Helping you live a better life on dialysis

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Gaining Weight

If you are on peritoneal dialysis (PD), the dextrose (sugar) in your PD fluid adds about 200 to 600 “empty” calories per day. You will stay healthier if you eat nutritious foods and make the rest of your calories count. And if you have diabetes, your insulin or diabetes pills may need to be adjusted after you start PD because of the sugar in the PD fluid.

If you are on in-center hemodialysis (HD), you may not have an appetite at first. After a few weeks on HD, your appetite should come back. If it does not, you may not be getting enough dialysis (speak to your dialysis healthcare team about the adequacy of your dialysis).

If you have diabetes, you need to keep a close eye on your weight and activity level—especially if you are using insulin.

Here are some tips to increase your appetite and get you the calories you need. Your dietitian can help you think of others. Choose the tips that you think may work for you:

  • Eat six small meals a day instead of three larger ones.
  • Take bigger portions of foods that you like and tolerate well.
  • If protein foods do not appeal to you right now, you can try them cold—like a chicken salad sandwich.
  • Choose high calorie foods, like meats and casseroles, instead of low calorie foods, like salads or broth.
  • Cook foods in a way that adds calories (like sautéing in oil that is low in saturated fat, like canola or olive oil).
  • Eat in a calm, relaxed atmosphere. Use a pretty plate or a colorful garnish so food is more appealing.
  • Drink fluids that have calories, instead of water, plain tea, or coffee.
  • Use tasteless protein powders or drinks to increase protein. (Protein drinks count as part of my fluid limit.)
  • Eat bland, light-colored foods at cool temperatures—like a turkey sandwich or pasta salad.
  • Choose foods that are easy to chew, like meatloaf, casseroles, or omelets, rather than steak.
  • Add extra calories to foods you already eat. Ask your dietitian about using olive oil, mayonnaise, low-salt salad dressings, sour cream, or butter. If you do not have diabetes, you can also use jelly, honey, syrup, non-dairy whipped topping, or other high calorie treats most people have to avoid.
  • Avoid foods with strong smells. Leave the room when food is cooked if smells bother you.
  • Drink your fluids after your meal, so they don’t fill you up.
  • Talk to your doctor about drugs to improve your appetite
  • Exercise to increase your appetite.

Content from Kidney School, a program of the Medical Education Institute, Inc.

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