Choosing The Right Treatment
Benefits of Home Dialysis
Home Dialysis FAQ's
Children's Home Peritoneal Dialysis
Working While On Dialysis
Diet & Nutrition
Diet and Nutrition
IF YOU ARE CONSIDERING HOME DIALYSIS, one of the
things you might want to think about is diet. This page
will briefly review the types of home dialysis and the
best diet for each type. There are two types of
peritoneal dialysis (PD): continuous ambulatory
peritoneal dialysis (CAPD) and continuous cycling
peritoneal dialysis (CCPD) or automated peritoneal
dialysis (APD). There are also three types of home
hemodialysis: conventional home hemodialysis, daily home
hemodialysis and nocturnal home hemodialysis.
PD uses the lining of your abdomen, called the
peritoneum, to filter fluid and wastes out of your
blood. About two liters of fluid, called dialysate, is
placed into the peritoneal cavity (belly) through an
abdominal catheter and allowed to remain for a period of
time. During this time wastes and extra fluids travel
from the body into the dialysis solution and are then
removed when the solution is drained. This process,
called an exchange, is done several times a day. It can
be done manually using gravity (CAPD) or with a machine
(CCPD or APD) called a cycler that typically does the
exchanges while you sleep.
Both CAPD and CCPD have the same diet restrictions.
During PD, protein and waste products are lost with each
exchange, so protein needs to be replaced. The high
protein diet is needed to build, maintain and repair
body tissues. High-quality protein such as eggs,
chicken, fish and lean red meats should be eaten at each
Potassium, a mineral in many foods, is more liberal
or less strict in PD compared to in-center hemodialysis
(HD). In PD, potassium leaves the body and needs to be
replaced daily. Too much or too little potassium in your
body can be dangerous and harmful to your heart.
Although potassium is found in salt substitutes, fruits
and vegetables, milk, meat, chocolate and nuts, fruits
and vegetables are the best choices for keeping
potassium in the normal range.
Many on PD are able to eat an orange, half of a
banana or one tomato daily to keep their potassium in
normal range. Milk, chocolate and nuts are high in
phosphorus and salt substitutes are not recommended.
For people on PD, fluids and sodium restrictions are
more liberal. Moderate intake of fluid can help improve
dialysis and flush out wastes. Sodium, a mineral that
can affect your blood pressure, is found in table salt,
canned foods and processed, pickled and cured foods. It
is usually best to limit table salt and salty foods to
prevent too much fluid weight gain, which can cause high
blood pressure and heart trouble. Phosphorus, a
mineral found in milk, cheese, nuts, dried beans,
lentils, peas and corn products,
is limited in PD.
You need to take phosphate binders with each
meal to remove phosphorus from foods eaten.
Calories give your body energy. Most of your calories
come from the foods you eat, but with PD the sugar in
the dialysate gives you more calories. Your body takes
in the sugar and can cause weight gain. Conventional
home HD, similar to in-center HD, is done three times a
week but at home. The diet, equivalent to in-center HD,
is limited in terms of one’s intake of sodium,
potassium, phosphorus and fluids.
Daily home HD consists of two to three-hour
treatments done five to six days a week totaling about
12 hours of dialysis per week. Since daily home HD is
done more often, more toxins and fluid are removed.
Those on daily home HD have increased energy levels and
decreased use of blood pressure medications. Phosphorus,
potassium, sodium and fluid restrictions are more
liberal than in-center HD.
In nocturnal home HD, treatment is done eight to 10
hours during the night, six to seven nights a week. One
of the benefits of nocturnal home HD is there are
almost no dietary restrictions. Because
phosphorus removal is improved, many people can stop
taking phosphate binders and are encouraged to eat more
phosphate and dairy products. Since dialysis is done
nightly, there is usually no fluid, sodium and potassium
restriction. Appetite is also improved due to better and
frequent removal of toxins and wastes.
The five types of home dialysis have different
dietary considerations to think about. Whatever type of
home dialysis you choose, your health care team will
continue to be available and serve as a valuable asset