Nutrition & Peritoneal Dialysis

  1. Living with Kidney Disease
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  3. Nutrition & Peritoneal Dialysis

Nutrition & Peritoneal Dialysis

When you have chronic kidney disease, nutrition is an important part of your treatment plan.

Your Dietitian will help you plan your meals with the right foods and in the right amounts. Nutrients affecting the kidneys at this stage are:

  • Protein
  • Sodium
  • Potassium
  • Phosphorus
  • Vitamins

Renal Dietitian

Your doctor or renal dietitian will monitor your blood work. If any changes are required to your diet, a renal dietitian will work with you to develop a meal plan that will fit within your cultural and lifestyle needs. It is important to remember that dietary changes may vary among people with kidney disease.

Please note that the following information applies to those using daily peritoneal dialysis as recommended by their nephrologist.

Some protein is removed from your body during each PD exchange. Adequate protein should be eaten when you are on dialysis.

Protein is found in many foods, but is higher in:

  • Tofu
  • Dried peas, beans and lentils
  • Nuts and nut butters
  • Eggs
  • Cheese
  • Fish and seafood
  • Poultry (chicken, turkey and duck)
  • Red meat

Eating the right amount of protein will help to:

  • Build muscles and repair body tissues
  • Fight infections and helps with healing
  • Prevent wastes from building up in your blood

Note: Cheese and processed meats are high in phosphorus and should be limited.  Try to include plant proteins such as tofu, dried peas, beans and lentils.

Limiting sodium to 2300 mg or less (about 1 teaspoon of salt) per day:

  • Helps reduce fluid build up in the body (swelling of the ankles, fingers and eyes)
  • Helps control blood pressure within normal ranges

Sodium is a mineral and is found in most foods, but is especially high in:

  • Table salt and sea salt
  • Salty seasonings (e.g. soy sauce, teriyaki sauce, garlic salt and seasoning salt)
  • Most canned foods and some frozen foods
  • Processed meats (e.g. ham, bacon, sausage and cold cuts)
  • Salted snack foods (e.g. chips, crackers and pickles)
  • Most restaurant and take-out foods
  • Canned or dehydrated soups (e.g. packaged noodle soup)

TIPS

  • Eat foods closest to their natural state (not processed)
  • Read food labels for the amount of sodium
  • Add flavour to your food. Try a dash of:
    — Hot pepper sauce
    — Lemon juice
    — Vinegar
    — Fresh or dried herbs and spices
    — No-added salt blends (Mrs. Dash®, McCormick’s No Salt Added®)

Avoid: Salt substitutes (Half Salt®, Salt Free® or No-Salt®)

  • Potassium in your blood is removed with each PD exchange
  • Potassium is not restricted in your diet unless the level of potassium in your blood is high
  • Also known as phosphate is a mineral that works with calcium to form strong bones and teeth

In the later stages of kidney disease, phosphorus starts to build up in your blood. Calcium is then pulled from your bones into your blood. This causes serious problems like:

  • Damage to the heart and other organs
  • Poor blood circulation
  • Bone pain and weakness
  • Skin sores

Phosphorus is found in most foods. Large amounts are found in:

  • Dairy products (milk, cheese, pudding, yogurt and ice cream)
  • Other beverages (colas, beer and cocoa)
  • Chocolate
  • Seasoned meats and processed/convenience foods
  • Baking powder

Your dietitian will discuss ways to help you lower your phosphorus intake. Your doctor may prescribe a phosphate binding medication to be taken just before meals to help control the level in your blood.

TIPS

  • Check the ingredient list of packaged food for phosphate containing food additives.
  • Include fruits and vegetables as they are lower in phosphorus
  • When your diet is limited, you may need to take a special vitamin pill made for people with kidney disease
  • Do not take over-the-counter vitamins
  • Do not take over-the-counter Vitamin D or calcium pills unless recommended by your kidney doctor
  • Check with your kidney doctor and/or pharmacist about herbal medications.

Fluid intake may or may not be limited and will depend on:

  • Your 24-hour urine volume collection
  • If you have fluid build up (hands, leg, feet, chest)
  • Comes from the foods you eat
  • Eating the correct amount of calories helps to give you energy (your dietitian will help you with this)
  • With peritoneal dialysis, your body will absorb some of the calories from the peritoneal dialysis solution (Dianeal). These extra calories may result in weight gain and increased blood sugars. Blood sugars may need to be checked more closely when you have diabetes.
  • Provide energy and are part of a healthy diet

TIPS

  • Include a small amount (30-45 ml or 2-3 tbsp) of unsaturated fat each day. This includes oil used for cooking, salad dressings, margarine and mayonnaise
  • Use vegetables oils such as canola, olive and soybean
  • Choose soft margarines that are low in saturated and trans fats (look for labels that say non-hydrogenated)
  • Limit butter, hard margarines, lard, shortening, fried and deep fried foods
  • Include lean meat and meat alternatives by consuming a portion between 2-3 ounces (about the size of a deck of cards), two to three times per day

Comparing Diets – No Restrictions vs. Kidney Friendly

MEALNO DIET RESTRICTIONSLOW: SALT, POTASSIUM,
PHOSPHORUS & PROTEIN
BREAKFASTOrange juice
Bran cereal
Milk
Coffee with milk		½ cup canned fruit/fresh
Rice Krispies®
½ cup of milk
1 boiled egg
1 slice white/rye toast with peanut butter
Coffee
LUNCHCanned Pea soup
Bologna sandwich
Salad (lettuce, tomato, cucumber, celery)
Banana
Milk		Homemade low-salt soup
Unsalted crackers
Roast beef sandwich (2-3 ounces beef)
Salad (lettuce, cucumber and celery)
½ cup grapes
Water/hot beverage/non-cola soda
DINNERHam
Canned peas
Frozen fried potatoes
Orange
Milk		5-6 ounces pork roast
frozen or fresh peas
homemade potatoes/1 small baked potato
1 dinner roll, margarine
Peach
Water/hot beverage/non-cola soda

Kidney Friendly Recipes

Check out tons of kidney friendly cooking ideas from simple snacks to holiday dinner ideas modified for people living with CKD and/or on dialysis.

Learn More

Visit our Nutrition Tools page to download “Nutrition Guidelines for Peritoneal Dialysis”.