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Eating well on Peritoneal Dialysis

Date issued: April 2023

Review date: April 2025

Ref: C-238/Dietetics/CT/Eating well on pertional dialysis v6

PDF:  Eating well on Peritoneal dialysis final April 2023 v6.pdf [pdf] 246KB

Eating well on Peritoneal Dialysis

Dialysis is used to help remove waste products from your blood, but it is less effective than healthy kidneys at removing them completely. You will be advised on whether you need to make some changes to your diet to help keep the wastes (such as potassium and phosphate) in your blood at a safe level.

Potassium:  If you are following a low potassium diet your dietitian will advise you on whether it is safe to relax this now you have started dialysis.

Phosphate:  You may already be following a low phosphate diet or take a phosphate binder (e.g. Calcichew, Sevelamer, Renacet) to help control your phosphate level

Your diet may need to change as your kidney function, blood results or medications change. Remember that every patient is different and the advice you are given is individual to you.

Eating well on peritoneal dialysis can:

  • Help you maintain a healthy weight and keep well

  • Replace protein that is lost during dialysis

  • Reduce the risk of fluid retention/becoming fluid overloaded

  • Help keep the levels of waste products within a safe range

Your blood results

Your bloods are usually checked at least once per month, and you can ask one of the dialysis nurses or the dietitian about your potassium and phosphate levels. 

If you have access to a computer, you can monitor your blood results using “Patients Know Best” (PKB).  Visit the website www.patientsknowbest.com/renal to register. Once you have registered, email the renal secretaries plh-tr.renaladmin@nhs.net who will add your data onto your PKB account. 

How can I eat well on peritoneal dialysis?

  1. Eat regular meals

Dialysis is a tiring process. Eating regularly will help keep your energy levels up and keep you feeling well.  If your appetite is poor, try eating small meals/snacks throughout the day and choose high calorie foods.

  1. Eat enough protein

Protein is needed for muscle growth, wound healing and fighting off infections. Unfortunately, a small amount of protein is lost from your blood during dialysis and so it is important to include enough protein rich foods in your diet as follows:

source of protein

Try to include a source of protein at each meal

Choose high protein snacks






Lentils, reduced salt baked beans, pulses

Tofu, soya, Quorn®


Unsalted nuts, nut butter

Cheese portions

Boiled eggs


Cereal bars or flapjacks with added protein

For example, a sandwich or egg/cheese/fish on toast for lunch will be much higher in protein than a soup and slice of bread.

Try to select more fresh foods rather than processed varieties, which tend to be high in salt and additives


If you get peritonitis you will need to eat even more protein to replace the extra protein you will be losing from your body. You may need high protein supplement drinks to help you, particularly if your appetite is poor.

  1. Manage your fluid intake

When you first start dialysis you may be passing plenty of urine. However over time you may pass less, or stop passing urine altogether.

The less urine you pass, the smaller the volume of fluid you will be able to drink without becoming fluid overloaded. 

Being fluid overloaded may result in damage to your heart and lungs and can cause the following side effects:

  • Shortness of breath                           

  • Raised blood pressure

  • Swollen ankles and feet

  • Puffy eyelids and face

  • Rapid increases in weight

Your peritoneal dialysis nurses will advise on how much fluid you should drink each day.

In general it is better to control your fluid balance by reducing your fluid intake rather than relying on “stronger” glucose peritoneal dialysis bags. The strongest bags have three times as many calories per bag (as many calories as a large slice of cake!) as the weak bags. This may make it more difficult to manage your body weight and your blood glucose levels if you have diabetes.

  1. Reduce your salt intake

Too much salt in your diet can make you thirsty, and so it will be more difficult to keep your fluid intake low. You can reduce your salt intake by limiting salt in cooking, not adding salt at the table and swapping to lower salt foods:

high - low salt

High in salt

Lower salt alternative

Cured, smoked or tinned meat and fish e.g. bacon, ham, anchovies, tinned fish in brine

Fresh, unprocessed meat and fish

Tinned fish in oil or spring water

Cook-in sauces

Seasonings and marinades

Table sauces e.g. soy, ketchup

Vinegar, lemon juice

Herbs and spices

Tomato puree

Salted or roasted nuts, crisps and cheese flavoured snacks

Unsalted popcorn and nuts, rice cakes, plain breadsticks

Tinned foods

Ready meals

Check traffic light labels for “green” or  “amber” options

Stock cubes and gravy granules

Choose “reduced salt” varieties

Salt substitutes, such as “Lo-Salt®” or “Saxa So Low®”, should be avoided as these are high in potassium.

  1. Eat enough fibre

Constipation can affect how well your dialysis works.  Eating enough fibre will help you open your bowels regularly.  Good sources of fibre include:

  • High fibre cereals e.g., Weetabix®, porridge, bran

  • Wholemeal or seeded bread

  • Brown rice and pasta

  • Ryvita®, oat cakes, digestive biscuits

  • Fruit and vegetables

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