Dietary restrictions for Peritoneal Dialysis

Dietary restrictions for Peritoneal Dialysis

What dietary restrictions are required for PD?

In general, there are fewer dietary restrictions for patients on PD than there are for those on thrice-weekly HD because of the continuous nature of PD as a RRT. Patients on PD can be allowed a reasonably liberal intake of potassium. Conversely, unrestricted sodium and water intake should be discouraged unless the patient has an excellent urine output and little need for high-concentration dextrose PD solutions. Chronic exposure to consistently high dextrose–containing PD solutions may contribute to the development of hypokalemia, adverse changes to the peritoneal membrane, and weight gain by the patient.

KDOQI recommends that all patients with ESKD on RRT be encouraged to ingest a diet high in protein, particularly protein with high biologic value. This helps offset the catabolic effects of dialysis related to HD and amino acids and/or protein lost in the spent hemodialysate or peritoneal dialysate. Approximately 5 to 15 g of protein can be lost in PD effluent over a 24-hour period, highlighting the importance of a recommended intake of 1.2 to 1.3 g/kg per day of dietary protein.

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