Question

what is the difference between peritoneal and hemodialysis? what are the nutrition recommendations for individuals with chronic kidney disease? how do these recommendations change once an individual with end stage renal disease begin dialysis?

Answer 1

INTRODUCTION

Dialysis means exchange of blood and to filter the blood to remove waste products and excess fluids used as a treatment for kidney failure.

Peritoneal dialysis means inside the abdominal cavity a cleansing fluid is circulated through a catheter. The dialysate absorbs waste products from blood vessels in the peritoneum and then is drawn back out of the body and discarded.

Hemodialysis means blood is pumped out of the body to an artificial kidney machine and returned to the body by tubes that connected to the machine.

DIFFERENCE BETWEEN HEMODIALYSIS AND PERITONEAL DIALYSIS

1. The main difference is in peritoneal dialysis the inside lining of our own belly acts as a natural filter but in hemodialysis, blood is pumped out of the body to an artificial kidney machine, and returned to the body by tubes that connected to the machine.

2. Peritoneal dialysis needs to be done multiple times in a single day. Hemodialysis may take a huge chunk of your day to complete but there are days when you don’t have to go through it at all.

3.Peritoneal dialysis has a more flexible schedule because we will be trained to administer the treatment at home, on our own schedule. Hemodialysis is usually done 3 times per week on a fairly set schedule.

4.Hemodialysis is typically done in a treatment center three times per week with each session lasting between four and five hours. By contrast, peritoneal dialysis can be done in the comfort of our home on our schedule.

NUTRITIONAL RECOMMENDATION FOR CHRONIC KIDNEY DISEASE

1. Limiting fluids,

2. Eating a low-protein

3. Limiting salt, potassium, phosphorous, and other electrolytes

4.Take enough calories if losing weight.

NUTRITIONAL RECOMMENDATION FOR END STAGE RENAL DISEASE

Nutritional status must be assessed in every patient with ESRD should receive a diet plan. ESRD patients on dialysis may spontaneously reduce protein and calorie intake as a result of uremic toxins, elevations in leptin and other cytokines, and delayed gastric emptying. If protein-calorie needs cannot be met with the usual diet, patients should be offered dietary supplements or, if necessary, tube feeding or parenteral nutrition.

ESRD patients should avoid high-sodium foods. Hypertension in dialysis patients is largely attributed to positive sodium balance and volume expansion

A high-potassium diet is desirable to control blood pressure and reduce risk for stroke. However, individuals with ESRD on hemodialysis cannot excrete potassium. Therefore, ESRD patients should be educated to avoid potassium rich foods.

The typical fluid allowance for patients on dialysis is 700-1000 mL/d, plus urine output.

Elevated blood phosphorus concentrations are associated with increased mortality in ESRD patients and increase the risk for cardiovascular events, at least in part by contributing to vascular calcification. So they should reduce phosphorus also.