Peritoneal Dialysis - diet

Alternative names

End Stage Renal disease - diet; Hemodialysis - diet; Kidney diet - dialysis patients

Definition

This article describes the diet necessary in patients with end-stage kidney disease on either hemodialysis or peritoneal dialysis. The diet is usually high in protein and low-sodium, low-potassium, and low-phosphorus. Fluid intake is also restricted.

Function

The purpose of this diet is to maintain a balance of electrolytes, minerals, and fluid in patients on dialysis. The special diet is important because dialysis alone does not effectively eliminate ALL waste products. These waste products can also accumulate between dialysis treatments.

Most dialysis patients urinate very little or not at all, and therefore fluid restriction between treatments is very important. Without urination, fluid will accumulate in the body and cause excess fluid in the heart, lungs and ankles.

Patients on dialysis need a high protein intake to maintain adequate nutrition. Patients can become malnourished on dialysis and this often predicts a poor outcome.

The diet will help dialysis patients feel as good as possible.

Food Sources

The dialysis diet controls the intake of fluid, protein, sodium, potassium, and phosphorus. The controlled amounts of each of these nutrients are based on the person's blood levels of sodium, potassium, phosphorus, calcium, albumin, and urea measured before and immediately after a dialysis treatment.

Fluid restriction is based on the amount of urine output and weight gain between dialysis treatments.

Recommendations

The following are some general dietary recommendations for dialysis patients.

PROTEIN

Pre-dialysis patients are often asked to limit protein intake to slow the progression of kidney disease. This changes with the start of dialysis: the patient now needs much more protein. Patients on peritoneal dialysis need even higher protein, because a large amount of protein can be lost in the peritoneal fluid which is discarded.

However, dialysis patients still need to limit salt, potassium and phosphorous, which makes it a little challenging to get enough protein. Moreover, many dialysis patients have poor appetites, especially early after start of dialysis. Every dialysis center has a dietician who can explain the dietary modifications required, suggest food selection, and prescribe supplements as required.

SODIUM

Most patients need to control the sodium (salt) content in their diet. This helps maintain fluid balance in the body to avoid fluid retention and elevated blood pressure.