Renal Diet for PD Patients Flashcards
Why do PD patients new to dialysis experience poor appetite?
Patients new to dialysis may have difficulty eating and getting enough calories due to feeling full and the increase of dextrose in the solution.
Eating smaller meals five or six times a day can provide the needed calories during the first weeks on dialysis.
Sometimes eating one to two hours after an exchange is also helpful.
Over time many patients gain weight on peritoneal dialysis.
Due to the dextrose, some patients may experience an increase in weight but are deficient in protein intake.
Why do PD patients experience protein losses and what can be done for them?
The body needs adequate nutrients, such as protein, to fight infection.
During the process of peritoneal dialysis, protein is lost through diffusion.
The amount lost can vary from patient to patient. But on average, is between 5-15 g during each 24 hour period.
Eating a diet higher in protein, with small, frequent protein snacks, or taking a protein supplement can replace these losses.
If the patient has peritonitis, protein losses can be 50-100% greater than normal.
During episodes of peritonitis, the already protein depleted patient may become further malnourished.
Patients who are malnourished are more at risk for infections due to a suppressed immune system placing the patient at higher risk for acquiring further infections.
Patients with low blood protein levels have a higher morbidity (hospitalization) and mortality (death) rate.
What does serum albumin levels tell us?
Albumin levels are one measure of nutritional status and are normally included in monthly blood tests. PD patients, who are well dialyzed and eating satisfactorily, should have a serum albumin in the normal ranges, certainly above 3.8g/dl and preferably 4.0g/dl or above.
Patients who are nutritionally deprived may run lower than 3.0g/dl and will need nutritional support.
Low albumin levels are predictive of higher risks of infection, morbidity and mortality along with overall poor quality of life.
