This patient was prescribed the following diet in the hospital: 1500 kcal, 75 g pro, 3000 mg Na, 3500 mg K, 1000 mg P, 2000 cc fluid Explain the rationale for each component of her nutrition therapy Rx

Question

How might this change once she has started peritoneal dialysis?

Answer 1

Nutrition therapy Rationale How it will change it with PD
1500 kcal To provide adequate energy to prevent malnutrition and protein wasting Will need to take into account kilocalories from dialysate
75 g protein To support protein synthesis, prevent protein malnutrition, and replace losses during hemodialysis PD will require more protein:
• ≥1.2-1.3 g/kg; ≥50% HBV
• Rationale: Dialysate protein losses of an average of 5-15 g/24 hr
3.5 g K To control serum levels since kidney cannot excrete 2000-4000 mg/day (not conflicting)
1 g phosphorus To control serum levels and prevent renal osteodystrophy Will not change
3 g Na To prevent thirst and excess fluid intake 2000-3000 mg/day (not conflicting)
2000 mL fluid To reduce weight gain between dialysis sessions No fluid restriction needed (maintain balance)