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Eating & Nutrition for Peritoneal Dialysis

How does what I eat and drink affect me while on peritoneal dialysis?

Your choices about what to eat and drink while on dialysis can affect how you feel and how well your treatments work.

Healthy kidneys balance the salts and minerals—such as calcium, phosphorus, sodium, and potassium—in your blood. Peritoneal dialysis removes wastes and extra fluid from your body but doesn’t maintain a perfect balance.

The eating plan for peritoneal dialysis may be less strict than the one for hemodialysis. Because you do peritoneal dialysis every day, there is less time for wastes and extra fluids to build up between treatments than between hemodialysis treatments.

How can I learn what I should eat?

Talk with a dietitian at your dialysis center to plan your meals. Renal dietitians have special training in caring for the food and nutrition needs of people with kidney disease. Your dietitian will help you choose foods that you enjoy while also meeting your health needs.

The information on this page can help you learn how to eat right to feel right on peritoneal dialysis. Print the Tips for Eating Right with Kidney Failure (PDF, 94.1 KB) and take it with you next time you meet with your dietitian.

Dietitian talking to couple.
Meet with a dietitian to create an eating plan that will work well for you.

Why should I limit how much liquid I eat or drink?

You may feel better if you limit how much liquid you eat and drink. Too much fluid can build up in your body and may cause

  • swelling and weight gain between dialysis treatments
  • changes in your blood pressure
  • your heart to work harder, which can lead to serious heart trouble
  • fluid buildup in your lungs, making it hard to breathe

Your dietitian can help you figure out how much liquid is right for you. Your nephrologist can change your dialysis prescription.

Which foods count as liquid and why?

Foods that are liquid at room temperature, such as soup, contain water. Gelatin, pudding, ice cream, and other foods that include a lot of liquid in the recipe also count. Some fruits and vegetables, such as watermelon, contain a lot of water. When you add up how much liquid you have in a day, be sure to count these foods.

Bowl of chicken soup.
Most foods that are liquid at room temperature contain water.

Set daily goals for liquids

Work with your dietitian to set a goal for how much liquid you can have each day. Keep track of the fluids that you eat and drink. I can have a total of ________ ounces of liquid each day.

Daily plan:

I can have _____ ounces of ______________ with breakfast.

I can have _____ ounces of ______________ in the morning.

I can have _____ ounces of ______________ with lunch.

I can have _____ ounces of ______________ in the afternoon.

I can have _____ ounces of ______________ with supper.

I can have _____ ounces of ______________ in the evening.

TOTAL: _______ ounces. This number should equal the goal that you set with your dietitian.

What do I need to know about potassium?

Potassium helps your nerves and muscles work the right way. Healthy kidneys keep the right amount of potassium in your blood to keep your heart beating at a steady pace. Peritoneal dialysis can remove too much potassium from your blood, so you may need to eat more high-potassium foods such as bananas, oranges, potatoes, and tomatoes.

Eat the right amount of potassium

Your dietitian will help you choose foods you like that have the right amount of potassium. He or she will also give you more specific information about how much potassium is in different foods. Make a food plan that includes foods with potassium. Start by noting the high-potassium foods you eat.

Set daily potassium goals

I can have _____ serving size(s) of ______________.

I can have _____ serving size(s) of ______________.

I can have _____ serving size(s) of ______________.

What do I need to know about phosphorus?

Too much phosphorus in your blood may make your bones weak and likely to break. Too much phosphorus also may make your skin itch. Peritoneal dialysis may not remove enough phosphorus from your body, so you probably will need to limit foods, which are high in phosphorus.

You may need to take a phosphate binder to control the phosphorus in your blood. Common phosphate binders include sevelamer, calcium acetate, lanthanum carbonate, and calcium carbonate. These medicines bind to the phosphorus in food while in your intestines and keep it from being absorbed.

Limit phosphorus

Food makers often add phosphorus to processed and packaged foods, such as lunch meats. You should avoid these foods. Poultry, fish, nuts, peanut butter, dried beans, cola, tea, and dairy products are high in phosphorus.

Take phosphorus binders with your meals and snacks.

Your dietitian will give you more specific information about phosphorus and protein food portions.

  • Meat, poultry, and fish: A cooked portion should be about 3 ounces, or about the size of a deck of cards.
  • Dairy foods: Keep your portions to 1/2 cup of milk or yogurt, or one thin slice of cheese.
  • Beans and lentils: Portions should be about 1/2 cup of cooked beans or lentils.
  • Nuts: Keep your portions to about 1/4 cup of nuts.

I can have _____ serving size(s) of ____________________________.

I can have _____ serving size(s) of ____________________________.

I can have _____ serving size(s) of ____________________________.

Packaged foods may have added phosphorus. Look for phosphorus, or for words with “phos,” on food labels. Choose a different food when the ingredient list has words with “phos.”

Ingredients:

Potatoes, Vegetable Oil (Partially Hydrogen Soybean Oil), Salt, Dextrose, Disodium Dihydrogen Pyrophosphate...

What do I need to know about protein?

Dietitians encourage most people on peritoneal dialysis to eat high-quality protein because it produces less waste, which has to be removed during dialysis. High-quality protein comes from meat, poultry, fish, and eggs. Avoid processed meats such as hot dogs and canned chili, which have high amounts of sodium and phosphorus.

Fish, beef, chicken, eggs.
Dietitians encourage most people on peritoneal dialysis to eat high-quality protein.

Eat the right amount of high-quality protein

Try to choose lean, or low-fat, meats that also are low in phosphorus, such as chicken, fish, or roast beef. If you’re a vegetarian, ask about other ways to get protein.

Low-fat milk is a good source of protein. However, milk is high in phosphorus and also adds to your liquid intake. Talk to your dietitian about how to choose the right combination of protein foods for you.

I can have _____ serving size(s) of ______________________.

I can have _____ serving size(s) of ______________________.

I can have _____ serving size(s) of ______________________.

If milk is in my food plan, I will drink ______ ounce(s) of milk a day.

What do I need to know about sodium?

Sodium is a part of salt. Sodium is found in many canned, packaged, frozen, and fast foods. Sodium is also found in many condiments, such as mustard and ketchup, and in seasonings and meats. Too much sodium makes you thirsty, which makes you drink more liquid.

Dried herbs and spice jars.
Talk with your dietitian about spices you can use to flavor your food.

Limit sodium

To limit sodium, try to eat fresh, naturally low-sodium foods. Buy fresh foods more often; cook from scratch; and use spices, herbs, and salt-free seasonings instead of salt. Look for products labeled “low sodium.” Rinse canned foods to remove salt. Talk with your dietitian about spices you can use to flavor your food. Your dietitian can help you find spice blends without sodium. List them here

Instead of _________, I can use this spice _________.

Instead of _________, I can use this spice _________.

Instead of _________, I can use this spice _________.

Instead of _________, I can eat _________.

Instead of _________, I can eat _________.

What do I need to know about calories?

All foods provide energy measured in calories. Some foods, such as oily and sugary foods, are high in calories. Your body can absorb the dextrose from your dialysis solution, which can increase your calorie intake. Taking in more calories than you use can make you gain weight over time. You may find that you need to take in fewer calories to prevent weight gain. Your dietitian can help you create and follow an eating plan to stay at a healthy weight.

Read about food portions.

Should I take vitamin and mineral supplements?

You may not get enough vitamins and minerals because you have to avoid some foods. Peritoneal dialysis also removes some vitamins from your body. Your health care provider may prescribe a vitamin and mineral supplement designed specifically for people with kidney failure.

Warning: Never take vitamin and mineral supplements you can buy over the counter (OTC). OTC vitamin and mineral supplements may be harmful to people with kidney failure. For safety reasons, talk with your health care provider before taking any medicines, vitamin and mineral supplements, or probiotics that he or she hasn’t prescribed for you.

Woman talking with pharmacist.
Talk with your health care provider before using probiotics, dietary supplements, or medicines.
August 2018
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.