Meal Planning
Peritoneal Dialysis replaces some—but not nearly all—of your kidney function. In addition to your dialysis treatments, a key part of staying healthy is following the meal plan your dietitian sets up. Some people on PD have few limits and a normal or near-normal diet. Others will need to be more careful about food choice.
Your dietitian will work with you to help you make a meal plan that meets your health needs and includes as many as possible of your favorite foods. Kidney friendly cookbooks and recipes, as well as shopping tips, will be provided to keep your meals pleasant and interesting. The exact details will depend on whether you are still making some urine and on the results of your blood tests. Here are some parts of your diet that you’ll be learning about:
- Fluid – Your PD exchanges will remove some of the extra fluid in your body. You’ll be able to use the three strengths of PD dialysate to take off more or less fluid, based on your weight, blood pressure, and any swelling in your body. If your PD removes all your excess fluid (using mostly the lowest strength, 1.25% dialysate), you may not need a fluid limit. The need to use a lot of high-strength, 4.25% bags, or signs of fluid overload (weight gain, higher blood pressure, or swelling), will tell you that you will have to reduce your fluid intake. (Using the 4.25% solution can scar your peritoneum over time, so it’s best not to overdo your fluids.)
- Calories – Most PD fluid contains sugar to help pull water out of your blood. You may absorb some of the sugar and gain unwanted weight on PD. This means that you will need to increase your exercise or cut back on calories elsewhere in your meal plan. So, if you drink soda, for example, you may want to switch from regular to diet or to water. Your dietitian can guide you to make food choices that will help you reach a weight that is healthy for you.
- Protein – Foods with protein (beef, pork, chicken, fish, soy, and eggs) help your body build and repair tissues. On PD, you lose some protein with each exchange. So, it is important to be sure you eat the amount of protein your dietitian suggests. If your monthly blood tests for enPCR or albumin are low, your dietitian may suggest that you eat more protein from food, or even add a protein powder or liquid to your food.
- Potassium – Potassium is a mineral needed for normal heart rhythm and muscle function. It is very important to have levels of potassium in your blood in a safe range. (Too high or too low potassium levels can stop your heart.) PD allows you to have some dialysis most or all of the time, so excess potassium is being removed. For more information on controlling potassium in your diet, click here.
- Phosphorus – This mineral is needed to keep your bones strong. Healthy kidneys remove extra phosphorus, so even with PD; your levels may be too high. High phosphorus can damage your heart and blood vessels by making them stiff, and can weaken your bones. Your phosphorus levels will be checked during your monthly blood test. In most cases, people on PD will need to take phosphate binder medication. These pills, taken with meals and snacks, bind with phosphorus and remove it in your stool. Your dietitian will talk with you about whether or not you may also need to limit the amount of high-phosphorus foods that you eat. You can get more information in the Managing Your Diet section.
- Sodium – Salt contains sodium, which helps to control fluid levels in your body. If you eat too much salt, you’ll be thirsty and may drink too much fluid. This can lead to swelling and high blood pressure. For tips on controlling sodium, click here.
Eating well can help to keep you healthy. Not eating well will cause you to become weak as you break down your muscles for protein, and become malnourished. Malnutrition is linked to a higher risk of infection, hospitalization and even death. If changes occur in your taste or appetite, talk with your dietitian to make changes to your meal plan. Your dietitian will be happy to work with you to make a meal plan you can follow and enjoy.
