Peritoneal dialysis (PD) only became a common treatment for end stage renal disease in the 1980s. APD and CAPD are types of peritoneal dialysis (more info about peritoneal dialysis). It is usually a continuous or daily treatment, which means that diet is generally a little easier than it is for most patients on 3-times weekly haemodialysis.
Individual patients have different needs, so what is written here may not be exactly right for you. Renal dietitians will give advice according to your own blood test results and nutritional needs.
Patients on PD lose some protein into the PD fluid, and this may add up to quite a lot each day. A higher protein intake is often recommended, e.g. an intake of 1-1.2 g/kg ideal body weight each day. The amount lost varies from patient to patient as it can depend on your peritoneal membrane. There are increased losses during episodes of peritonitis.
As for all renal patients, avoiding excessive salt is important. Too much salt will raise blood pressure, cause fluid retention (fluid overload or oedema), and it will make you thirsty making it difficult to stick to any fluid restriction you may have. We recommend a 'no added salt' diet. Do not use salt substitutes e.g. to salt, these contain large amounts of potassium.
The frequent or continuous dialysis that patients on PD have generally means that potassium is usually easier to control than on haemodialysis. Many patients do not need to restrict potassium at all, and some may need to deliberately eat high potassium foods. However a small number of patients need to restrict their potassium.
Fluid (liquids including water)
You can normally drink an amount of fluid equal to the volume of urine that you pass over 24 hrs, plus 750ml. The amount of fluid removed by dialysis usually allows you more flexibility in the volume you can drink than haemodialysis, as the fluid is removed every day. This needs to be judged for you individually. If you eat too much salt, you will not be able to keep your fluid intake down and will accumulate fluid.
Eating a diet higher in protein means that your phosphate intake is higher so this can be challenging. Most patients need to follow a diertphosphate restriction, and need to take phosphate binders with food. The aim is to keep the phosphate level in the blood below 1.7mmol/l.
PD fluid contains sugar (glucose, also called dextrose), and some of this goes into the blood. It can contribute up to 500 calories per day in some patients. Some patients may therefore need to reduce the calories that they eat if body weight (BMI) is high. However under-nutrition can be a problem in dialysis patients, so advice on this depends on your own needs. This is around 30-35kcals/kg/ideal body weight.
Constipation can cause problems with peritoneal dialysis, so most patients are encouraged to eat enough fibre to keep things moving.
A healthy diet
All renal patients are at extra risk of developing heart disease. It is important to live and eat healthily, eating a varied diet and avoiding fatty foods.
Acknowledgements: The authors of this page were Elizabeth Sloan, Hazel Elliott and Susan Reed. It was first published in January 2001 and extensively revised in August 2006, then reviewed again by Susan Reed in August 2013. The date is was last modified is shown in the footer.