If you are undergoing peritoneal dialysis (PD), your protein requirements will be increased due to dialysis related protein losses, elevated energy expenditure and persistent inflammation. Based on KDOQI (Kidney Disease Outcomes Quality Initiative) Clinical Practice Guideline for Nutrition, the protein needs are up to 1.0 - 1.2g protein per kilogram body weight per day.

For instance, for a 65kg person who is undergoing peritoneal dialysis, the daily protein requirements are 65 – 78g protein per day. Hence, your daily protein intake varies depending on your body weight. If you are unsure of the exact amount or portion of protein you should be consuming, it is recommended that you consult your dietitian to get a diet plan.

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If you are undergoing peritoneal dialysis (PD), there is usually no need for you to restrict your potassium intake, unless your blood potassium level is not within the ideal range.

On the other hand, if you are undergoing PD, you may have a higher risk of hypokalaemia (low blood potassium levels). This is because peritoneal dialysis is performed daily, reducing the likelihood of potassium build-up overtime. With PD, you may also be experiencing poorer or reduced appetite, which may lead to low intake of foods with potassium content. In addition, side effects of PD may include diarrhoea and usage of medications, which could also affect potassium levels in your body

Peritoneal dialysis (PD) will help to remove some but not all of the excess phosphorus from your blood. While undergoing peritoneal dialysis, you may also need to consume more protein foods, which are usually high in phosphorus.

Your doctor may prescribe you with phosphate binders, which are medications that help to reduce the amount of phosphorus absorbed by your body from the foods you eat. This is to prevent a build-up of phosphorus in your blood which may lead to weak and brittle bones, increasing the risk of breakage. Take them as suggested by your doctor or dietitian.

If your blood phosphorus level remains within the recommended range, no restriction is needed but you are encouraged to adjust your daily food intake to maintain your phosphorus level within the recommended range. However, if your blood phosphorus level increases progressively or is persistently high even after treatment and medication, phosphorus restriction may be needed. When following a low phosphorus diet, aim to keep your phosphorus intake to 800 – 1,000 mg per day. Some tips to help you achieve this include limiting your intake of processed foods with phosphorus-based additives, and preparing home-cooked meals by using fresh ingredients.

Peritoneal dialysis (PD) removes waste products, excess fluids and sodium, and it is done daily compared to haemodialysis. However, it is still important to control your sodium intake as excess sodium will affect:

• Blood pressure

• Thirst

• Weight gain due to fluid retention

For CKD patients on dialysis, it is recommended to limit sodium intake to less than 2,300mg per day to reduce blood pressure, improve volume control and achieve desirable body weight.

Sodium is found in a variety of foods other than table salt. Other sources of sodium include:

• Commercial condiments and seasonings such as sauces, gravy mix/granules, bouillon cubes or liquid stock, ready-made pastes, ketchup, flavoured salts (i.e garlic, onion salt)

• Processed foods such as cold-cuts, sausages, cheese, canned foods, preserved foods (i.e salted fish, anchovies), smoked/cured foods, instant noodles, canned/instant soups, savoury snacks and pastries, microwaveable or ready-to-eat meals, fast-food

• Sports or isotonic drinks, packaged vegetable juice

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Peritoneal dialysis (PD) removes waste products, excess fluids and sodium, and it is done daily compared to haemodialysis. Even so, it is still important to know your fluid allowances and keep track of your fluid intake. The dextrose solution used in PD to remove fluids can vary in concentrations, whereby higher concentrations remove more fluids.

Taking too much fluids can result in fluid retention and symptoms such as:

• Swelling in your face, arms and legs

• Weight gain

• Increased blood pressure

• Shortness of breath (due to fluid build-up in the lungs) and consequent lung infections

• Heart failure (due to weakened heart muscles and/or enlarged heart)

Yet, not consuming adequate fluids can instead lead to dehydration. How much fluids you need while on PD depends on factors such as your weight changes, blood pressure, the amount of excess fluid that is removed by PD and signs of fluid retention. Speak with your physician, PD nurse or dietitian to understand your body’s fluid balance and how much you should be taking each day.

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