Nutrition for Your Child on Peritoneal Dialysis

Calories give your child energy to grow, think, run, jump, and play. If your child’s weight is normal for their height, your child is getting enough calories. If their weight is too low, your child needs more calories. If their weight is too high, your child needs fewer calories.

Protein helps your child grow, build muscles, and repair tissues (like healing a cut in the skin). When your child is on peritoneal dialysis, they need more protein than before.

Make sure to include high-protein food at each meal. To learn more about protein foods, read our handout “Protein” at seattlechildrens.org/pdf/PE277.pdf.

Vegetarian protein-rich foods like soy, tofu, beans, lentils, quinoa, amaranth, mung beans, and eggs can help your child get enough protein.

When your child’s kidneys do not work, the amount of phosphorus in their blood goes up. This causes your child’s bones to weaken and break easily. Calcium helps to keep your child’s bones strong, so it is very important for your child to eat the right amount of calcium and phosphorus.

There are 3 things you can do to balance your child’s phosphorus and calcium to keep their bones strong:

1. Limit your child to 1 or 2 servings of dairy foods each day. Your child may need to avoid milk, yogurt, and cheese if their phosphorus levels are not well controlled. You can substitute unfortified rice milk for regular milk. To learn more about phosphorus, visit seattlechildrens.org/pdf/PE237.pdf.
2. Give your child phosphate binders with each meal or snack if ordered by your child’s healthcare provider.
3. Give your child vitamin D each day if ordered by their doctor. A special type of vitamin D, called Calcitriol (also called Rocaltrol), is often needed by children on dialysis. Your child may also need another kind of vitamin D called cholecalciferol (kol-ee-kal-SIH-fur-ahl) or ergocalciferol (er-go-kal-SIH-fur-ahl) to help keep their bones strong.

Dialysis filters some of the vitamins your child needs. Your child will need to take a special “renal vitamin” (like Nephrovite or Nephronex) while they are on dialysis. Avoid giving your child a regular multivitamin-mineral supplement. Multivitamins that are not designed for children on dialysis are unsafe because they have more vitamin A than is safe for your child’s body.

You may have been told not to let your child eat a lot of foods that have potassium before they started dialysis. Now, your child may need to eat extra potassium while on peritoneal dialysis because dialysis may filter more potassium.

Your child may be taking erythropoietin (EPO) or darbepoetin to help make red blood cells. They also need iron to make red blood cells. If your child’s iron level is low, they will receive iron supplements. Eating high-iron foods also helps keep iron levels high. Some high-iron foods are: 

If your child has problems with high blood pressure or retaining fluids, they need to eat low-salt (low-sodium) foods. Your child’s dietitian will teach you how to eat a low-sodium diet if needed. To learn more about low sodium eating visit seattlechildrens.org/pdf/PE386.pdf.