Peritoneal dialysis is a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter your blood inside your body. Learn about the different types of peritoneal dialysis treatments you can do at home—how to prepare and do exchanges, and what are the possible risks.
A depiction of Peritoneal dialysis in case of kidney failure.
Image by Scientific Animations, Inc.
What Is Peritoneal Dialysis?
Profile outline of a male figure receiving peritoneal dialysis. An inset shows a man holding his permanent catheter and a disconnected tube over his lap
Image by NIDDK Image Library
Profile outline of a male figure receiving peritoneal dialysis. An inset shows a man holding his permanent catheter and a disconnected tube over his lap
In peritoneal dialysis, the catheter stays in your belly permanently.
Image by NIDDK Image Library
What Is Peritoneal Dialysis and How Does It Work?
Peritoneal dialysis is a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter your blood inside your body. Health care providers call this lining the peritoneum.
A few weeks before you start peritoneal dialysis, a surgeon places a soft tube, called a catheter, in your belly.
When you start treatment, dialysis solution—water with salt and other additives—flows from a bag through the catheter into your belly. When the bag is empty, you disconnect it and place a cap on your catheter so you can move around and do your normal activities. While the dialysis solution is inside your belly, it absorbs wastes and extra fluid from your body.
Peritoneal dialysis
After a few hours, the solution and the wastes are drained out of your belly into the empty bag. You can throw away the used solution in a toilet or tub. Then, you start over with a fresh bag of dialysis solution. When the solution is fresh, it absorbs wastes quickly. As time passes, filtering slows. For this reason, you need to repeat the process of emptying the used solution and refilling your belly with fresh solution four to six times every day. This process is called an exchange.
You can do your exchanges during the day, or at night using a machine that pumps the fluid in and out. For the best results, it is important that you perform all of your exchanges as prescribed. Dialysis can help you feel better and live longer, but it is not a cure for kidney failure.
How will I feel when the dialysis solution is inside my belly?
You may feel the same as usual, or you may feel full or bloated. Your belly may enlarge a little. Some people need a larger size of clothing. You shouldn’t feel any pain. Most people look and feel normal despite a belly full of solution.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (16)
Living Well with Kidney Failure, Part 4: Peritoneal Dialysis
Video by National Kidney Foundation/YouTube
"Complications of Peritoneal Dialysis" by Sharon Su for OPENPediatrics
Video by OPENPediatrics/YouTube
"Peritoneal Dialysis" by Sharon Su for OPENPediatrics
Differences Between Hemodialysis and Peritoneal Dialysis
MassGeneralHospital/YouTube
1:03
What are Hemodialysis and Peritoneal Dialysis?
MassGeneralHospital/YouTube
6:28
Pediatric Outpatient Dialysis Clinic
Johns Hopkins Medicine/YouTube
3:32
Peritoneal Relations (preview) - Human Anatomy | Kenhub
Kenhub - Learn Human Anatomy/YouTube
9:12
Dialysis Treatment Procedure
Larry Wall/YouTube
4:23
Dialysis
Covenant Health/YouTube
1:14
Dialysis for Kidney Patients
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/YouTube
1:46
Thirst Tips for Dialysis Patients
National Kidney Foundation/YouTube
4:27
DIALYSIS
7activestudio/YouTube
57:40
Webinar: What CAN I eat? Nutrition for dialysis patients
kidneyfund/YouTube
What Are the Types?
Hookup
Infusion
Diffusion (fresh)
Diffusion (waste)
Drainage
1
2
3
4
5
Peritoneal Dialysis Process
Interactive by Nanoxyde
Hookup
Infusion
Diffusion (fresh)
Diffusion (waste)
Drainage
1
2
3
4
5
Peritoneal Dialysis Process
Interactive by Nanoxyde
What Are the Types of Peritoneal Dialysis?
You can choose the type of peritoneal dialysis that best fits your life:
continuous ambulatory peritoneal dialysis (CAPD)
automated peritoneal dialysis
The main differences between the two types of peritoneal dialysis are
the schedule of exchanges
one uses a machine and the other is done by hand
If one type of peritoneal dialysis doesn’t suit you, talk with your doctor about trying the other type.
CAPD doesn’t use a machine. You do the exchanges during the day by hand.
You can do exchanges by hand in any clean, well-lit place. Each exchange takes about 30 to 40 minutes. During an exchange, you can read, talk, watch television, or sleep. With CAPD, you keep the solution in your belly for 4 to 6 hours or more. The time that the dialysis solution is in your belly is called the dwell time. Usually, you change the solution at least four times a day and sleep with solution in your belly at night. You do not have to wake up at night to do an exchange.
During an exchange, you can read, talk, watch television, or sleep.
Automated peritoneal dialysis. A machine does the exchanges while you sleep.
With automated peritoneal dialysis, a machine called a cycler fills and empties your belly three to five times during the night. In the morning, you begin the day with fresh solution in your belly. You may leave this solution in your belly all day or do one exchange in the middle of the afternoon without the machine. People sometimes call this treatment continuous cycler-assisted peritoneal dialysis or CCPD.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Cycler. A cycler performs four or five exchanges overnight, while you sleep.
Image by NIDDK Image Library
Where Can I Do Peritoneal Dialysis?
You can do both CAPD and automated peritoneal dialysis in any clean, private place, including at home, at work, or when travelling.
Before you travel, you can have the manufacturer ship the supplies to where you’re going so they’ll be there when you get there. If you use automated peritoneal dialysis, you’ll have to carry your machine with you or plan to do exchanges by hand while you’re away from home.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (1)
Drawing of a male patient during peritoneal dialysis exchange
During an exchange, you can read, talk, watch television, or sleep.
Image by NIDDK Image Library
Drawing of a male patient during peritoneal dialysis exchange
NIDDK Image Library
How Do I Prepare For the Procedure?
Drawing of three steps in peritoneal dialysis exchange, labeled
Image by NIDDK Image Library
Drawing of three steps in peritoneal dialysis exchange, labeled
The first step of an exchange is to drain the used dialysis solution from the peritoneal cavity into the drain bag. Near the end of the drain, you may feel a mild "tugging" sensation that tells you most of the fluid is gone. After the used solution is removed from your abdomen, you will close or clamp the transfer set and let some of the fresh solution flow directly into the drain bag. This flushing step removes air from the tubes.
Image by NIDDK Image Library
How Do I Prepare for Peritoneal Dialysis?
Surgery to put in your catheter
Before your first treatment, you will have surgery to place a catheter into your belly. Planning your catheter placement at least 3 weeks before your first exchange can improve treatment success.
Although you can use the catheter for dialysis as soon as it’s in place, the catheter tends to work better when you have 10 to 20 days to heal before starting a full schedule of exchanges.
Your surgeon will make a small cut, often below and a little to the side of your belly button, and then guide the catheter through the slit into your peritoneal cavity. You’ll receive general or local anesthesia, and you may need to stay overnight in the hospital. However, most people can go home after the procedure.
You’ll learn to care for the skin around the catheter, called the exit site, as part of your dialysis training.
Dialysis training
After training, most people can perform both types of peritoneal dialysis on their own. You’ll work with a dialysis nurse for 1 to 2 weeks to learn how to do exchanges and avoid infections. Most people bring a family member or friend to training. With a trained friend or family member, you’ll be prepared in case you have a sick day and need help with exchanges.
If you choose automated peritoneal dialysis, you’ll learn how to
prepare the cycler
connect the bags of dialysis solution
place the drain tube
If you choose automated peritoneal dialysis, you also need to learn how to do exchanges by hand in case of a power failure or if you need an exchange during the day in addition to nighttime automated peritoneal dialysis.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
A depiction of Peritoneal dialysis in case of kidney failure.
Image by Scientific Animations, Inc.
A depiction of Peritoneal dialysis in case of kidney failure.
Peritoneal dialysis in case of kidney failure ensures survival until a transplant can be performed.
Image by Scientific Animations, Inc.
How Do I Perform an Exchange?
You’ll need the following supplies:
transfer set
dialysis solution
supplies to keep your exit site clean
If you choose automated peritoneal dialysis you’ll need a cycler.
Your health care team will provide everything you need to begin peritoneal dialysis and help you arrange to have supplies such as dialysis solution and surgical masks delivered to your home, usually once a month. Careful hand washing before and wearing a surgical mask over your nose and mouth while you connect your catheter to the transfer set can help prevent infection.
Use a transfer set to connect your catheter to the dialysis solution
A transfer set is tubing that you use to connect your catheter to the bag of dialysis solution. When you first get your catheter, the section of tube that sticks out from your skin will have a secure cap on the end to prevent infection. A connector under the cap will attach to any type of transfer set.
You connect your catheter to the transfer set to do your exchange.
Between exchanges, you can keep your catheter and transfer set hidden inside your clothing. At the beginning of an exchange, you’ll remove the disposable cap from the transfer set and connect the set to a tube that branches like the letter Y. One branch of the Y-tube connects to the drain bag, while the other connects to the bag of fresh dialysis solution.
Use dialysis solution as prescribed
Dialysis solution comes in 1.5-, 2-, 2.5-, or 3-liter bags. Solutions contain a sugar called dextrose or a compound called icodextrin and minerals to pull the wastes and extra fluid from your blood into your belly. Different solutions have different strengths of dextrose or icodextrin. Your doctor will prescribe a formula that fits your needs.
You’ll need a clean space to store your bags of solution and other supplies.
Doing an exchange by hand
After you wash your hands and put on your surgical mask, drain the used dialysis solution from your belly into the drain bag. Near the end of the drain, you may feel a mild tugging sensation that tells you most of the fluid is gone. Close the transfer set.
Warm each bag of solution to body temperature before use. You can use an electric blanket, or let the bag sit in a tub of warm water. Most solution bags come in a protective outer wrapper, and you can warm them in a microwave. Don’t microwave a bag of solution after you have removed it from its wrapper.
Hang the new bag of solution on a pole and connect it to the tubing.
Remove air from the tubes—allow a small amount of fresh, warm solution to flow directly from the new bag of solution into the drain bag.
Clamp the tube that goes to the drain bag.
Open or reconnect the transfer set, and refill your belly with fresh dialysis solution from the hanging bag.
Using a cycler for automated peritoneal dialysis exchanges
In automated peritoneal dialysis, you use a machine called a cycler to fill and drain your belly. You can program the cycler to give you different amounts of dialysis solution at different times.
Each evening, you set up the machine to do three to five exchanges for you. You connect three to five bags of dialysis solution to tubing that goes into the cycler—one bag of solution for each exchange. The machine may have a special tube to connect the bag for the last exchange of the night.
Automated peritoneal dialysis uses a machine called a cycler to fill and empty your belly three to five times during the night while you sleep.
At the times you set, the cycler
releases a clamp and allows used solution to drain out of your belly into the drain line
warms the fresh dialysis solution before it enters your body
releases a clamp to allow body-temperature solution to flow into your belly
A fluid meter in the cycler measures and records how much solution the cycler removes. Some cyclers compare the amount that was put in with the amount that drains out. This feature lets you and your doctor know if the treatment is removing enough fluid from your body.
Some cyclers allow you to use a long drain line that drains directly into your toilet or bathtub. Others have a disposal container.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Peritoneal dialysis uses the lining of the abdomen (peritoneum), which is rich in arteries and veins, as a filter. Dialysis fluid is placed into the abdominal cavity through a permanent access port in the abdomen. The fluid remains there long enough for all the wastes in the blood to be transferred to the dialysis fluid, which is then drained out of the abdomen.
Image by TheVisualMD
What Changes Will I Have to Make When I Start Peritoneal Dialysis?
Daily routine
Your schedule will change as you work your dialysis exchanges into your routine. If you do CAPD during the day, you have some control over when you do the exchanges. However, you’ll still need to stop your normal activities and take about 30 minutes to perform an exchange. If you do automated peritoneal dialysis, you’ll have to set up your cycler every night.
Physical activity
You may need to limit some physical activities when your belly is full of dialysis solution. You may still be active and play sports, but you should discuss your activities with your health care team.
Make changes to what you eat and drink
If you’re on peritoneal dialysis, you may need to limit
sodium
phosphorus
calories in your eating plan
You may also need to
watch how much liquid you drink and eat. Your dietitian will help you determine how much liquid you need to consume each day.
add protein to your diet because peritoneal dialysis removes protein.
choose foods with the right amount of potassium.
take supplements made for people with kidney failure.
Eating the right foods can help you feel better while you’re on peritoneal dialysis. Talk with your dialysis center’s dietitian to find a meal plan that works for you.
Medicines
Your doctor may make changes to the medicines you take.
Coping
Adjusting to the effects of kidney failure and the time you spend on dialysis can be hard for both you and your family. You may
have less energy
need to give up some activities and duties at work or at home
A counselor or social worker can answer your questions and help you cope.
Take care of your exit site, supplies, and catheter to prevent infections
Your health care team will show you how to keep your catheter clean to prevent infections. Here are some general rules:
Store your supplies in a cool, clean, dry place.
Inspect each bag of solution for signs of contamination, such as cloudiness, before you use it.
Find a clean, dry, well-lit space to perform your exchanges.
Wash your hands every time you need to handle your catheter.
Clean your skin where your catheter enters your body every day, as instructed by your health care team.
Wear a surgical mask when performing exchanges.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
What Are Possible Problems?
Transfer set
Image by NIDDK Image Library
Transfer set
Drawing of transfer set, catheter, and disposable tubing, labeled. Between exchanges, you can keep your catheter and transfer set hidden inside your clothing. At the beginning of an exchange, you will remove the disposable cap from the transfer set and connect it to the Y-tube. The branches of the Y-tube connect to the drain bag and the bag of fresh dailysis solution. Always wash your hands before handling your catheter and transfer set, and wear a surgical mask whenever you connect or disconnect.
Image by NIDDK Image Library
What Are the Possible Problems From Peritoneal Dialysis?
Possible problems from peritoneal dialysis include infection, hernia, and weight gain.
Infection
One of the most serious problems related to peritoneal dialysis is infection. You can get an infection of the skin around your catheter exit site or you can develop peritonitis, an infection in the fluid in your belly. Bacteria can enter your body through your catheter as you connect or disconnect it from the bags.
Seek immediate care if you have signs of infection
Signs of an exit site infection include redness, pus, swelling or bulging, and tenderness or pain at the exit site. Health care professionals treat infections at the exit site with antibiotics.
Peritonitis may cause
pain in the abdomen
fever
nausea or vomiting
redness or pain around your catheter
unusual color or cloudiness in used dialysis solution
the catheter cuff to push out from your body—the cuff is the part of the catheter that holds it in place
Health care professionals treat peritonitis with antibiotics. Antibiotics are added to the dialysis solution that you can usually take at home. Quick treatment may prevent additional problems.
Hernia
A hernia is an area of weakness in your abdominal muscle.
Peritoneal dialysis increases your risk for a hernia for a couple of reasons. First, you have an opening in your muscle for your catheter. Second, the weight of the dialysis solution within your belly puts pressure on your muscle. Hernias can occur near your belly button, near the exit site, or in your groin. If you have a swelling or new lump in your groin or belly, talk with your health care professional.
Weight gain from fluid and dextrose
The longer the dialysis solution remains in your belly, the more dextrose your body will absorb from the dialysis solution. This can cause weight gain over time.
Limit weight gain
With CAPD, you might have a problem with the long overnight dwell time. If your body absorbs too much fluid and dextrose overnight, you may be able to use a cycler to exchange your solution once while you sleep. This extra exchange will shorten your dwell time, keep your body from absorbing too much fluid and dextrose, and filter more wastes and extra fluid from your body.
With automated peritoneal dialysis, you may absorb too much solution during the daytime exchange, which has a long dwell time. You may need an extra exchange in the midafternoon to keep your body from absorbing too much solution and to remove more wastes and extra fluid from your body.
Your dietitian can provide helpful guidance to reduce weight gain.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (1)
"Complications of Peritoneal Dialysis" by Sharon Su for OPENPediatrics
Video by OPENPediatrics/YouTube
9:23
"Complications of Peritoneal Dialysis" by Sharon Su for OPENPediatrics
OPENPediatrics/YouTube
How Do I Know It's Working?
Who performs peritoneal dialysis?
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"
Who performs peritoneal dialysis?
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"
How Will I Know If My Peritoneal Dialysis Is Working?
To find out if your dialysis exchanges are removing enough wastes, you’ll have a blood test and collect used dialysis solution once a month. If you’re still urinating, you may need to collect urine.
These tests help your doctor prescribe a dialysis schedule and dose to meet your health needs. If your dialysis schedule isn’t removing enough wastes or your body is absorbing too much dextrose, your doctor will make adjustments.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Electrolyte Panel
Electrolyte Panel
Also called: Electrolytes, Lytes
An electrolyte panel measures the level of the body's main electrolytes. Electrolytes are electrically charged minerals that help control many important functions in the body. Levels that are too high or too low can indicate a serious health problem.
Electrolyte Panel
Also called: Electrolytes, Lytes
An electrolyte panel measures the level of the body's main electrolytes. Electrolytes are electrically charged minerals that help control many important functions in the body. Levels that are too high or too low can indicate a serious health problem.
Electrolytes are electrically charged minerals that help control the amount of fluids and the balance of acids and bases in your body. They also help control muscle and nerve activity, heart rhythm, and other important functions. An electrolyte panel, also known as a serum electrolyte test, is a blood test that measures levels of the body's main electrolytes:
Sodium, which helps control the amount of fluid in the body. It also helps your nerves and muscles work properly.
Chloride, which also helps control the amount of fluid in the body. In addition, it helps maintain healthy blood volume and blood pressure.
Potassium, which helps your heart and muscles work properly.
Bicarbonate, which helps maintain the body's acid and base balance. It also plays an important role in moving carbon dioxide through the bloodstream.
Abnormal levels of any of these electrolytes can be a sign of a serious health problem, including kidney disease, high blood pressure, and a life-threatening irregularity in heart rhythm.
An electrolyte panel is often part of a routine blood screening or a comprehensive metabolic panel. The test may also be used to find out if your body has a fluid imbalance or an imbalance in acid and base levels.
Electrolytes are usually measured together. But sometimes they are tested individually. Separate testing may be done if a provider suspects a problem with a specific electrolyte.
You may need this test if you have symptoms indicating that your body's electrolytes may be out of balance. These include:
Nausea and/or vomiting
Confusion
Weakness
Irregular heartbeat (arrhythmia)
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't any special preparations for an electrolyte panel.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Your results will include measurements for each electrolyte. Abnormal electrolyte levels can be caused by several different conditions, including:
Dehydration
Kidney disease
Heart disease
Diabetes
Acidosis, a condition in which you have too much acid in your blood. It can cause nausea, vomiting, and fatigue.
Alkalosis, a condition in which you have too much base in your blood. It can cause irritability, muscle twitching, and tingling in the fingers and toes.
Your specific results will depend on which electrolyte is affected and whether levels are too low or too high. If your electrolyte levels were not in the normal range, it doesn't necessarily mean you have a medical problem needing treatment. Many factors can affect electrolyte levels. These include taking in too much fluid or losing fluid because of vomiting or diarrhea. Also, certain medicines such as antacids and blood pressure medicines may cause abnormal results.
If you have questions about your results, talk to your health care provider.
Your health care provider may order another test, called an anion gap, along with your electrolyte panel. Some electrolytes have a positive electric charge. Others have a negative electric charge. The anion gap is a measurement of the difference between the negatively charged and positively charged electrolytes. If the anion gap is either too high or too low, it may be a sign of a serious health problem.
Electrolyte Panel: MedlinePlus Medical Test [accessed on Dec 20, 2023]
Additional Materials (10)
Overview of Fluid and Electrolyte Physiology (Fluid Compartment)
Video by Armando Hasudungan/YouTube
Electrolytes - What Are Electrolytes - Functions Of Electrolytes
Video by Whats Up Dude/YouTube
What Do Electrolytes Actually Do?
Video by Reactions/YouTube
Why You Need Electrolytes - Can It Help With Getting Stronger?
Video by PictureFit/YouTube
Fluid and Electrolytes: Chloride
Video by EmpoweRN/YouTube
Fluid and Electrolytes: Sodium
Video by EmpoweRN/YouTube
Fluid and Electrolytes: Magnesium
Video by EmpoweRN/YouTube
Fluid & Electrolytes: Potassium
Video by EmpoweRN/YouTube
Fluid & Electrolytes: Phosphate
Video by EmpoweRN/YouTube
Fluids and Electrolytes Sodium
Video by DrBruce Forciea/YouTube
8:05
Overview of Fluid and Electrolyte Physiology (Fluid Compartment)
Armando Hasudungan/YouTube
1:12
Electrolytes - What Are Electrolytes - Functions Of Electrolytes
Whats Up Dude/YouTube
2:42
What Do Electrolytes Actually Do?
Reactions/YouTube
1:47
Why You Need Electrolytes - Can It Help With Getting Stronger?
PictureFit/YouTube
3:26
Fluid and Electrolytes: Chloride
EmpoweRN/YouTube
9:43
Fluid and Electrolytes: Sodium
EmpoweRN/YouTube
4:19
Fluid and Electrolytes: Magnesium
EmpoweRN/YouTube
8:19
Fluid & Electrolytes: Potassium
EmpoweRN/YouTube
6:36
Fluid & Electrolytes: Phosphate
EmpoweRN/YouTube
3:04
Fluids and Electrolytes Sodium
DrBruce Forciea/YouTube
Sodium
Sodium Blood Test
Also called: Sodium, Hyponatremia Test, Hypernatremia Test
A sodium blood test measures the amount of sodium in your blood. If your sodium blood levels are too high or too low, it may mean that you have a problem with your kidneys, dehydration, or another medical condition.
Sodium Blood Test
Also called: Sodium, Hyponatremia Test, Hypernatremia Test
A sodium blood test measures the amount of sodium in your blood. If your sodium blood levels are too high or too low, it may mean that you have a problem with your kidneys, dehydration, or another medical condition.
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Low sodium levels most often occur as a result of disease or a side effect of medicines; they are rarely due to too little sodium in the diet.
Related conditions
A sodium blood test measures the amount of sodium in your blood. Sodium is a type of electrolyte. Electrolytes are electrically charged minerals. They help control the amount of fluid and the balance of acids and bases (pH balance) in your body. Sodium also helps your nerves and muscles work properly.
You get most of the sodium you need in your diet. If you take in too much, your kidneys get rid of the extra sodium in your urine. Normally, your body keeps your sodium levels in a very narrow range. If your sodium blood levels are too high or too low, it may mean that you have a kidney problem, dehydration, or another type of medical condition.
A sodium blood test is a routine test that may be used to check your general health. It may be used to help find and monitor conditions that affect the balance of fluids, electrolytes, and acidity in your body.
The test is often done as part of a group of tests called an electrolyte panel. It may also be part of two other groups of tests called a basic metabolic panel (BMP) and a comprehensive metabolic panel (CMP)
Your health care provider may order a sodium blood test as part of your regular checkup or if you take medicine that can affect your fluid balance. You may also have this test if you have symptoms of too much sodium or too little sodium in your blood.
Symptoms of high sodium levels (hypernatremia) include:
Thirst
Urinating (peeing) very little
Vomiting
Diarrhea
Confusion
Muscle twitching
Seizures
Without treatment, extremely high levels of sodium may lead to a coma and become life threatening.
Symptoms of low sodium levels (hyponatremia) include:
Weakness
Fatigue
Confusion
Muscle twitching
Seizures
Without treatment, extremely low levels of sodium may lead to a coma and become life threatening.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Your provider will let you know exactly how to prepare for a sodium blood test. On the day of the test, you may need to skip or delay certain medicines. Be sure to tell your provider about any medicines, herbs, or supplements that you take. But don't stop any medicines without talking with your provider first.
You may also need to fast (not eat or drink) for several hours before the test. Ask your provider if you have any questions.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Blood sodium levels that are too high or too low can be a sign of many different types of conditions. To make a diagnosis, your provider will usually look at the results of your sodium blood test with the results of other tests, such as measurements of other electrolytes.
Sodium blood test results that are higher than normal may be a sign of a condition, such as:
Dehydration, which may be caused by not drinking enough, diarrhea, or certain medicines called diuretics (water pills)
A disorder of the adrenal glands
A kidney disease
Diabetes insipidus (uncommon).
Sodium blood test results that are lower than normal may be a sign of a condition, such as:
A loss of sodium from diarrhea or vomiting
A condition that may cause the body to hold onto extra fluid (which dilutes sodium), including:
Kidney diseases
Cirrhosis of the liver
Heart failure
Certain brain and lung diseases
Certain types of cancer
Certain medicines, including many over-the-counter pain relievers and some antidepressants
Addison disease
Malnutrition
If your results are not in the normal range, it doesn't always mean that you have a medical condition that need treatment. Certain medicines can increase or decrease your sodium levels. If you have questions about your results, talk with your provider.
Sodium levels are often measured with other electrolytes in another test called the anion gap. An anion gap test looks at the difference between negatively charged and positively charged electrolytes. The test checks for acid imbalances and other conditions.
Sodium Blood Test: MedlinePlus Medical Test [accessed on Dec 19, 2023]
Additional Materials (16)
Hyponatremia SALT LOSS Nursing Mnemonics, Nursing School Study Tips
Video by NURSINGcom/YouTube
Hypernatremia FRIED, SWINE, SALT, MODEL Nursing Mnemonics, Nursing School Study Tips
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You're Probably not Dehydrated: The Eight Glasses of Water a Day Myth
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Electrolytes - What Are Electrolytes - Functions Of Electrolytes
Video by Whats Up Dude/YouTube
Why You Need Electrolytes - Can It Help With Getting Stronger?
Video by PictureFit/YouTube
What Do Electrolytes Actually Do?
Video by Reactions/YouTube
Dietary Salt Recommendations Don't Line Up with Recent Evidence
Video by Healthcare Triage/YouTube
Fluids and Electrolytes Sodium
Video by DrBruce Forciea/YouTube
Aldosterone raises blood pressure and lowers potassium | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Plate of High Sodium Food
Salt is essential to life, but because our bodies are built to crave salt, modern diets often include too much. The kidneys balance the amount of salt and fluid in the body in order to maintain proper blood pressure. When healthy people eat too much salt, their bodies adjust and the kidneys excrete more sodium. But when the kidneys are damaged, they are less able to excrete sodium so that even normal salt intake can result in an increase in the fluid retained by the body, which causes blood pressure to rise. Controlling salt is key to controlling hypertension. High sodium foods to avoid: table salt, potato chips, bacon, pickles, olives hot dogs, pastrami, cheese.
Image by TheVisualMD
Living With the DASH Eating Plan
A glass salt shaker with a metal top photographed on a white background. Reduction of salt intake is important in reducing blood pressure.
Image by Dubravko Soric SoraZG on Flickr
Salt
Image by Sam Bald
Man with Visible Musculature Lifting Weights (sodium)
Sodium is an electrolyte that plays key roles in nerve transmission and muscle contraction, as well as helps balance bodily fluids and facilitate the movement of materials across cell membranes. Abnormal sodium levels can be caused by many conditions; either too much or too little sodium can be dangerous. The body maintains sodium blood levels in a narrow range; urine is the primary way in which the body balances sodium levels. Normal sweating is one of the ways the nervous system regulates body temperature; excessive sweating can lead to low sodium, particularly when only water is used to replace lost fluids.
Image by TheVisualMD
Fluid Regulation
The body's fluid balance is kept within a narrow range by the kidneys, which constantly monitor and adjust blood levels of electrolytes (sodium, calcium, potassium, bicarbonate, and chloride) as well as blood proteins such as albumin. If the body is unable to self-regulate, however, treatment may involve dietary changes (lower salt intake or increased fluid intake, for example), diuretics or treatment of the underlying disease causing the fluid imbalance.
Image by TheVisualMD
Sodium: Blood Vessels
A test for sodium, along with other electrolytes, is routinely included in the basic metabolic panel (BMP). If blood levels are abnormal, urine levels are also tested in order to help determine whether the problem is excessive intake of sodium or excessive loss.
Image by TheVisualMD
U.S. Army Sergeant Kornelia Rachwal gives a young Pakistani girl a drink of water as they are airlifted
U.S. Army Sergeant Kornelia Rachwal gives a young Pakistani girl a drink of water as they are airlifted from Muzaffarabad to Islamabad, Pakistan, aboard a U.S. Army CH-47 Chinook helicopter
Image by Technical Sergeant Mike Buytas of the United States Air Force
3:07
Hyponatremia SALT LOSS Nursing Mnemonics, Nursing School Study Tips
NURSINGcom/YouTube
3:33
Hypernatremia FRIED, SWINE, SALT, MODEL Nursing Mnemonics, Nursing School Study Tips
NURSINGcom/YouTube
6:46
You're Probably not Dehydrated: The Eight Glasses of Water a Day Myth
Healthcare Triage/YouTube
1:12
Electrolytes - What Are Electrolytes - Functions Of Electrolytes
Whats Up Dude/YouTube
1:47
Why You Need Electrolytes - Can It Help With Getting Stronger?
PictureFit/YouTube
2:42
What Do Electrolytes Actually Do?
Reactions/YouTube
4:42
Dietary Salt Recommendations Don't Line Up with Recent Evidence
Healthcare Triage/YouTube
3:04
Fluids and Electrolytes Sodium
DrBruce Forciea/YouTube
13:18
Aldosterone raises blood pressure and lowers potassium | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
Plate of High Sodium Food
TheVisualMD
Living With the DASH Eating Plan
Dubravko Soric SoraZG on Flickr
Salt
Sam Bald
Man with Visible Musculature Lifting Weights (sodium)
TheVisualMD
Fluid Regulation
TheVisualMD
Sodium: Blood Vessels
TheVisualMD
U.S. Army Sergeant Kornelia Rachwal gives a young Pakistani girl a drink of water as they are airlifted
Technical Sergeant Mike Buytas of the United States Air Force
Chloride
Chloride Blood Test
Also called: Chloride, Hypochloremia Test, Hyperchloremia Test
A chloride test measures the chloride in your blood. Chloride is a mineral that helps maintain the acid-base balance in your body. The test is usually part of a routine blood screening or to help determine if there is a problem with your body's electrolyte or acid-base (pH) balance.
Chloride Blood Test
Also called: Chloride, Hypochloremia Test, Hyperchloremia Test
A chloride test measures the chloride in your blood. Chloride is a mineral that helps maintain the acid-base balance in your body. The test is usually part of a routine blood screening or to help determine if there is a problem with your body's electrolyte or acid-base (pH) balance.
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Use the slider below to see how your results affect your
health.
meq/L
96
106
Your result is Low.
Low levels of chloride, called hypochloremia, may be caused by conditions like diarrhea or kidney disease, certain medications, or excessive sweating.
Related conditions
A chloride blood test measures the amount of chloride in your blood. Chloride is a type of electrolyte. Electrolytes are electrically charged minerals that help control the amount of fluids and the balance of acids and bases (pH balance) in your body. Chloride is often measured with other electrolytes to diagnose or monitor conditions, such as kidney disease, heart failure, liver disease, and high blood pressure.
You usually get a chloride test as part of a routine blood screening to check your general health. It's also used to help diagnose conditions related to an imbalance of acids or fluids in your body.
Your health care provider may have ordered a chloride blood test as part of an electrolyte panel, which is a routine blood test. An electrolyte panel is a test that measures chloride and other electrolytes, such as potassium, sodium, and bicarbonate. You may also need a chloride blood test if you have symptoms of an acid or fluid imbalance, including:
Vomiting over a long period of time
Diarrhea
Fatigue
Weakness
Dehydration
Trouble breathing
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a chloride blood test or an electrolyte panel. If your provider has ordered other blood tests, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There are many reasons why your chloride levels may not be in the normal range.
High levels of chloride may be a sign of:
Dehydration
Kidney disease
Metabolic acidosis, a condition in which you have too much acid in your blood. It can cause nausea, vomiting, and fatigue.
Low levels of chloride may be a sign of:
Heart failure
Lung disease
Addison disease, a condition in which your body's adrenal glands don't produce enough of certain types of hormones. It can cause a variety of symptoms, including weakness, dizziness, weight loss, and dehydration.
Metabolic alkalosis, a condition in which you have too much base in your blood. It can cause irritability, muscle twitching, and tingling in the fingers and toes.
If your chloride levels are not in the normal range, it doesn't always mean you have a medical problem that needs treatment. Many things can affect your chloride levels, such as drinking too much fluid or losing fluid because of vomiting or diarrhea. Also, certain medicines such as antacids can cause abnormal results. To learn what your results mean, talk with your provider.
Urine also contains some chloride. Your provider may also recommend a urine chloride test to get more information about your chloride levels.
Chloride Blood Test: MedlinePlus Medical Test [accessed on Dec 20, 2023]
Chloride test - blood: MedlinePlus Medical Encyclopedia [accessed on Dec 20, 2023]
Chloride - Health Encyclopedia - University of Rochester Medical Center [accessed on Dec 20, 2023]
Berend K, van Hulsteijn LH et al. Chloride: the queen of electrolytes?. European journal of internal medicine. Apr 1, 2012. doi:10.1016/j.ejim.2011.11.013 [accessed on Dec 20, 2023]
Additional Materials (12)
Fluid Regulation
The body's fluid balance is kept within a narrow range by the kidneys, which constantly monitor and adjust blood levels of electrolytes (sodium, calcium, potassium, bicarbonate, and chloride) as well as blood proteins such as albumin. If the body is unable to self-regulate, however, treatment may involve dietary changes (lower salt intake or increased fluid intake, for example), diuretics or treatment of the underlying disease causing the fluid imbalance.
Image by TheVisualMD
Chloride: Stomach Wall Lining Close Up
Cells in the lining of the stomach use chloride to produce hydrochloric acid, a powerful acid that aids digestion. Other cells in the stomach lining produce biocarbonate to buffer the acid and mucus to prevent the acid from damaging the stomach lining.
Image by TheVisualMD
Chloride: Stomach
Cells in the lining of the stomach use chloride to produce hydrochloric acid, a powerful acid that aids digestion. Other cells in the stomach lining produce biocarbonate to buffer the acid and mucus to prevent the acid from damaging the stomach lining.
Image by TheVisualMD
Fluid and Electrolytes: Chloride
Video by EmpoweRN/YouTube
What Do Electrolytes Actually Do?
Video by Reactions/YouTube
Why You Need Electrolytes - Can It Help With Getting Stronger?
Video by PictureFit/YouTube
Electrolytes - What Are Electrolytes - Functions Of Electrolytes
Video by Whats Up Dude/YouTube
What would happen if you didn’t drink water? - Mia Nacamulli
Video by TED-Ed/YouTube
Chloride Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
Video by NURSINGcom/YouTube
Calcium chloride
Calcium chloride
Image by Firetwister _ Markus Brunner
Cross section Human Stomach
Cross section Human Stomach
Image by TheVisualMD
gastric acid in stomach hydrochloric acid, potassium chloride and sodium chloride
gastric acid in stomach hydrochloric acid, potassium chloride and sodium chloride
Image by TheVisualMD
Fluid Regulation
TheVisualMD
Chloride: Stomach Wall Lining Close Up
TheVisualMD
Chloride: Stomach
TheVisualMD
3:26
Fluid and Electrolytes: Chloride
EmpoweRN/YouTube
2:42
What Do Electrolytes Actually Do?
Reactions/YouTube
1:47
Why You Need Electrolytes - Can It Help With Getting Stronger?
PictureFit/YouTube
1:12
Electrolytes - What Are Electrolytes - Functions Of Electrolytes
Whats Up Dude/YouTube
4:52
What would happen if you didn’t drink water? - Mia Nacamulli
TED-Ed/YouTube
4:07
Chloride Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
NURSINGcom/YouTube
Calcium chloride
Firetwister _ Markus Brunner
Cross section Human Stomach
TheVisualMD
gastric acid in stomach hydrochloric acid, potassium chloride and sodium chloride
TheVisualMD
Potassium
Potassium Blood Test
Also called: Potassium, Hypokalemia Test, Hyperkalemia Test
A potassium blood test measures the potassium levels in your blood. It is often included in a series of routine blood tests called an electrolyte panel. Too much or too little potassium may indicate a serious medical problem.
Potassium Blood Test
Also called: Potassium, Hypokalemia Test, Hyperkalemia Test
A potassium blood test measures the potassium levels in your blood. It is often included in a series of routine blood tests called an electrolyte panel. Too much or too little potassium may indicate a serious medical problem.
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Use the slider below to see how your results affect your
health.
meq/L
3.5
5
Your result is Low.
Low levels of potassium (hypokalemia) can be caused by vomiting and diarrhea, or the side effects of drugs including, mostly commonly, diuretics.
Related conditions
A potassium blood test measures the amount of potassium in your blood. Potassium is a type of electrolyte. Electrolytes are electrically charged minerals that help control fluid levels and the balance of acids and bases (pH balance) in your body. They also help control muscle and nerve activity and perform other important functions.
Your cells, nerves, heart, and muscles need potassium to work properly. Potassium levels that are too high or too low may be a sign of a medical problem.
Other names: potassium serum, serum potassium, serum electrolytes, K
A potassium blood test measures how much potassium is in your blood. The test is often part of a group of routine blood tests called an electrolyte panel. It may be used to monitor or diagnose conditions related to abnormal potassium levels. These conditions include kidney disease, high blood pressure, and heart disease.
Your health care provider may order a potassium blood test as part of your regular checkup or to monitor an existing condition, such as diabetes, kidney disease, or adrenal gland disorders. You may also need this test if you take medicines that could affect your potassium levels or if you have symptoms of having too much or too little potassium.
If your potassium levels are too high (hyperkalemia), your symptoms may include:
Arrhythmia (a problem with the rate or rhythm of your heartbeat)
Fatigue
Muscle weakness
Nausea
Numbness or tingling
If your potassium levels are too low (hypokalemia), your symptoms may include:
Irregular heartbeat
Muscle cramps
Weak or twitching muscles
Fatigue
Nausea
Constipation
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a potassium blood test or an electrolyte panel. If your provider has ordered more tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Too much potassium in the blood (hyperkalemia). It's often the result of two or more causes. High potassium levels may be a sign of:
Kidney disease. Your kidneys remove extra potassium from your body. Too much potassium may mean your kidneys aren't working well.
Addison disease, a disorder of the adrenal glands
Injuries, burns, or surgery that can cause your cells to release extra potassium into your blood
Type 1 diabetes that is not well controlled
The side effects of certain medicines, such as diuretics ("water pills") or antibiotics
A diet too high in potassium (not common). Bananas, apricots, green leafy vegetables, avocados and many other foods are good sources of potassium that are part of a healthy diet. But eating very large amounts of potassium-rich foods or taking potassium supplements can lead to health problems.
Too little potassium in the blood (hypokalemia) may be a sign of:
Use of prescription diuretics
Fluid loss from diarrhea, vomiting, or heavy sweating
Using too many laxatives
Adrenal gland disorders, including Cushing's syndrome and aldosteronism
Kidney disease
Alcohol use disorder (AUD)
A diet too low in potassium (not common)
If your test results are not in the normal range, it doesn't always mean that you have a medical condition that needs treatment. Certain prescription and over-the-counter medicines and supplements may raise your potassium levels. And eating a lot of licorice may lower your levels. But only real licorice, which comes from licorice plants, has this effect. Most licorice products sold in the U.S. don't contain any real licorice. Check the package ingredient label to be sure.
To learn what your results mean, talk with your provider.
Repeated clenching and relaxing of your fist just before or during your blood test may temporarily increase the potassium levels in your blood. This may lead to an incorrect result.
Potassium Blood Test: MedlinePlus Medical Test [accessed on Dec 19, 2023]
Additional Materials (16)
Fluid & Electrolytes: Potassium
Video by EmpoweRN/YouTube
Electrolytes - What Are Electrolytes - Functions Of Electrolytes
Video by Whats Up Dude/YouTube
Why You Need Electrolytes - Can It Help With Getting Stronger?
Video by PictureFit/YouTube
What Do Electrolytes Actually Do?
Video by Reactions/YouTube
What would happen if you didn’t drink water? - Mia Nacamulli
Video by TED-Ed/YouTube
3 Signs You're Not Getting Enough Potassium
Video by DoctorOz/YouTube
Muscle Cramps & Spasms – Dr.Berg On Charley Horses
Video by Dr. Eric Berg DC/YouTube
What Causes Cramps?
Video by Life Noggin/YouTube
Charley Horse Causes, Relief
Video by Wendy Westwood/YouTube
High potassium levels: Should I Worry?
Video by Fox News/YouTube
Aldosterone raises blood pressure and lowers potassium | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Plate of High Potassium Food
Clockwise from top left: tomato, orange, broccoli, carrot, butternut squash, beets, banana, spinach, almonds, avocado
Image by TheVisualMD
Potassium Ion
Potassium is an electrolyte; that is, a substance that conducts electricity in the body. Potassium is critical for the proper function of all cells, tissues, and organs in the body. It is essential to heart function, and plays a major role in smooth muscle contraction, making it important for normal digestive and muscle function. The mineral also plays a role in decreasing high blood pressure, as it attenuates the water-gathering effects of sodium. Many foods contain potassium, including all meats, some types of fish (salmon, cod, flounder), and many fruits, vegetables, and legumes. Dairy products are also good sources. If you eat a variety of foods, you'll likely meet the daily requirement. Maintaining the proper balance of sodium and potassium can be difficult; E209most Americans take in far more sodium than potassium. As a rule, five times more potassium than sodium should be consumed.
Image by TheVisualMD
Potassium: Muscle Spasm
Muscles contract in response to nerve impulses. Electrolytes such as potassium establish an electric potential between the inside and outside of cell membranes, which enables the transmission of these nerve impulses. Too little potassium can result in muscle weakness or spasms.
Image by TheVisualMD
Potassium: Heart Rate
Potassium plays an important role in maintaining cardiac electrical activity. A potassium imbalance can result in a slow or irregular heart beat, or even cardiac arrest.
Image by TheVisualMD
Potassium: Neural Conduction
Electrolytes can be either negatively and positively charged (potassium has a positive charge); they establish an electric potential between the inside and outside of cell membranes, which makes possible the transmission of nerve impulses.
Image by TheVisualMD
8:19
Fluid & Electrolytes: Potassium
EmpoweRN/YouTube
1:12
Electrolytes - What Are Electrolytes - Functions Of Electrolytes
Whats Up Dude/YouTube
1:47
Why You Need Electrolytes - Can It Help With Getting Stronger?
PictureFit/YouTube
2:42
What Do Electrolytes Actually Do?
Reactions/YouTube
4:52
What would happen if you didn’t drink water? - Mia Nacamulli
TED-Ed/YouTube
5:18
3 Signs You're Not Getting Enough Potassium
DoctorOz/YouTube
4:03
Muscle Cramps & Spasms – Dr.Berg On Charley Horses
Dr. Eric Berg DC/YouTube
1:46
What Causes Cramps?
Life Noggin/YouTube
3:26
Charley Horse Causes, Relief
Wendy Westwood/YouTube
3:35
High potassium levels: Should I Worry?
Fox News/YouTube
13:18
Aldosterone raises blood pressure and lowers potassium | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
Plate of High Potassium Food
TheVisualMD
Potassium Ion
TheVisualMD
Potassium: Muscle Spasm
TheVisualMD
Potassium: Heart Rate
TheVisualMD
Potassium: Neural Conduction
TheVisualMD
Bicarbonate
Carbon Dioxide Blood Test
Also called: Carbon Dioxide, CO2, Bicarbonate, Metabolic Alkalosis Test, Metabolic Acidosis Test
A carbon dioxide (CO2) blood test measures the amount of carbon dioxide is in the blood in your veins. Too much or too little CO2 in the blood can indicate a health problem. The test is most often done as part of an electrolyte or metabolic panel.
Carbon Dioxide Blood Test
Also called: Carbon Dioxide, CO2, Bicarbonate, Metabolic Alkalosis Test, Metabolic Acidosis Test
A carbon dioxide (CO2) blood test measures the amount of carbon dioxide is in the blood in your veins. Too much or too little CO2 in the blood can indicate a health problem. The test is most often done as part of an electrolyte or metabolic panel.
{"scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":1,"max":21},"text":"Lower levels of bicarbonate, called metabolic acidosis, means your blood is too acidic. It may be a sign that your body is having a hard time keeping the right acid-base balance (pH balance)."},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":21,"max":28},"text":"Changes in your bicarbonate level may suggest that you are losing or retaining acidic fluid. This may cause an imbalance in your body's acid-base balance (pH balance)."},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":28,"max":60},"text":"Higher levels of bicarbonate in your blood, called metabolic alkalosis, may indicate that your body has an electrolyte imbalance, or that there is a problem removing CO2 through your lungs."}],"units":[{"printSymbol":"meq\/L","code":"meq\/L","name":"milliequivalent per liter"}],"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
meq/L
21
28
Your result is Low.
Lower levels of bicarbonate, called metabolic acidosis, means your blood is too acidic. It may be a sign that your body is having a hard time keeping the right acid-base balance (pH balance).
Related conditions
A carbon dioxide (CO2) blood test measures the amount of carbon dioxide in your blood. Carbon dioxide is an odorless, colorless gas. It is a waste product that your body makes when it uses food for energy.
Your blood carries carbon dioxide to your lungs. When you exhale, you breathe out carbon dioxide. Having too much or too little carbon dioxide in your blood can be a sign of a health problem.
Most of the carbon dioxide in your body is in the form of bicarbonate, which is a type of electrolyte. Electrolytes are electrically charged minerals that help control the amount of fluid and the balance of acids and bases (pH balance) in your body. A CO2 blood test is often part of a group of tests called an electrolyte panel.
An electrolyte panel may be part of a regular check-up. The test may also help diagnose or monitor conditions related to an electrolyte imbalance. These include high blood pressure and diseases of the kidneys, lungs, or liver.
Your health care provider may order a CO2 blood test as part of your regular checkup or if you have symptoms of an electrolyte imbalance. These symptoms may include:
Trouble breathing
Confusion
Weakness
Fatigue
Vomiting and/or diarrhea over a long period of time
Your provider may also order a CO2 blood test to check for side effects of certain medicines that can cause electrolyte imbalances.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a CO2 blood test or an electrolyte panel. If your provider has ordered more tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Abnormal test results may be a sign that your body is having a hard time keeping the right acid-base balance (pH balance). This may be because your lungs or kidneys are having a problem removing carbon dioxide or because you have an electrolyte imbalance. Many different types of conditions can cause these problems.
Too much CO2 in the blood can be a sign of many conditions, including:
Lung diseases
Cushing's syndrome
Kidney failure
Metabolic alkalosis, a condition in which your blood is not acidic enough. You may lose acid from conditions such as vomiting, dehydration, and anorexia.
Too little CO2 in the blood may be a sign of:
Addison disease, a complication of type 1 and type 2 diabetes
Diabetic ketoacidosis
Shock
Metabolic acidosis, a condition in which your blood is too acidic. It may be caused by many things, including kidney or liver disease, or long-lasting diarrhea.
Respiratory alkalosis, a condition in which your blood is not acidic enough because of lung or breathing disorders, including hyperventilation (rapid, deep breathing).
If your test results are not in the normal range, it doesn't necessarily mean you have a medical condition that needs treatment. Other factors, including certain medicines, can affect the level of CO2 in your blood. To learn what your results mean, talk with your provider.
Some prescription and over-the-counter medicines can increase or decrease the amount of carbon dioxide in your blood. Be sure to tell your provider about any medicines you are taking.
Carbon Dioxide (CO2) in Blood: MedlinePlus Medical Test [accessed on Dec 20, 2023]
CO2 blood test: MedlinePlus Medical Encyclopedia [accessed on Dec 20, 2023]
Carbon Dioxide (Blood) - Health Encyclopedia - University of Rochester Medical Center [accessed on Dec 20, 2023]
Blood Urea Nitrogen Test
Blood Urea Nitrogen Test
Also called: BUN, Urea Nitrogen
The test measures the amount of urea nitrogen in your blood. Urea nitrogen is one of the waste products removed from your blood by your kidneys. Higher than normal BUN levels may be a sign that your kidneys aren't working efficiently.
Blood Urea Nitrogen Test
Also called: BUN, Urea Nitrogen
The test measures the amount of urea nitrogen in your blood. Urea nitrogen is one of the waste products removed from your blood by your kidneys. Higher than normal BUN levels may be a sign that your kidneys aren't working efficiently.
{"scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":8},"text":"Low BUN levels are rare and not usually a cause for concern."},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":8,"max":23},"text":"Normal results vary based on the laboratory and the method used."},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":23,"max":60},"text":"A high level of blood urea nitrogen is a sign that your kidneys are not working properly.<br \/>\n"}],"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
mg/dL
8
23
Your result is Low.
Low BUN levels are rare and not usually a cause for concern.
Related conditions
A BUN, or blood urea nitrogen test, can provide important information about your kidney function. The main job of your kidneys is to remove waste and extra fluid from your body. If you have kidney disease, this waste material can build up in your blood. Over time, this may lead to serious health problems, including high blood pressure, anemia, and heart disease.
The BUN test measures the amount of urea nitrogen in your blood. Urea nitrogen is a waste product that your kidneys remove from your blood. Higher than normal BUN levels may be a sign that your kidneys aren't working well.
People with early kidney disease may not have any symptoms. A BUN test can help uncover kidney problems at an early stage when treatment can be more effective.
A BUN test is often part of a series of tests called a comprehensive metabolic panel. It can help diagnose or monitor a kidney disease or disorder.
Your health care provider may order a BUN test as part of a routine check-up or if you have or are at risk for a kidney problem. Early kidney disease usually does not have any signs or symptoms. You may be more likely to develop kidney disease if you have:
Family of kidney problems
Diabetes
High blood pressure
Heart disease
Your provider may check your BUN levels if you are having symptoms of later stage kidney disease, such as:
Needing to urinate (pee) more often or less often than usual
Itching
Fatigue
Swelling in your legs, feet, or ankles
Muscle cramps
Trouble sleeping
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Usually there is no special preparation necessary for a BUN test. But if your provider has ordered other tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Normal BUN levels can vary, but generally a high level of blood urea nitrogen is a sign that your kidneys are not working well. But abnormal results don't always mean that you have a medical condition that needs treatment.
Higher than normal BUN levels can also be caused by dehydration (too little fluid in your body), burns, certain medicines, a high protein diet, or other factors, including your age. BUN levels normally increase as you get older. To learn what your results mean, talk to your health care provider.
A BUN test is only one type of measurement of kidney function. If your provider thinks you may have kidney disease, you may need other tests. These may include tests to measure:
Creatinine, which is another waste product that your kidneys remove from your body
GFR (Glomerular Filtration Rate), which estimates how well your kidneys are filtering blood
BUN (Blood Urea Nitrogen): MedlinePlus Lab Test Information [accessed on Sep 06, 2018]
001040: Urea Nitrogen | LabCorp [accessed on Sep 06, 2018]
BUN | LabCorp [accessed on Sep 06, 2018]
Fontanarosa, P., & Christiansen, S. (2009, April 01). Laboratory Values. AMA Manual of Style. Ed. [accessed on Oct 09, 2018]
Additional Materials (15)
✔✔✔ What is BUN and Creatinine - Kidney Function Test ✔✔✔
Video by NKN/YouTube
Acute Renal Failure
Video by Armando Hasudungan/YouTube
BUN and Creatinine
Video by PhysioPathoPharmaco/YouTube
Kidney Function Tests and Interpretation of Results.
Video by Medcrine Medical/YouTube
Blood Urea Nitrogen (BUN) (Nursing Lab Values)
Video by NURSINGcom/YouTube
Kidney Disease: Understanding Your Lab Values
Video by UC San Diego Health/YouTube
BUN Test/Urea: Role in Kidney function Testing- Conditions with High Blood Urea Nitrogen- Dr Kasi MD
Video by Interpret Your Lab Tests/YouTube
Kidney function test normal range
Video by Shomu's Biology/YouTube
Urea Nitrogen Molecule
The blood urea nitrogen (BUN) test measures the amount of the waste urea found in the blood. Nitrogen, in the form of ammonia, is produced by the breakdown of proteins; it combines with carbon, hydrogen and oxygen to form urea, which is then released into the bloodstream and carried to the kidneys, where it is filtered out and eliminated in the urine. If the kidneys are damaged, their ability to remove urea from the blood is impaired.
Image by TheVisualMD
Male Urinary System
This anterior view of a male torso reveals the upper urinary tract (kidneys, ureter and bladder) in situ. Anatomy overlaying this system including the liver, pancreas, small intestines, and ribs, have been \"ghosted in\" in order to allow an unobstructed view of the structures underneath. Completely visible anatomy surrounding the kidneys include the perirenal fat, adrenal gland, pelvis, aorta, vena cava and lower spinal column. The kidneys are the body's primary filtering system, responsible for processing and eliminating wastes from the bloodstream such as excess salts and proteins. Once extracted, these are then broken down into a substance called urea. Urea flows to the bladder and is eventually expelled as urine. Working non-stop day and night, the kidneys filter nearly 200 quarts of blood per day, producing about two quarts of urine (depending on body size). The left kidney is usually positioned slightly higher in the body than the right. This occurs because the developing liver on the right side of the spine grows more rapidly than the kidneys and displaces the right kidney downwards.
Image by TheVisualMD
Blood Urea Nitrogen (BUN): Protein
Nitrogen, in the form of ammonia, is produced by the breakdown of proteins; it combines with carbon, hydrogen and oxygen to form urea, which is released into the blood; the kidneys, in turn, filter it out and eliminate it in the urine.
Image by TheVisualMD
Blood Urea Nitrogen (BUN): Kidneys
Each day, our kidneys filter 200 quarts of blood to extract 2 quarts of waste products and excess water. The wastes and water become urine, which flows via tubes called ureters to the bladder, where it is stored until released through urination.
Image by TheVisualMD
Diagnosing CKD
Glomerular Filtration Rate (GFR) Glomerular filtration rate (GFR) is the standard means of expressing overall kidney function. Normal GFR is approximate; it is about 100-140 mL/min in men and 85-115 mL/min in women. Patients are divided into five stages of chronic kidney disease based on their GFR. In the first four stages the kidneys are still working, but function lessens with each successive stage. In stage 5, kidney failure, the kidneys stop functioning altogether.
Image by TheVisualMD
Blood Urea Nitrogen (BUN): Glomerulus
The kidneys are extraordinarily good at filtering and removing wastes from the bloodstream (at a rate of 200 quarts each day). The basic filtering unit in the kidney is the glomerulus, a tuft of capillaries that remove wastes.
Image by TheVisualMD
Nitrogenous Wastes
Nitrogenous waste is excreted in different forms by different species. These include (a) ammonia, (b) urea, and (c) uric acid. (credit a: modification of work by Eric Engbretson, USFWS; credit b: modification of work by B. "Moose" Peterson, USFWS; credit c: modification of work by Dave Menke, USFWS)
Image by CNX Openstax
8:29
✔✔✔ What is BUN and Creatinine - Kidney Function Test ✔✔✔
NKN/YouTube
10:12
Acute Renal Failure
Armando Hasudungan/YouTube
5:26
BUN and Creatinine
PhysioPathoPharmaco/YouTube
15:01
Kidney Function Tests and Interpretation of Results.
Medcrine Medical/YouTube
1:42
Blood Urea Nitrogen (BUN) (Nursing Lab Values)
NURSINGcom/YouTube
11:44
Kidney Disease: Understanding Your Lab Values
UC San Diego Health/YouTube
2:34
BUN Test/Urea: Role in Kidney function Testing- Conditions with High Blood Urea Nitrogen- Dr Kasi MD
Interpret Your Lab Tests/YouTube
4:45
Kidney function test normal range
Shomu's Biology/YouTube
Urea Nitrogen Molecule
TheVisualMD
Male Urinary System
TheVisualMD
Blood Urea Nitrogen (BUN): Protein
TheVisualMD
Blood Urea Nitrogen (BUN): Kidneys
TheVisualMD
Diagnosing CKD
TheVisualMD
Blood Urea Nitrogen (BUN): Glomerulus
TheVisualMD
Nitrogenous Wastes
CNX Openstax
BUN/Creatinine Ratio
BUN/Creatinine Ratio
Also called: BUN-to-creatinine ratio
BUN-to-creatinine ratio shows the proportion of protein breakdown waste products like blood urea nitrogen and creatinine in your blood. The result allows your doctor to assess your kidney function and to distinguish different kidney disorders.
BUN/Creatinine Ratio
Also called: BUN-to-creatinine ratio
BUN-to-creatinine ratio shows the proportion of protein breakdown waste products like blood urea nitrogen and creatinine in your blood. The result allows your doctor to assess your kidney function and to distinguish different kidney disorders.
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Use the slider below to see how your results affect your
health.
{ratio}
10
20
Your result is Normal.
Normal results can vary based on the laboratory and the method used.
Related conditions
BUN (blood urea nitrogen) is a waste product that is formed during a breakdown of proteins. When you eat, your liver breaks down the proteins in your food and, as a result, blood urea nitrogen is created. The levels of BUN are related to your total muscle mass because every now and then your muscles are going through breakdown and rebuilding processes.
Your kidneys help remove BUN from the body through urine, leaving a small amount circulating in your blood. Testing for BUN helps to assess your kidney function as well as evaluate if your liver works properly.
Creatinine is also produced as a result of muscle activity. It is actively processed and secreted by small structures called nephrons, which are located in the kidneys. Measuring the creatinine level in your blood helps your doctor to assess your kidney function.
As different diseases affect BUN-to-creatinine ratio differently, the changes of BUN-to-creatinine ratio in the blood make it possible to distinguish kidney diseases.
BUN-to-creatinine ratio is mainly used to diagnose kidney disease.
Your doctor may order a BUN-to-creatinine ratio if you are experiencing symptoms of kidney disease, such as:
Problems when urinating (pain, urinating too often or too rarely)
Abnormal urine (foamy, bloody, brown, too light)
Pain in the middle of your back
Swelling in different areas of your body (arms, legs, ankles, around the eyes)
Restless legs
Fatigue
Pain in joints or bones
Sometimes, a BUN test is separately ordered to assess your risk of developing kidney disease. People at high risk of developing kidney disease are:
People who have a family history of kidney disease
People who have high blood pressure
People with diabetes
People with heart disease
Testing for BUN-to-creatinine ratio starts with blood sample collection from the vein. The blood is collected into small tubes and sent to the laboratory.
No fasting or other preparations are needed. However, you should inform your healthcare practitioner if you are taking any over-the-counter or prescription drugs.
You may feel discomfort when the needle is inserted and extracted but otherwise is a quick procedure. You may also experience bruising and a little bleeding, as well as mild soreness for a short amount of time after the blood extraction.
The normal result for BUN-to-creatinine ratio is from 10:1 to 20:1.
Lower results may indicate kidney disease (glomerulonephritis or acute tubular necrosis), liver failure, or malnutrition.
An increased BUN-to-creatinine ratio could refer to a condition that prevents blood flow to the kidneys (heart failure, dehydration). A higher ratio could also be seen in cases of high protein intake, high levels of protein in the blood, or in cases of gastrointestinal bleeding.
The level of BUN is affected by the amount of proteins in the blood. So, high protein intake causes an increase in BUN levels, while a low intake decreases the BUN levels.
Pregnancy could be related to both increased or decreased concentrations of BUN.
Blood Urea Nitrogen (BUN) - Understand the Test & Your Results [accessed on Sep 06, 2018]
BUN (Blood Urea Nitrogen): MedlinePlus Lab Test Information [accessed on Sep 06, 2018]
BUN/Creatinine Ratio [accessed on Sep 06, 2018]
Blood Urea Nitrogen (BUN) Test: High vs. Low Levels, Normal Range [accessed on Sep 06, 2018]
BUN/Creatinine Ratio Test - Healthlabs.com [accessed on Oct 09, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
Creatinine Molecule
Glomeruli are tiny filters in the kidneys that remove waste products from the blood, while preventing the loss of other constituents, including proteins, electrolytes and blood cells. The glomerular filtration rate is the amount of blood that is filtered by the glomeruli per minute. When a person`s kidney function declines, the filtration rate decreases and waste products, including creatinine, which is produced in the muscles and normally filtered out and excreted into the urine, instead begin to accumulate in the blood.
Image by TheVisualMD
Creatinine
Measuring serum creatinine is a simple test, and it is the most commonly used indicator of renal function.
Image by TheVisualMD
✔✔✔ What is BUN and Creatinine - Kidney Function Test ✔✔✔
Video by NKN/YouTube
Acute Renal Failure
Video by Armando Hasudungan/YouTube
Nephrology - Glomerular Filtration
Video by Armando Hasudungan/YouTube
Creatinine Clearance Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
Video by NURSINGcom/YouTube
Blood Urea Nitrogen BUN Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
Video by NURSINGcom/YouTube
Creatinine Molecule
TheVisualMD
Creatinine
TheVisualMD
8:29
✔✔✔ What is BUN and Creatinine - Kidney Function Test ✔✔✔
NKN/YouTube
10:12
Acute Renal Failure
Armando Hasudungan/YouTube
14:02
Nephrology - Glomerular Filtration
Armando Hasudungan/YouTube
3:01
Creatinine Clearance Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
NURSINGcom/YouTube
4:32
Blood Urea Nitrogen BUN Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
NURSINGcom/YouTube
How Does Diet Affect It?
Food for CKD
Image by TheVisualMD
Food for CKD
Changing your diet and learning what foods it’s best to eat, and in what amounts, is one of the trickiest parts of CKD treatment. That’s why it’s a very good idea to sit down with a registered dietitian to plan meals that you like and that provide the right types of nutrition, while avoiding foods that can cause problems. Protein is necessary in everyone’s diet to maintain all the tissues of the body. Eating too much protein, however, can worsen CKD because proteins break down into byproducts that must be eliminated by the kidneys. (People on dialysis, however, need to eat a high-protein diet.) A dietitian can tell you how many grams of protein you should eat per day and help you to figure out how to reduce any excess consumption.
Fats provide energy and contain important vitamins. Some fats are healthier than others, though. Avoid trans fats (hydrogenated vegetable oils), found in commercial baked goods, many fried fast foods, and some snack foods such as chips. Use canola oil and olive oil whenever possible.
Salt is harmful if you eat too much because it causes your body to retain water, raising your blood pressure and straining your heart and kidneys. One way to avoid eating too much salt is to steer clear of canned and processed foods, which often contain large amounts of sodium. Cured foods like ham and pickles are very salty, too. Always check the nutrition labels on the food you buy, and keep your sodium intake below 1,500 mg/day.
Image by TheVisualMD
How Does What I Eat and Drink Affect Me While on Peritoneal Dialysis?
Your choices about what to eat and drink while on dialysis can affect how you feel and how well your treatments work.
Healthy kidneys balance the salts and minerals—such as calcium, phosphorus, sodium, and potassium—in your blood. Peritoneal dialysis removes wastes and extra fluid from your body but doesn’t maintain a perfect balance.
The eating plan for peritoneal dialysis may be less strict than the one for hemodialysis. Because you do peritoneal dialysis every day, there is less time for wastes and extra fluids to build up between treatments than between hemodialysis treatments.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (2)
What should I eat if I have chronic kidney disease?
Video by National Kidney Foundation/YouTube
Eat Healthy to Prevent Kidney Disease and Diabetes
Video by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/YouTube
0:59
What should I eat if I have chronic kidney disease?
National Kidney Foundation/YouTube
1:20
Eat Healthy to Prevent Kidney Disease and Diabetes
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/YouTube
How Can I Learn What I Should Eat?
Kidney Vasculature
Image by TheVisualMD
Kidney Vasculature
The kidneys are bean-shaped, fist-sized organs located on either side of the spine, near the middle of the back. The main function of the kidneys is to remove waste products and excess water from the blood.
Image by TheVisualMD
How Can I Learn What I Should Eat?
Talk with a dietitian at your dialysis center to plan your meals. Renal dietitians have special training in caring for the food and nutrition needs of people with kidney disease. Your dietitian will help you choose foods that you enjoy while also meeting your health needs.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (1)
Tips for Eating Right with Kidney Failure
Tips for Eating Right with Kidney Failure
Tips for Eating Right with Kidney Failure
Why Should I Limit How Much Liquid I Eat or Drink?
Carrot gingerSoup
Image by Einladung_zum_Essen/Pixabay
Carrot gingerSoup
Image by Einladung_zum_Essen/Pixabay
Why Should I Limit How Much Liquid I Eat or Drink?
You may feel better if you limit how much liquid you eat and drink. Too much fluid can build up in your body and may cause
swelling and weight gain between dialysis treatments
changes in your blood pressure
your heart to work harder, which can lead to serious heart trouble
fluid buildup in your lungs, making it hard to breathe
Your dietitian can help you figure out how much liquid is right for you. Your nephrologist can change your dialysis prescription.
Which foods count as liquid and why?
Foods that are liquid at room temperature, such as soup, contain water. Gelatin, pudding, ice cream, and other foods that include a lot of liquid in the recipe also count. Some fruits and vegetables, such as watermelon, contain a lot of water. When you add up how much liquid you have in a day, be sure to count these foods.
Set daily goals for liquids
Work with your dietitian to set a goal for how much liquid you can have each day. Keep track of the fluids that you eat and drink. I can have a total of ________ ounces of liquid each day.
Daily plan:
I can have _____ ounces of ______________ with breakfast.
I can have _____ ounces of ______________ in the morning.
I can have _____ ounces of ______________ with lunch.
I can have _____ ounces of ______________ in the afternoon.
I can have _____ ounces of ______________ with supper.
I can have _____ ounces of ______________ in the evening.
TOTAL: _______ ounces. This number should equal the goal that you set with your dietitian.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
What Do I Need to Know About Potassium?
Potassium
Image by TheVisualMD
Potassium
Image by TheVisualMD
What Do I Need to Know About Potassium?
Potassium helps your nerves and muscles work the right way. Healthy kidneys keep the right amount of potassium in your blood to keep your heart beating at a steady pace. Peritoneal dialysis can remove too much potassium from your blood, so you may need to eat more high-potassium foods such as bananas, oranges, potatoes, and tomatoes.
Eat the right amount of potassium
Your dietitian will help you choose foods you like that have the right amount of potassium. He or she will also give you more specific information about how much potassium is in different foods. Make a food plan that includes foods with potassium. Start by noting the high-potassium foods you eat.
Set daily potassium goals
I can have _____ serving size(s) of ______________.
I can have _____ serving size(s) of ______________.
I can have _____ serving size(s) of ______________.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (6)
Nutritional Advice : How to Increase Potassium With Food Intake
Video by ehowhealth/YouTube
Kidney Conversations: High Potassium & Your Kidneys
Video by National Kidney Foundation/YouTube
Foods Rich In Potassium - Bananas
Video by Foods4Health/YouTube
Foods Rich In Potassium - Peaches
Video by Foods4Health/YouTube
Foods Rich In Potassium - Apricots
Video by Foods4Health/YouTube
Foods Rich In Potassium - Cherries
Video by Foods4Health/YouTube
1:29
Nutritional Advice : How to Increase Potassium With Food Intake
ehowhealth/YouTube
38:25
Kidney Conversations: High Potassium & Your Kidneys
National Kidney Foundation/YouTube
1:48
Foods Rich In Potassium - Bananas
Foods4Health/YouTube
1:48
Foods Rich In Potassium - Peaches
Foods4Health/YouTube
1:48
Foods Rich In Potassium - Apricots
Foods4Health/YouTube
1:48
Foods Rich In Potassium - Cherries
Foods4Health/YouTube
What Do I Need to Know About Phosphorus?
Phosphorus Test and Phosphorus Rich Foods
Image by TheVisualMD
Phosphorus Test and Phosphorus Rich Foods
Phosphorus Test and Phosphorus Rich Foods : The phosphorus test is used to monitor the levels of phosphorus in the blood. Most of the body's phosphorus is in a form combined with calcium to help form bones and teeth, but it is also found in muscle, nerve tissue, and, in tiny but crucial amounts, within cells throughout the body, where it is a component of key molecules such as DNA. A wide variety of foods, such as meat, eggs, fish, dairy, beans, peas, nuts, and grains contain significant amounts of phosphorus. Plant-based sources of phosphorus, however, are less available to the body because we lack digestive enzymes to fully utilize them.
Image by TheVisualMD
What Do I Need to Know About Phosphorus?
Too much phosphorus in your blood may make your bones weak and likely to break. Too much phosphorus also may make your skin itch. Peritoneal dialysis may not remove enough phosphorus from your body, so you probably will need to limit foods, which are high in phosphorus.
You may need to take a phosphate binder to control the phosphorus in your blood. Common phosphate binders include sevelamer, calcium acetate, lanthanum carbonate, and calcium carbonate. These medicines bind to the phosphorus in food while in your intestines and keep it from being absorbed.
Limit phosphorus
Food makers often add phosphorus to processed and packaged foods, such as lunch meats. You should avoid these foods. Poultry, fish, nuts, peanut butter, dried beans, cola, tea, and dairy products are high in phosphorus.
Take phosphorus binders with your meals and snacks.
Your dietitian will give you more specific information about phosphorus and protein food portions.
Meat, poultry, and fish: A cooked portion should be about 3 ounces, or about the size of a deck of cards.
Dairy foods: Keep your portions to 1/2 cup of milk or yogurt, or one thin slice of cheese.
Beans and lentils: Portions should be about 1/2 cup of cooked beans or lentils.
Nuts: Keep your portions to about 1/4 cup of nuts.
I can have _____ serving size(s) of ____________________________.
I can have _____ serving size(s) of ____________________________.
I can have _____ serving size(s) of ____________________________.
Packaged foods may have added phosphorus. Look for phosphorus, or for words with “phos,” on food labels. Choose a different food when the ingredient list has words with “phos.”
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (5)
Phosphorus and kidney disease - American Kidney Fund
Video by kidneyfund/YouTube
Phosphorus and kidney disease - Dining out
Video by kidneyfund/YouTube
Phosphorus and kidney disease - Grocery shopping
Video by kidneyfund/YouTube
Itchy Skin & Chronic Kidney Disease - A sign of low kidney function & high phosphorus
Video by Dadvice TV - Kidney Health Coach/YouTube
Phosphorus Intake and Chronic Kidney Disease
Video by UC San Diego Health/YouTube
2:54
Phosphorus and kidney disease - American Kidney Fund
kidneyfund/YouTube
4:27
Phosphorus and kidney disease - Dining out
kidneyfund/YouTube
4:09
Phosphorus and kidney disease - Grocery shopping
kidneyfund/YouTube
8:19
Itchy Skin & Chronic Kidney Disease - A sign of low kidney function & high phosphorus
Dadvice TV - Kidney Health Coach/YouTube
3:34
Phosphorus Intake and Chronic Kidney Disease
UC San Diego Health/YouTube
What Do I Need to Know About Protein?
Protein Breakdown and Reassembly
Image by TheVisualMD
Protein Breakdown and Reassembly
Proteins are made from non-essential amino acids already in the body and from the essential amino acids derived from the diet. Though essential amino acids are utilized most expediently when they come neatly packaged up in high-quality dietary protein, the body can`t make use of the bundled amino acids until they are broken down into separate components. During digestion an enzyme continually breaks down chains of amino acids, called polypeptides, until the smaller particles can be absorbed through the small intestine. Once that breakdown process is complete, the body gets to work reassembling them with other molecules to be used for energy and other protein functions.
Image by TheVisualMD
What Do I Need to Know About Protein?
Dietitians encourage most people on peritoneal dialysis to eat high-quality protein because it produces less waste, which has to be removed during dialysis. High-quality protein comes from meat, poultry, fish, and eggs. Avoid processed meats such as hot dogs and canned chili, which have high amounts of sodium and phosphorus.
Eat the right amount of high-quality protein
Try to choose lean, or low-fat, meats that also are low in phosphorus, such as chicken, fish, or roast beef. If you’re a vegetarian, ask about other ways to get protein.
Low-fat milk is a good source of protein. However, milk is high in phosphorus and also adds to your liquid intake. Talk to your dietitian about how to choose the right combination of protein foods for you.
I can have _____ serving size(s) of ______________________.
I can have _____ serving size(s) of ______________________.
I can have _____ serving size(s) of ______________________.
If milk is in my food plan, I will drink ______ ounce(s) of milk a day.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (3)
Chronic Kidney Disease: Protein Intake
Video by UC San Diego Health/YouTube
Dietary Protein
There is a wooden cutting board on a white tablecloth. There are various cuts of meat and fish on both the table and the block, garnished with sliced lemons, watercress and parsley. A blue bowl in the background is full of cottage cheese.
Image by National Cancer Institute
Plate of High Protein Food
When your body digests protein, a waste product called urea is produced. If kidney function is diminished, this waste can build up in the blood and cause fatigue and loss of appetite. CKD patients are usually placed on a modest protein restriction. In some patients a low-protein diet can improve symptoms like nausea or vomiting.
Image by TheVisualMD
2:38
Chronic Kidney Disease: Protein Intake
UC San Diego Health/YouTube
Dietary Protein
National Cancer Institute
Plate of High Protein Food
TheVisualMD
What Do I Need to Know About Sodium?
Sodium-Restricted DIet
Image by CDC
Sodium-Restricted DIet
Entitled, “Reducing Sodium: From Menu to Mouth”, this is one of a series of informative infographics created in 2014, by the Centers for Disease Control and Prevention (CDC) in order to disseminate information to consumers about the high levels of sodium contained in fast food, or sit-down restaurants, as compared to home-cooked meals. The graphic also provides the following “5 strategies” to help support sodium reduction in restaurant foods: - Provide nutrition information at the point of purchase - Make sodium reduction a part of training for restaurant licensing - Make health department dietitians available to assist with nutrition support - Incentivize sodium reduction through favorable changes to licensure and zoning requirements - Create group purchasing organizations for saving on purchase of lower sodium items
Image by CDC
What Do I Need to Know About Sodium?
Sodium is a part of salt. Sodium is found in many canned, packaged, frozen, and fast foods. Sodium is also found in many condiments, such as mustard and ketchup, and in seasonings and meats. Too much sodium makes you thirsty, which makes you drink more liquid.
Limit sodium
To limit sodium, try to eat fresh, naturally low-sodium foods. Buy fresh foods more often; cook from scratch; and use spices, herbs, and salt-free seasonings instead of salt. Look for products labeled “low sodium.” Rinse canned foods to remove salt. Talk with your dietitian about spices you can use to flavor your food. Your dietitian can help you find spice blends without sodium. List them here
Instead of _________, I can use this spice _________.
Instead of _________, I can use this spice _________.
Instead of _________, I can use this spice _________.
Instead of _________, I can eat _________.
Instead of _________, I can eat _________.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (6)
Sodium (salt) and your kidneys
Video by kidneyfund/YouTube
Where do we get most of our sodium?
Video by American Heart Association/YouTube
Fluid and Electrolytes: Sodium
Video by EmpoweRN/YouTube
Fluids and Electrolytes Sodium
Video by DrBruce Forciea/YouTube
Choose Wisely—Sodium Content Can Vary Within Food Categories
Two sandwiches, one marked Higher Sodium Choices and the other marked Lower Sodium Choices. Each component of the sandwiches is labeled with its amount of sodium. The higher sodium choices yield a total of 1,522 milligrams of sodium per whole sandwich, while the lower sodium choices yield a total of 917 milligrams of sodium per whole sandwich.
Image by CDC
Sodium Ion
Sodium is an essential mineral and electrolyte, a positively charged molecule that performs key roles along with other electrolytes such as calcium, potassium, bicarbonate and chloride. The body maintains sodium blood levels in a narrow range; urine is the primary way in which the body balances the amount of sodium and water ingested with the amount eliminated. Urine sodium levels are tested in patients who have abnormal blood sodium levels in order to determine whether the imbalance is from inadequate water intake or excessive loss. The sodium test is done to determine electrolyte balance in the body as well as kidney function. A test for sodium, along with other electrolytes, is routinely included in the basic metabolic panel (BMP).
Image by TheVisualMD
3:12
Sodium (salt) and your kidneys
kidneyfund/YouTube
1:37
Where do we get most of our sodium?
American Heart Association/YouTube
9:43
Fluid and Electrolytes: Sodium
EmpoweRN/YouTube
3:04
Fluids and Electrolytes Sodium
DrBruce Forciea/YouTube
Choose Wisely—Sodium Content Can Vary Within Food Categories
CDC
Sodium Ion
TheVisualMD
What Do I Need to Know About Calories?
Menu with calories
Image by U.S. Food and Drug Administration (FDA)
Menu with calories
FDA's final rule on menu labeling gives consumers the information on calories they need to make informed food choices.
Image by U.S. Food and Drug Administration (FDA)
What Do I Need to Know About Calories?
All foods provide energy measured in calories. Some foods, such as oily and sugary foods, are high in calories. Your body can absorb the dextrose from your dialysis solution, which can increase your calorie intake. Taking in more calories than you use can make you gain weight over time. You may find that you need to take in fewer calories to prevent weight gain. Your dietitian can help you create and follow an eating plan to stay at a healthy weight.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (3)
Menu or Menu Board Offering Standard Items for a Special Price
This example shows a menu or menu board describing an opportunity for the consumer to combine standard menu items for a special price. In such cases, the calories of the combination do not need to be declared if the calories for each standard item is declared elsewhere on the menu or menu board.
Image by The U.S. Food and Drug Administration
Single Signs for Multiple Items
Close-up of a single sign use to declare calories for multiple items on a self-service salad bar. Such signs must be near the food and indicate the number of calories per serving or per item (e.g., 80 calories per egg, 180 calories per scoop of potato salad, 130 calories per tablespoon of Ranch dressing), as appropriate. Here you can see both the succinct statement and the statement of availability.
Image by The U.S. Food and Drug Administration
Portion Control
Twenty years ago a typical turkey sandwich, purchased in a deli, contained about 320 calories. Today the average turkey sandwich contains 820 calories. In those days, a regular-size portion of French fries from a fast-food restaurant contained 210 calories. Today the size of a typical serving has increased so much that it has 610 calories—about three times as much!
Image by TheVisualMD
Menu or Menu Board Offering Standard Items for a Special Price
The U.S. Food and Drug Administration
Single Signs for Multiple Items
The U.S. Food and Drug Administration
Portion Control
TheVisualMD
Should I Take Vitamin and Mineral Supplements?
Vitamins, Minerals, & Development
Image by TheVisualMD
Vitamins, Minerals, & Development
Image by TheVisualMD
Should I Take Vitamin and Mineral Supplements?
You may not get enough vitamins and minerals because you have to avoid some foods. Peritoneal dialysis also removes some vitamins from your body. Your health care provider may prescribe a vitamin and mineral supplement designed specifically for people with kidney failure.
Warning: Never take vitamin and mineral supplements you can buy over the counter (OTC). OTC vitamin and mineral supplements may be harmful to people with kidney failure. For safety reasons, talk with your health care provider before taking any medicines, vitamin and mineral supplements, or probiotics that he or she hasn’t prescribed for you.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Peritoneal Dialysis
Peritoneal dialysis is a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter your blood inside your body. Learn about the different types of peritoneal dialysis treatments you can do at home—how to prepare and do exchanges, and what are the possible risks.