Potassium and Peritoneal dialysis
Potassium is a mineral which is important for the nerves and muscles function. Potassium is significantly removed during peritoneal dialysis. Thus, peritoneal dialysis patient may need to eat more potassium-rich foods. Signs and symptoms of low potassium are muscle cramps, difficulty breathing and irregular heart beat. Too low or high potassium can be dangerous, resulting in cardiac arrest. Be sure to speak with your dietitian about your potassium levels and which foods are best for you to have with your meals and snacks safely.
Low in phosphorus
As the kidneys become less effective at filtering waste products, blood phosphate level rises. When it begins to build up in the blood, calcium is drawn from the bone. The calcium phosphate product forms hard deposits in patient’s tissues leading to skin itchiness, joint pain, and eye irritation and hardens their blood vessels. Over time, patients’ bones become weak and brittle. This lead to fractures and constant pain.
Both haemodialysis and peritoneal dialysis patients need to control the amount of phosphate in their diet. Almost all patients with high phosphate levels will also need to take phosphate binders as most foods contain some amount of phosphate. Phosphate binders prevent the body from absorbing the phosphate from the foods eaten and thus helping to prevent renal bone disease.
Food rich in phosphorus that patients need to avoid when they have high serum phosphate level include:
- All sorts of seafood, sardines, anchovies (ikan bilis) and dried shrimp paste
- Processed food and canned food (e.g. canned meat or fish, sausage, meat patty)
- Dairy products (e.g. milk, cheese, yogurt)
- Bean products (e.g. all forms of nuts, seeds, bean soup)
- Malt drinks (e.g. Milo, Horlicks, Ovaltine)
- Oats, cereals
- Chocolate and related products
- Wholegrain and related products (e.g. wholemeal bread, brown rice, wholemeal noodles)
- Organ meats (e.g. liver, intestine)
- Bone-based soups (e.g. chicken feet and pork bone)
Read more about phosphate
Control in fluids
Dialysis patients can no longer excrete large quantities of fluid consumed; therefore, excess fluid can be retained in the body resulting in overloading of the blood circulation. Symptoms such as shortness of breath, high blood pressure and swelling of the legs can occur. Thus, both peritoneal dialysis and haemodialysis patients will need to consider urine output, remaining kidney function, and body size to restrict their fluid intake. Peritoneal dialysis patients will also need to see how much fluid is removed during an exchange.
Daily allowance for fluid intake can vary from 500 to 1000 ml per day, depending on the patient’s urine output. Limited urine output does not indicate dehydration in dialysis patients. However, it is an indication of further deterioration of kidney functions.
Your daily fluid allowance includes plain water, tea, coffee, milk, gravy, soup and porridge. Other fluids that are liquid at room temperature such as ice-cube, ice cream, jellies are considered as fluid too.
You can refer to Helpful Resources for fluid leaflet
Prevention of Anemia
Anemia is common among dialysis patients and it appears to be more common in those who suffer from malnutrition or protein energy wasting. Symptoms of anemia include fatigue, weakness, dizziness, headache, low immunity, breathless or shortness of breath, chest pain, low appetite and pale.
Anemia of chronic kidney disease is one of the complications of kidney failure. Its severity can be related to how well the kidney is functioning. The main reason of anemia happen among chronic disease patients is reduced production of erythropoietin (EPO) by the kidney. EPO prompts the bone marrow to make red blood cells. When the kidney’s function is decreasing, the amount of EPO produced will be reduced. Other factors that cause anemia among dialysis patients are:
Reduced red blood cell lifespan due to accumulated urea toxic
- Lack of iron
- Lack of folate and other vitamins
- Blood loss during haemodialysis
Adequate intake of protein, iron, vitamin C, vitamin B 12 and folate are important in preventing and treating anemia as these nutrients are the important elements in making new red blood cells.
*The above information and recommendations are general guidelines, and should not be viewed as specific advice for any individual. Please consult your physician or other health care advisors for personal health decisions.