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KMID : 0377619920570120823
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Korean Jungang Medical Journal
1992 Volume.57 No. 12 p.823 ~ p.827
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Dietary Management for the Patients on CAPD (Adult)
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Abstract
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The dietary management in CAPD is essential for special transport form that is absorpted or excreted by some dietary substances via peritoneam.
The aim of the dietary management of this CAPD is to maintain an ideal body weight with adequate calory volume and water intake, as well as to supply protein that lost through the peritoneal membrane and to prevent hypertriglyceridemia and artherosclerosis with avoiding overconsumption of fat.
The recommended daily intake for the management of these patients are as below.
1. Energy: The recommended energy needs are 30 35 Kcal/kg/day. The balance of oral intake and output energy must be considered to prevent obesity or hypertriglyceridemia due to high calory supply.
2. Protein and Phosphorous: The protein loss via peritoneam is average 6 8 g/day in the non-peritonitis group, about 5 - 15 g/day in the peritonitis group. Recommended protein needs are 1.2 - 1.3 g/kg/day with 50 % high biological protein. Also; there is positive relation between the amounts of the protein intake and the amount of nitrogen. Therefore hyperphosphoatamia depending upon high protein intake must be noticed.
3. Fat: Also, there is a changes of hypertriglyceridemia due to continuously absorbed dextrose via peritoneum. To control triglyceride, it is suggested that the dietary intake of fat be reduced to 50 55 % of total calories and the ratio of polyunsaturated to saturated fat is 1.0.
4. Na, K and Water: In CAPD patients, sodium, potassium and water intake are moderately restricted according to water balance, serum sodium and serum potassium. The daily recommended dietary sodium and potassium intake is260 350 mEq (6- 8 g), 70 80 mEq (2.7 - 3.1 g) each. And water is allowed to 2000 ml/day relatively free even if urine output is zero because fluid removed about 2000 2200 ml with 4 dialysate exchanges/day.
5. Vitamin: In most CAPD patients, Vitamin A, E, B12 tend to reach a high level in blood. So there is no need to intake their, the dietary intake of Vitamin C, water soluble Vitamin is 100 mg/day, folic acid is 1 mg/day.
6. During peritonitis episode: In this time, the permeability of protein and fat increases and then the amount of protein loss increases about 50 ^- 100 % more than usual and fat is increases about 1.8 12 time more too.
Also, oral intake be reduced with gastrointestinal symptoms such as abdominal pain, nausea and vomiting were seen, in results, minus nitrogen balance may be reach. Since during peritonitis episode, patients try to supplement their intake of protien and energy.
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