice. Add to beverages or meals for an extra protein boost. No chemicals are used during processing. All that we use to process our rice protein is purified water and natural enzymes.

                  Supplement Facts
                  Nutrition Facts
                  Serving Size 1 heaping Tbsp. ( 15 g )
                  Servings Per Container: 40
                  Amount Per Capsule % Daily Value*
                  Calories 55
                  Calories from Fat 2
                  Vitamin C 0%
                  Total Fat 0.3 g 0.5%
                  Saturated Fat 0.1 g 0.5%
                  Cholesterol 0 0%
                  Sodium 8 mg 0.4%
                  Potassium 0 mg 0%
                  Total Carbohydrate 1.8 g 0.6%
                  Dietary Fiber .5 g 2.0%
                  Sugars 1 g
                  Protein 12 g
                  Not a significant source of other nutrients.
                  * Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.


                  • #10
                    The protein powder my husband used was also whey protein and it was okayed by the renal dietician. The processing of the whey to a powder removes most of the phosphorous. I also use this after my workout. I can't use the soy-based protein powders (or any soy products) due to Hashimoto's Thyroiditis.


                    • #11
                      The best way of increasing Protein intake without eating adding meat to your diet is to add Protein supplements such as high protein drinks from ensure, boost, and others. If protein drinks such as ensure is not your style then another alternative is Pro-Stat 64..

                      However, based on my Doctor's suggestions and recomendations, protein from meats is the best high quality protein you can get, so try adjusting to eating meat.
                      My Blog Site


                      • #12
                        Ensure, Boost and similar ready to drink supplements are not recommended for dialysis patients. Nepro is formulated for those on dialysis. The already prepared supplements do not have as much protein as the powder. The one I use and that my husband used has 46 g of protein in one scoop as compared to 17 g in Nepro (Boost or Ensure, etc.). I get it at General Nutrition.


                        • #13
                          Depends on patient's labs I think it is best to consult with dietician. I am currently taking Boost, prescribed by my clinic so I think every clinic varies. I have tried all of them including Nepro, but found Boost to be better tasting. The only protein supplement that may be best without the other nutrients is Pro-Stat 64...comes in different flavors and all you need is 1oz a day, depending how your Albumin is...

                          Originally posted by StansWife View Post
                          Ensure, Boost and similar ready to drink supplements are not recommended for dialysis patients. Nepro is formulated for those on dialysis. The already prepared supplements do not have as much protein as the powder. The one I use and that my husband used has 46 g of protein in one scoop as compared to 17 g in Nepro (Boost or Ensure, etc.). I get it at General Nutrition.
                          My Blog Site


                          • #14
                            Vegetarian on dialysis

                            Hi. I too am vegetarian and have been doing pretty well on my renal diet. Well, actually, I have since added some fish. So, in reality I am now a "pescatarian". Aside from some fish, however, my main diet consists of tofu, tempeh and eggs. (I used to eat beans too but have cut them out for the most part...for now anyway.)

                            I also make smoothies with Nepro and a protein powder all of which have been pre-approved by my in-clinic dietician. It's a very flexible diet and easy to accommodate. As everyone else has suggested, best to work with a renal dietician. I am lucky with my dietician as she is very aware of my needs as a (mostly!) vegetarian and is also very knowledgeable about supplements too....

                            My monthly blood work has been fine...perfect in fact. I am getting plenty of protein on my diet.

                            Best of luck with your research!


                            • #15
                              the dieticians when I am are not very good.
                              I used to and still do use a lot of the Rice Dream products and they are not dairy.
                              I actually had some of the dieticians say that because it has the word milk in it it is not good for you.

                              Only now at least 5 years later Rice Dream is very popular- so now they know a little about it.

                              But they do not seem to realize also that most shrimp and fish is preserved with phosphates- even tha stuff you get in the "fresh" cold case at the grocers.
                              So, unless the fish you buy is already packaged and labeled- it has most likely been sitting in a salt and phosphate solution.

                              I know quite a lot o about nutrition and supplemenmts as I used to compete in a lot of sports. It's too bad the dieticians here are not very good.
                              They tell people to just use less milk instead of giving other options.

                              Also, the food trays I see the people at Dialysis have....they have all the "wrong" foods.
                              They use regular white bread that surely has phosphates in it.
                              Cheerios...I could go on, but won't bother...

                              Just wanted to add.
                              If you do like whey products there is actually a whey ice tea. Walmart sells it, it is in a powder.
                              Called Whey Cooler I think.

                              pretty sure Walmart sells it. The peach ice tea one is so good!
                              GNC also should sel this and i know you can buy single servings pouches to try it out.
                              I found in the summer could not eat as much and protein drinks that are warm in the sun were gross.

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                              per 600ml serving/ 28 gram scoop:
                              Calories 80
                              Fat 0
                              Cholesterol 0
                              Sodium 80mg
                              Potasium 20mg
                              Carbohydrate 0.5
                              Fibre 0
                              Sugars 0
                              Protein 20grams!


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