Nutrition and Peritoneal Dialysis

An advantage to peritoneal dialysis over hemodialysis is fewer diet and fluid restrictions. Peritoneal dialysis involves removing dialysate (fluid, toxic substances and waste products) through the abdomen. Getting all your dialysis exchanges as ordered is important to your overall health and can also affect how well you eat.

Protein

Patients will need a high protein diet due to protein that is lost through the peritoneal membrane and from risk of infection. Increasing protein can help against infection and improve wound healing. Albumin is a type of protein measured in dialysis patients.

High Protein Foods

Serving Size
1 serving = 7 grams of protein
8 oz = 1 cup

Beef, pork, chicken, turkey or fish 1 oz
Egg 1
Egg whites or egg substitute 2 oz (¼ cup)
Tuna fish 2 oz (¼ cup)
Meatless vegetable burger 1
Tofu 2 oz (¼ cup)

Potassium

Levels may be normal to low because dialysis is done daily. However, each person is different. Talk with your dietitian on how much potassium is best for you.

Phosphorus

Phosphorous is not cleared well through PD. High protein foods are also high in phosphorous. Patients will need to take phosphorus binders as prescribed and may need to limit other foods high in phosphorous.

The most concentrated sources of phosphorus are dark colored carbonated beverages and commercial iced tea, followed by dairy products and some dried cooked beans. However, the phosphorus in dried cooked beans is less absorbed and seldom requires restriction when eaten as one protein serving per day. To restrict phosphorus, follow these guidelines:

High Phosphorus Foods

Serving Size
1 serving = 7 grams of protein
8 oz = 1 cup

Dairy products and milk substitutes
1 serving daily
2 oz (¼ cup) cheese
3 oz soy cheese
1½ cups ice cream
8 oz (1 cup) milk
8 oz (1 cup) yogurt

Dried cooked beans
1 serving daily

½ cup cooked
Note: Avoid dark carbonated sodas like colas, Pepsi, Dr. Pepper, Hires root beer and bottled or canned iced tea.

Sodium and fluid

Less restricted in peritoneal dialysis because dialysis is performed daily and sodium is easily cleared. Eating too much sodium can make you thirsty and cause your body to hold more fluid. High sodium foods to limit include:

  • convenience foods: frozen meals, canned or dehydrated soups, packaged entrees
  • processed meat and cheese: lunch meat, American-style cheese, cheese-based dips and spreads
  • fast foods: pizza, tacos, deluxe-type hamburgers, french fries
  • snack foods: chips, crackers, salted popcorn, pretzels
  • condiments such as: bottled salad dressing, soy sauce, seasoning salts (garlic salt, onion salt)

Calories

The dialysate (dialysis solution), contains a type of sugar called Dextrose. Weight gain can occur as the body absorbs some of the glucose from the dialysate. This extra sugar from the dialysis solution can increase in your blood sugar.

If you have diabetes you may need to eat more protein and fewer carbohydrates. You will also want to check your blood sugars regularly.

Speak to the registered dietitian at your dialysis center to make a diet that works for you.