When you are established on peritoneal dialysis, it is important that you eat a healthy diet to get the maximum benefit from your treatment. The principles of a healthy diet on peritoneal dialysis (PD) are as follows:
It is important that you have a good protein intake whilst you are on peritoneal dialysis as some will be lost in your exchanges. Therefore, you need to eat enough protein to replace these losses.
Protein is essential for many functions in the body such as repair of your muscles, skin and other tissues. If you do not eat enough protein it will show as a low blood albumin (protein) level, muscle breakdown and weakness.
Protein rich foods include meat, fish, eggs, dairy products and pulses.
The dialysis fluid used in PD is normally a sugar solution, some of which is absorbed by the body. Too many calories absorbed this way may lead to undesirable weight gain. You may therefore need to reduce the fat and sugar containing foods in your diet e.g. butter, cakes, biscuits, pies and pasties.
As kidney function deteriorates many patients pass less urine over time. Fluid intake needs to be matched to the amount of fluid you can pass as urine. Drinking more than you can pass will result in fluid overload. Fluid overload can lead to shortness of breath, swollen ankles and it can put a strain on your heart. Your doctor or PD nurse will be able to tell you how much to drink to avoid these problems. The dietitian can suggest ways to help you manage your fluid restriction.
The more salt you eat in your diet, the thirstier you will feel. This can make it difficult for you to comply with a fluid restriction. Salt intake can also contribute to high blood pressure. It is therefore sensible to keep the salt in your food to a minimum. Foods that are high in salt include soup, salted crisps and salted nuts.
Fibre is important in preventing constipation which can reduce the effectiveness of your dialysis. Fibre is contained in whole grain products, pulses, fruit and vegetables.
In renal failure, the kidneys are unable to remove excess phosphate from the body. High levels of phosphate can lead to your bones being weakened and may affect your circulation.
A way of keeping phosphate levels normal is to take phosphate binders e.g. titralac, calcichew. These drugs bind to the phosphate in the food you eat in your stomach and prevent it from being absorbed into the bloodstream. Ideally, binders should be taken 10 – 15 minutes before a meal. Your dietitian can advise you further on this.
Potassium is a type of salt that builds up in the bloodstream in kidney failure. When you are established on PD, it is unlikely that potassium will build up to a high level because PD provides continuous dialysis. You should, therefore, not need to restrict potassium in your diet.
If you develop peritonitis you will lose more protein than usual into the PD fluid. You will need to eat more protein at this time to replace these losses. If you feel that you have lost your appetite, the dietitian will advise you on what to do.
You will be given individual advice about your diet during your PD training. The dietitian will give you practical advice on how to adapt your diet to follow these guidelines.
A dietitian is available in the PD clinic and will be happy to talk to you about any aspect of your diet that concerns you.