醫療新知

Definition

When you start receiving peritoneal dialysis, you have not to restrain food intake strictly. You can have higher protein and potassium diet. Partial energy is from absorbed glucose from PD dialysate. Therefore, you should reduce the intake of carbohydrate to maintain appropriate weight. As to the standard of nutritional intake, physicians and dieticians will adjust it based on patients’ individual conditions.

 

Protein

Protein includes fish, meat, egg, milk, soybean milk, and soybean curd. Protein enhances growth, strengthens muscle, and repairs tissues. Protein in food is absorbed, utilized, and degraded into wastes that refer to urea. Urea can be cleaned up via dialysis but useful protein, albumin and amino acid, is also lost at the same time. If peritonitis happens, the amount of protein loss will increase substantially. Therefore, you must eat more protein during the first two weeks of infection. However, it may be difficult for patients to have adequate amount of protein because of poor appetite; dietician often provide patients with suggestions regarding sufficient protein supplement.

 

Calorie

Calorie is the unit of energy. If you ingest calories as the same as you consume, your body weight will maintain constant. During dialysis, glucose in dialysate is used to remove excessive water of body. Meanwhile, your body will absorb some glucose to retrieve energy. Hence, you must decrease the intake of energy from food or increase exercise to consume excessive energy if you wish to maintain ideal body weight.

 

Potassium

Potassium is the ion existing in the food. A normal kidney can eliminate excessive potassium in the body but end stage renal disease (ESRD) patients must eliminate potassium via dialysis. Continuous ambulatory peritoneal dialysis (CAPD) can persistently eliminate potassium, so serum potassium concentration is easier to control even with high potassium intake. Both high and low potassium levels put our life at stake. For patients with chronic hypokalemia, physicians will suggest them to intake supplement of high-potassium food that includes potassium salt, fresh fruits and vegetables, candied fruits, nuts, meats, and milk. When you eat this kind of high-potassium food, it is necessary to measure serum potassium concentration periodically.

 

Water and Salt

Salt is also the ion existing in the food. Because there is a close relationship between salt and water, it could affect blood pressure. Glucose concentration in dialysate decides how much amount of water to be removed. In other words, the denser the glucose is, the more fluid is removed and energy absorbed. Our physician will recommend appropriate glucose concentration to keep the balance of volume and blood pressure under control.

 

Phosphorus

Phosphorus is mineral which maintains the strength of bone with calcium. However, phosphorus cannot be appropriately removed via dialysis. Excessive phosphorus often have calcium released from bones easily, resulting in fragile bones. Because phosphorus exists within all food containing protein, it is hard to avoid the intake of phosphorus whenever you have food with protein. It is necessary to use phosphate binders containing calcium or aluminum salt with meals to control serum phosphate concentration. Phosphate binders prevent absorption of phosphorus and elimination of phosphorus via feces. Its side effect could trigger constipation; therefore, CAPD patients should eat fresh fruits and vegetables and high-fiber food to reduce the occurrence of constipation.