Peritoneal Dialysis

Group Assignment B1 – Pn.
Wan (CRRT)
1.) Cheah Chui Fen -A158813
2.) Wani Aqilah-
3.) Mahirah-
4.) Aleesa-
Peritoneal Dialysis
There are 2 types of peritoneal dialysis treatment –
i.) continuous ambulatory peritoneal dialysis (CAPD)

ii.) automated peritoneal dialysis (APD)
Peritoneal dialysis is the removal of toxins and extra fluid from body by using the peritoneal
membrane as a filter. The peritoneal membrane is the natural lining of your abdomen that
surrounds most of your organs. The peritoneal membrane has a good blood supply and can
act as a filter to enable dialysis to take place. A soft tube, called a catheter, is surgically
placed in the abdomen. This catheter makes it possible for patient to connect to a special
tubing allowing 2 litres of cleansing fluid (called dialysate) to flow into the abdomen. The
dialysate usually stays in abdomen for a few hours (dwell time) and during this dwell time
wastes and extra fluid pass through the peritoneal membrane into the cleansing fluid. During
the dwell time, the catheter is capped and patient can continue usual activities. After this
dwell time, then can drain the cleansing fluid from abdomen into an empty bag and discard it.
Patient needs to repeat the in-and-out process usually 4 times a day using fresh dialysate. The
process of exchanging bags (called an exchange) usually takes 20 to 30 minutes (National
Kidney Foundation Malaysia).
Haemodialysis
Haemodialysis is a way of cleansing the blood of toxins, extra salt and fluids through a
dialysis machine. It helps maintain proper chemical balance such as potassium, sodium and
chloride and keeps blood pressure under control. During dialysis, two needles will be inserted
into the vascular access, one to remove the blood and the other to return cleansed blood to the
body. The patient is connected (via tubing) to the dialysis machine through a vein in the arm,
the blood is pumped from the body to a special filter called the dialyser, which is made of
tiny capillaries. Blood is continuously pumped through the dialyser, where waste products
and excess water are removed. The blood becomes purified when the waste products diffuse
from the blood across the membrane of these tiny capillaries. This purified blood is then
returned to the patient’s body through larger tubes. Haemodialysis is performed 3 times a
week, with each session lasting about 4 hours, depending on the body size and medical
condition (The National Kidney Foundation Singapore).
Difference between Continuous Ambulatory Peritoneal Dialysis(CAPD) and

Haemodialysis (HD)
CAPD Haemodialysis
Can carry out by hand at home every day Need to go dialysis centre
Time management can be more flexible Need time and travelling cost to dialysis
centre
4 exchanges of dialysate per day It takes an average of 4 hours per session

and 3 treatments a week
No machine is necessary Machine is necessary
Requires the insertion of permanent catheter Required vascular assess surgery
Fewer fluid and diet restriction Need more fluid and diet restriction
Prolongs remaining kidney function Less maintain kidney function
Nutritional management for dialysis patient
Assumed that this patient is 60kg,
Energy requirement ≈ 1800 kcal/day
Protein requirement = 1.2-1.3g/kg (at least 50% HBV Protein) (MNT CKD)
Whereby 1.3g/kg for severe malnourished or acute illness
= 1.2g/kg x 60 kg
=72g/day ≈ 16%
CHO : 50% ≈ 225g ≈ 15 exc/day
Fat : 34% ≈ 68g
Exchange table for 1800kcal/day :
Food groups Exchange Kcal CHO(g) Protein(g) Fat(g)
Milk 2 145 11 8 8
Fruit 2 120 30 0 0
Cereal grains, 12 900 180 24 6

starch
vegetables
Chicken, meat, 2 130 0 14 8

poultry
Fish 2 70 0 14 2
Egg 1 84 0.5 7 6
Taukua 3 67 3 7 3
Fat 7 315 0 0 35
Total 1831 224.5 74 68
Distribution
Food groups Breakfast Morning Lunch Afternoon dinner

tea tea
Milk 1 1
Fruit 1 1
Cereal grains, 3 1 4 4
starch
vegetables
Chicken, meat, 1 1
poultry
Fish 2
Egg 1
Taukua 1
Fat 2 3 2
Total 8 2 9 2 8
Menu planning
Meal time Menu Serving size
Breakfast Low fat milk + 1 glass (1 exc)
Oats 3 tbsp (1 exc)
Sandwiches
+ wholemeal bread 2 pieces (2 exc CHO)
+ scrambled egg 1 biji (1 exc egg)
+ chicken ½ ketul (1 exc chicken)
+ soft margarine 2 tbsp (2 exc fat)
Morning Apple 1 biji (1 exc fruit)

tea
Plain crackers 3 pieces (1 exc CHO)
Lunch Cooked rice 1 medium bowl (3 exc

CHO)
½ ketul (1 exc chicken)

+ roasted pandan chicken
+ fried taukua 1 piece (1 exc taukua)
+ mixed vegetables (cauliflower+ carrot+ 1 bowl (1 exc starchy

capsicum) vegetables)
Oil 3 exc fat
Afternoon Low fat milk 1 glass (1 exc milk)

tea
Guava 1 biji (1 exc fruit)
Dinner Cooked rice 1 medium bowl (3 exc

CHO)
1 ekor (2 exc fish)

+ grilled fish with fried potatoes
1 exc CHO
+ stir-fry broccoli
2 exc fat
Oil

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Group Assignment B1 – Pn.

i.) continuous ambulatory peritoneal dialysis (CAPD)

Difference between Continuous Ambulatory Peritoneal Dialysis(CAPD) and

4 exchanges of dialysate per day It takes an average of 4 hours per session

No machine is necessary Machine is necessary

Requires the insertion of permanent catheter Required vascular assess surgery

Prolongs remaining kidney function Less maintain kidney function

Nutritional management for dialysis patient

Assumed that this patient is 60kg,

Energy requirement ≈ 1800 kcal/day

Whereby 1.3g/kg for severe malnourished or acute illness

Fat : 34% ≈ 68g

Exchange table for 1800kcal/day :

Food groups Exchange Kcal CHO(g) Protein(g) Fat(g)

Cereal grains, 12 900 180 24 6

Chicken, meat, 2 130 0 14 8

Total 1831 224.5 74 68

Food groups Breakfast Morning Lunch Afternoon dinner

Meal time Menu Serving size

Breakfast Low fat milk + 1 glass (1 exc)

Oats 3 tbsp (1 exc)

+ wholemeal bread 2 pieces (2 exc CHO)

+ scrambled egg 1 biji (1 exc egg)

+ chicken ½ ketul (1 exc chicken)

+ soft margarine 2 tbsp (2 exc fat)

Morning Apple 1 biji (1 exc fruit)

Lunch Cooked rice 1 medium bowl (3 exc

½ ketul (1 exc chicken)

+ mixed vegetables (cauliflower+ carrot+ 1 bowl (1 exc starchy

Oil 3 exc fat

Afternoon Low fat milk 1 glass (1 exc milk)

Dinner Cooked rice 1 medium bowl (3 exc

1 ekor (2 exc fish)

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