Diet and Nutrition
Peritoneal Dialysis “” Diet and Nutrition Information
Nutrition plays a vital role in your dialysis treatment plan, no matter what type of dialysis you choose. Following a dietitian’s recommendations can have huge benefits to your overall health. You may reduce adverse symptoms, prevent or improve some medical problems, or possibly slow down further damage to your kidneys.
At Washington University, all dialysis patients are assigned to a dietitian who will work directly with them to identify the right foods, in the right portions for both meal planning and while dining out. I
n determining food choices, diet recommendations are based on your level of kidney function, body size, age, gender, blood test results, and any other medical problems. Food preferences and cultural backgrounds also are taken into consideration.
Your dietitian will make sure you get the right amount of calories and protein as well as maintain a healthy body weight. Patients on peritoneal dialysis tend to gain weight over time from the absorption of calories from the dialysate, which contains sugar. Your diet plan will take into account these extra sugar calories from the dialysis and will have the right amount of calories to keep you at a healthy weight. You also will be encouraged to exercise.
Important nutrients in your diet include:
Protein “” Proteins are critical to build and repair tissues such as muscles, bones, and skin and to resist infections. Proteins are not stored in the body and must be eaten daily. In patients electing peritoneal dialysis, dietitians typically recommend a diet higher in protein than patients who elect hemodialysis because protein is lost through the peritoneal membrane with every dialysis exchange.
Sodium “” Sodium, or salt, is used in the body to control blood pressure, balance fluids and control muscle contractions. Too much sodium, however, can cause swelling, high blood pressure and shortness of breath. Too much sodium may result in high fluid weight gains and swelling, that might require stronger dialysate to remove the extra fluid.
Potassium “” Potassium is a mineral that helps to keep nerves and muscles working properly. Both high and low levels of potassium can cause serious health problems. The kidneys normally help balance potassium levels in the body. In patients with kidney failure, potassium levels are controlled with dietary choices and dialysis. Patients on peritoneal dialysis, however, often have few, if any, restrictions on potassium in their diet (and may in fact be asked to increase their potassium intake) because they dialyze daily.
Phosphorus “” Phosphorus, along with calcium, works to keep your bones healthy and strong. When kidneys fail, phosphorus builds up in the blood, causing a drop in calcium levels, both of which can cause weak bones, damaged blood vessels, and heart disease. Your phosphorus level will be controlled by food choices, dialysis and medications, called phosphorus binders.
Fluids “” Without healthy kidneys to maintain proper fluid balance, excess water in your body can raise blood pressure, make it difficult to breathe, and cause a strain on your heart. Fluids will need to be controlled in the diet to prevent these problems. Dialysis removes excess fluids, but it is important that fluids remain at a safe level. The dietitian will help you to know how much fluid you can have.
Diabetes and Your Diet
If you already are on a special diet because of diabetes, your dietitian will help you combine your diabetic diet with a diet for dialysis. You may need to make only a few changes that will keep your diet in line while on dialysis.
You don’t have to stop visiting other family members, friends, or even your favorite restaurant if you have dietary restrictions. You will need to learn how to make smart meal choices and read menus closely. It’s best to talk directly with your dietitian for tips on dining out and what to look for in take-out foods.
It’s All About You
It is important to follow through and learn about your individual dietary needs. Because every person is different, a diet should not be started without the recommendation and supervision of your doctor and dietitian. Each diet plan is specific to each person. What may be helpful to one patient may actually harm another, so make sure to follow your own diet recommendations.