Peritoneal Dialysis Nutrition

    The goal of peritoneal dialysis nutrition therapy is to maintain nutritional status, replace albumin, minimize complications of fluid imbalance, minimize symptoms of uremic toxicity, and minimize metabolic disorders. Compared to hemodialysis, energy needs are lower with peritoneal dialysis. Approximately 60% of the dextrose is absorbed and should be considered an energy source, hence less energy from nutrients is needed. Peritoneal dialysis patients are at risk for deficiencies of water-soluble vitamins and minerals. These vitamin and mineral supplements are recommended, including folic acid and vitamin D. 

    Protein needs are higher for peritoneal dialysis. During PD, protein losses are from 20-30 g/day. It is recommended to monitor serum blood urea nitrogen and creatinine levels, uremic symptoms, and weight. Protein shakes are specially made for patients who are on peritoneal dialysis to ensure adequate nutrition. Sodium, potassium, and fluid are not restricted on peritoneal dialysis in comparison with hemodialysis. 

    Phosphorus should be restricted to prevent osteodystrophy. Phosphate binders can be used in order to provide adequate nutrition. Phosphate binders are simple molecules that react with phosphate and form an insoluble compound. Calcium supplements may also be necessary since dairy products are restricted due to phosphorus. 

    When patients who are on peritoneal dialysis also have diabetes more monitoring is needed. Blood glucose and serum lipid levels are more difficult to control. Weight gain is more common and patients tend to become dehydrated. In order to prevent this, ongoing nutritional assessment should be followed with patients. 


Sources: 

Mancino, J. (Presenter). (2021, April 8). Chapter 14 Liver, GB, Pancreas Chapter
     18 Nutrition for Diseases of the Kidney. Lecture presented at Duquesne
     University, Fisher Hall, Pittsburgh, PA, United States.

Patient Manual [Leaflet]. (2019). Dialysis Clinic, Inc.

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