Is it true that all dialysis patients automatically need to consume more calories?

Recent studies suggest that many individuals undergoing dialysis have a resting energy expenditure comparable to healthy adults. This indicates that the stress of dialysis and uremic toxins might not always lead to increased energy needs, potentially challenging the traditional advice to increase calorie intake. Factors like reduced physical activity and decreased muscle mass often play a more significant role in determining overall energy needs.

How does physical activity impact the calorie needs of dialysis patients?

Dialysis patients often have reduced physical activity, leading to decreased muscle mass, which can significantly lower total energy expenditure. The research suggests that lower activity levels mean your calorie needs might be less than standard recommendations. It's important to consider your lifestyle and daily activity level when determining your caloric intake to avoid unwanted weight gain.

What if I have other health conditions besides kidney failure? Does that change the recommendation about calorie intake during dialysis?

The research primarily focuses on resting energy expenditure in stable dialysis patients. Conditions such as uncontrolled diabetes, hyperthyroidism, or severe infections can increase energy expenditure. These factors were not the focus, so energy needs might be different if you have any of these conditions. Always consult with your healthcare team to address these specific needs.

What are some practical steps I can take to figure out my individual energy needs while on dialysis?

To manage your energy needs effectively, collaborate closely with your healthcare team, including a registered dietitian, to assess your individual requirements. Instead of blindly following general recommendations, understand your resting energy expenditure (REE) and physical activity levels. Then adjust your diet accordingly. The practical tips include monitoring your weight, tracking your food intake, and regularly reassessing your energy needs with your healthcare provider.

Balanced nutrition for dialysis patients, personalized approach.

Dialysis and Energy: Are You Getting Enough Calories?

Q: Why is it so important to get the right amount of calories when undergoing dialysis?

Balancing nutrition is crucial because underfeeding can increase mortality, while overfeeding can also be harmful. The common practice of prescribing high-calorie diets is based on the assumption that conditions like metabolic acidosis, insulin resistance, and inflammation increase energy expenditure. However, if your resting energy expenditure is comparable to healthy adults and you have reduced activity, excessive calories could lead to unwanted weight gain.

Lena Kashyap in Health & Wellness December 2025 • 4 min read.

"Unraveling the Myths: New research reveals that dialysis patients may not need extra calories, challenging common dietary advice."

If you're undergoing dialysis, you've likely heard that you need to increase your calorie intake. This advice stems from the belief that dialysis and related conditions increase energy expenditure. However, recent research suggests that this might not always be the case, and in some situations, increasing calories could lead to unwanted weight gain.

Balancing nutrition during dialysis is crucial. Underfeeding can increase mortality, while overfeeding can also be harmful. Healthcare professionals often prescribe high-calorie diets, assuming that conditions like metabolic acidosis, insulin resistance, and inflammation increase energy expenditure. But what if the opposite is true for many patients?

This article explores the latest research on the energy needs of dialysis patients, examining resting energy expenditure (REE) and physical activity levels. We'll clarify whether you actually need extra calories, how to assess your individual needs, and provide practical tips for maintaining a healthy weight during dialysis.

Do Dialysis Patients Really Need More Calories?

Balanced nutrition for dialysis patients, personalized approach.

A comprehensive review analyzed numerous studies on energy expenditure in dialysis patients. The surprising finding? Many patients on dialysis have resting energy expenditures comparable to healthy adults. This means that the stress of dialysis and uremic toxins might not always lead to increased energy needs as previously thought.

The review highlighted that many dialysis patients tend to be less active than their healthy counterparts. Reduced physical activity, often linked to decreased muscle mass, significantly impacts total energy expenditure. Therefore, if you're not very active, your calorie needs might be lower than standard recommendations suggest.

Comparable REE: Studies showed no significant difference in resting energy expenditure between dialysis patients and healthy controls in many cases.
Reduced Activity: Dialysis patients generally exhibit lower physical activity levels.
Muscle Mass: Decreased physical activity is often related to reduced muscle mass, impacting overall energy needs.

It's important to note that conditions like uncontrolled diabetes, hyperthyroidism, or severe infections can increase energy expenditure. The research focused on stable patients without these additional factors. If you have any of these conditions, your energy needs might be different.

Practical Tips for Managing Your Energy Needs on Dialysis

Managing your energy needs during dialysis requires a personalized approach. Instead of blindly following general recommendations, work closely with your healthcare team, including a registered dietitian, to assess your individual needs and adjust your diet accordingly.

Here are some practical tips to help you maintain a healthy weight and optimize your nutrition:

<ul> <li>Track Your Food Intake: Keep a food diary to monitor your calorie consumption and identify areas for improvement.</li> <li>Monitor Your Weight: Regularly weigh yourself to track weight trends and make necessary adjustments to your diet.</li> <li>Assess Your Activity Level: Consider using a pedometer or fitness tracker to monitor your physical activity.</li> <li>Consult a Dietitian: A registered dietitian can help you create a personalized meal plan based on your individual needs and preferences.</li> <li>Address Comorbidities: Manage any underlying health conditions that may affect your energy expenditure.</li> </ul>