Managing Triglycerides When You Are On Dialysis

By DaVita^® dietitian Susan Zogheib, MHS, RD

Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.

Here are two quick things to know about triglycerides: 1) The word is pronounced try-glis-er-ides and 2) they are fats, plain and simple. Triglycerides are the most common type of fat in your blood. They are used for energy and stored as body fat. .However, high levels of triglycerides can increase your risk of heart disease.

Why are triglycerides important for dialysis patients

Triglycerides are especially concerning in dialysis patients. People on dialysis are more likely than the general population to develop heart disease, also called cardiovascular disease. This increased risk is related to a person’s kidney disease and typically to other health problems such as diabetes and high blood pressure.

In dialysis, protein plays a crucial role in the kidney diet because it helps fight infection, build muscle and repair tissues. It may be more challenging for people on dialysis to limit fat intake because of the increased need for protein. Some foods high in protein may also contain high amounts of triglycerides.  

How do triglycerides compare with peritoneal dialysis (PD) to hemodialysis?

PD patients require a diet higher in protein than those on a hemodialysis diet because protein is removed through the peritoneal membrane with every dialysis exchange. As a result of the dietary increase in protein, PD patients also consume more fat than hemodialysis patients. In addition, triglycerides may also increase more in PD patients than hemodialysis patients because PD patients receive glucose in their PD dialysate which can be stored as fat. People on peritoneal dialysis (PD) need to monitor their fat intake a little more closely. Some proteins are also lost during hemodialysis, but not as much with PD.

What should triglycerides level be?

A blood test can be done to measure your triglycerides. The most desirable level of triglycerides should be less than 150 mg/dL. 150-199 mg/dL is borderline high and anything over 200 mg/dL is considered high.

How can people on dialysis manage their triglyceride level?

• Limit your fat intake. Choose low fat protein sources such as fish, poultry, lean meat and egg whites.
• Limit the amount of carbohydrate you eat. Avoid sugars and sweets.
• Consume a diet rich in omega-3 fatty acids. Oily fish like salmon, albacore tuna, lake trout and mackerel are high in omega-3s.
• Keep your blood sugar in a good range if you have diabetes.
• Drain all liquid from ground meat after cooking, then place meat into a strainer and rinse under hot water.
• Avoid or limit frying foods. Baking, broiling, steaming and boiling are healthier options.
• Trim fat from all meats and remove skin from poultry.
• Substitute skim milk for whole milk.
• Avoid American, blue, Brie, cheddar, Colby, Edam, Monterey Jack, whole-milk mozzarella, Parmesan, and Neufchatel cheeses.
• Avoid butter, lard, coconut oil and shortening. Use olive and canola oil instead.
• Limit alcohol.
• Add physical activity to your daily schedule. Talk to your doctor before you begin a workout routine.
• Quit smoking.
• Keep your weight at a healthy level. If necessary, reduce your calories to lose weight.

Triglyceride maintenance for dialysis patients

Following a kidney-friendly diet that is low in unhealthy fats and sugars is important for dialysis patients to maintain their triglycerides in a safe range. It is essential for people on dialysis to follow the guidance from their doctor, nurse and dietitian to help prevent cardiovascular disease complications such as heart attacks and strokes. Make a heart-healthy choice by trimming triglycerides.