CKD and fluid intake

Fluid intake for dialysis patients is limited between dialysis treatments since the kidneys lose the ability to produce urine and remove excess fluid from the body.

  • I am on dialysis, how much water should I drink and why?
  • One of the key questions of patients with renal insufficiency and / or dialysis patients is "how much water should I consume". The kidney patient MUST be aware of the fluids he consumes, otherwise it will accumulate in his body until pulmonary edema (water in the lung) occurs.
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  • What do we mean when we say liquids?
  • Liquids include any food or drink that is liquid or with a high-water content such as water, ice cubes, coffee, tea, chamomile, juices, ice cream, soups and fruits such as watermelon which contains about 92% water.
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  • How much water should I consume?
  • It depends on the amount of urine that are excreted. So, the kidney patient can consume one day (in 24 hours) 500ml + the volume of urine that he had eliminated the day before. That is, if on the previous day the dialysis patient has excreted 200 cc. urine, he will be able to consume 700 ml of liquids (500 + 200 ml) the next day.  
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  • Are there any foods that cause increased thirst?
  • Yes, salt! It greatly increases the feeling of thirst. In general:
  • Less salt = less thirst = less water consumption.
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  • A few tips for limited fluid consumption:
  • -In the morning fill a jar or a bottle of water and drink only from it. In this way, you know how much water you drink every day. 
  • -Stick to your refrigerator door a paper where you write each time the amount of water you consume.
  • -Always drink water with a small glass.
  • -Avoid high-sodium foods, since this will reduce your thirst.
  • -In between meals, eat fruits and frozen food (as allowed).
  • -When you are thirsty and would like to drink water, moisten your mouth with slices of lemon.
  • -Take your medicine during your meals, not separately.
  • -Try to keep yourself as much as active and energetic as possible.
  • -Set as a target to gain only half a kilo per day.
  • -Rinse your mouth with water but remember in the end to throw it away and not swallow it.
  • -Eat mastic, mint or chewconfectionery, which relieve you from thirst.
  • -Put a plastic with wateron the radiator in winter so that it produces water vapor that will moisten the room you are sitting in, as to help you dry your mouth.
  • -Stay away from places that you think will make you drink large quantities of liquids (eg kitchen, bath).
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  • What will I feel if I have excessive "fluids" (more than my dry – ideal weight)?
  • Increase in blood pressure, difficulty in breathing that becomes more intense when you lie down and improves while seated, increase swelling of the legs, and cough especially in the supine position.
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  • Mesogeios Dialysis Centers Group Scientific Team 
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  • Bibliography 
  • 1. Liang X, Wang W, Li H. Water and sodium restriction on cardiovascular disease in young chronic hemodialysis patients. Chin Med J (Engl). 2013;126(9):1667-72. PubMed PMID: 23652048.
  • 2. Baraz S, Parvardeh S, Mohammadi E, Broumand B. Dietary and fluid compliance: an educational intervention for patients having haemodialysis. J Adv Nurs. 2010 Jan;66(1):60-8. doi: 10.1111/j.1365-2648.2009.05142. x. PubMed PMID: 20423436.
  • 3. Tomson CR. Advising dialysis patients to restrict fluid intake without restricting sodium intake is not based on evidence and is a waste of time. Nephrol Dial Transplant. 2001 Aug;16(8):1538-42. Review. PubMed PMID: 11477150.
  • 4. Rodrigues Telini LS, de Carvalho Beduschi G, Caramori JC, Castro JH, Martin LC, Barretti P. Effect of dietary sodium restriction on body water, blood pressure, and inflammation in hemodialysis patients: a prospective randomized controlled study. Int Urol Nephrol. 2014 Jan;46(1):91-7. doi: 10.1007/s11255-013-0382-6. Epub 2013 Jan 23. PubMed PMID: 23340794.
  • 5. Bushman MC. Treating fluid noncompliance in the hemodialysis population using unit wide contests. J Ren Nutr. 1999 Jan;9(1):35-7. PubMed PMID: 9861101.
  • 6. Safdar N, Baakza H, Kumar H, Naqvi SA. Non-compliance to diet and fluid restrictions in haemodialysis patients. J Pak Med Assoc. 1995 Nov;45(11):293-5.PubMed PMID: 8920608
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