Peritoneal dialysis

Protein and your peritoneal dialysis diet

As a peritoneal dialysis patient, your diet is different than other dialysis diets. One of the ways your diet differs from hemodialysis diets is that you may require more protein. Learn why you may require more protein, the best kind of protein to eat, how to ensure you are getting enough protein and how to manage your phosphorus intake.

Why do I have to eat so much protein just because I am on peritoneal dialysis?

Since you are on peritoneal dialysis (PD), you need to consume more protein than the average hemodialysis patient because you lose small amounts of protein every time you drain the dialysate from your abdomen.

Protein is important because it builds your body tissues, heals wounds, fights infections and prevents swelling by helping fluids to stay inside your blood vessels. To keep your body from breaking down its own tissues to get protein, you have to make sure to include plenty of high-protein foods in your daily diet.

What kinds of foods have the best protein in them?

It's important that most of the protein you eat is high-quality protein, a form of protein that is easy for your body to utilize. High-quality protein can be found in nutritional supplements and in foods that come from animals, such as:

Beef, pork, veal, lamb
Poultry
Fish, shellfish
Eggs, egg substitutes

It's important to note that while you want to make sure you are getting enough protein, it should be the right kind of protein. Foods such as soy beans, nuts, peanut butter, dried beans and dried peas offer you a lower quality of protein. These kinds of foods are also high in phosphorus, a mineral that you may be advised to limit in your diet.

What can I do to manage my phosphorus intake?

Phosphorus, a mineral found in the food you eat, is present in high quantities in meats, whole grain breads, processed foods, cola beverages and chocolate. Too much phosphorus in your diet can lead to bone and heart problems, bone pain, itching, and low blood calcium, among other things.

Here are some ways to manage your phosphorus intake:

Get all of the dialysis you are prescribed to get

Shortening or skipping dialysis treatments results in a buildup of phosphorus in your blood. This can be avoided by doing the full amount of dialysis your doctor has prescribed for you.

Take your phosphate-binding medication with every meal

Phosphate binders such as PhosLo®, Renagel®, Fosrenol® or TUMS® may be prescribed by your doctor and should be taken in the correct dose every time you eat. These medications bind to the phosphorus in your food to keep the phosphorus from entering your bloodstream.

Control the amount of high-phosphorus foods you eat

High-phosphorus foods that you may try to limit or avoid include cheese, dried beans, dried peas, liver, chocolate, nuts, peanut butter and cola beverages. In addition, you may need to limit your intake of dairy products and whole grain products.

How much high-quality protein should I eat?

Your dietitian will be able to help you decide how much high-quality protein you should eat during the day. Generally, you may want to aim to eat high-quality protein at every meal. You can also add protein into your diet throughout the day by choosing snack foods that are rich in high quality protein.

In order to keep up with how much protein you are eating, you can use a scale to weigh your food or you can estimate the amount of high-quality protein present in common serving sizes. This table can help you estimate:

1 ounce protein	2 ounces protein	3 ounces protein
1 egg Chicken wing ¼ cup chopped meat or fish ¼ cup cottage cheese ¼ cup egg substitute Ping pong ball-sized meatball	Chicken drumstick or thigh ½ cup cottage cheese or tuna Small pork chop	Piece of meat, poultry or fish the size of: A deck of cards A woman's palm A checkbook Medium pork chop or chicken breast 6 – 8 large shrimp

Protein supplements and powders are also a good way to add protein to your diet. They can be added to various foods in order to increase the amount of protein in your meals without increasing the amount of food you eat.

Summary

The peritoneal dialysis diet is different than other dialysis diets. One way that it is different is in regard to protein. More specifically, the peritoneal dialysis diet may require more protein than other dialysis diets. Talk with your doctor and dietitian for more information on your particular protein needs.