The kidneys help:
- Filter waste from your body
- Control fluid levels
- Regulate levels of potassium and sodium
When the kidneys are not working well, dialysis can take over for the kidneys. In peritoneal dialysis, the lining of your stomach is used to filter the blood. The diet helps to relieve stress on the kidneys and improve the effects of dialysis by managing:
This diet is strict. It may also need to be changed as your kidney functioning changes. That is why you have to work closely with your dietician. The dietician will determine how much of each nutrient you can eat and design a meal plan that is right for you.
Elements that are managed include:
You will need extra protein. This is because some protein is lost into the peritoneal fluid. If you do not eat enough protein, dialysis can cause protein deficiency and muscle loss. Your dietitian will help determine how much protein you need. Make sure that the protein you eat is high-quality. High-quality protein sources include meat, fish, poultry, and eggs. Milk contains high-quality protein, but it is also high in potassium and phosphorous. Grains and vegetables contain low-quality protein. You may need to limit your intake of these.
Sodium is found in table salt and many other foods. Most canned and processed foods contain high amounts. Because sodium is found in so many foods, it is easy to eat too much of it.
When the kidneys are not fully functioning, extra sodium can result in fluid retention and
high blood pressure.
Dialysis can help remove some of the extra sodium, but it does not remove all of it. Limit the amount of sodium in your diet. Do not add salt to foods while cooking or eating. If you want to add more flavor to your food, use herbs and spices. Salt substitutes contain potassium.
Potassium is found in many fruits and vegetables. It is a mineral that is essential for proper muscle functioning and heart rhythm. When you have
kidney failure, potassium can build up in the blood. This could cause
While on dialysis, your potassium level will be closely monitored. You may need to restrict your intake. Foods high in potassium include potatoes, tomatoes, citrus fruits, avocados, bananas, and dried fruit. Try to choose low-potassium foods. You may still be able to eat your favorite high-potassium foods if you limit them to a very small portion size. Your dietitian can help with this.
Phosphorous is another mineral that needs to be limited on this diet. If phosphorous builds up in the blood, it can draw calcium out of the bones. This causes your bones to weaken. Phosphorous is found in protein-rich foods. Examples include dairy products, meat, legumes, nuts, and seeds. Whole grains and cola also contain phosphorous. Your doctor may have you take a medicine called a phosphate-binder. This soaks up extra phosphorous and passes it out in your stool.
In peritoneal dialysis, fluid is added and later withdrawn from the peritoneal membrane. You may need to increase or decrease your fluid intake. This depends on the balance of fluid in your body. It is important to remember that many foods are made up of mostly fluid. Examples include fruits, soups, and dairy products. Consuming too much fluid can result in fluid retention. This can lead to increased blood pressure and edema.
The type of dialysis that you are having provides some extra calories from the dialysis solution. The sugar in this solution gets absorbed into the blood and can provide an extra 500 calories per day. This varies from person to person. In your case, you may still need to increase your caloric intake. Your dietician can help you with this.
This diet can vary a lot from one person to the next. Also, your needs may change over time. This depends on your kidney functioning and overall health status. A dietitian can create a meal plan that is right for you. Here are some general suggestions you can follow:
Avoid eating too much salt:
- Do not use the salt shaker.
- When cooking, use herbs and spices instead of salt.
- Do not use salt substitutes that contain potassium.
- Eat fresh foods instead of processed foods.
- Look for foods that say low-sodium on the label.
Monitor your fluid needs:
- Remember that many foods contain fluids.
- All foods that are liquid at room temperature are considered fluids. Examples include popsicles, ice cream, and Jell-O.
- If you limit your salt intake, you will also reduce thirst.
Be aware of how much food you are eating:
- Read food labels for portion size information.
- When first becoming familiar with portion sizes, use measuring cups or scales.
Cook at home more often:
- Restaurant food is generally high in sodium and fat.
- Cooking at home will give you control of the ingredients.
Monitor your calorie needs. You may need to increase or decrease how many calories you consume. Consider asking your dietician for recipes for people on dialysis.
Nutrition and peritoneal dialysis. National Kidney Foundation website. Available at:
http://www.kidney.org/atoz/content/nutripd.cfm. Accessed February 14, 2013.
The peritoneal dialysis diet. DaVita website. Available at:
http://www.davita.com/kidney-disease/diet-and-nutrition/diet-basics/the-peritoneal-dialysis-diet/e/5315. Accessed February 14, 2013.
Understanding the perioneal dialysis diet. American Association of Kidney Patients website. Available at:
http://www.aakp.org/education/resourcelibrary/dialysis-resources/item/understanding-the-peritoneal-dialysis-diet.html?category_id=5. Accessed February 14, 2013.
Last reviewed March 2014 by Dianne Scheinberg Rishikof MS, RD, LDN
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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