If you were stranded on a desert island, you would feel thirsty before you felt hungry. It is said that a healthy body normally needs up to eight glasses of water a day to maintain fluid balance. For people in advanced stages of chronic kidney disease (CKD), these amounts can accumulate in the body and this can be dangerous.
Fluid intake control for hemodialysis patients
Restricting fluids can help you feel comfortable before, during, and after hemodialysis sessions. Although treatment removes excess fluids and waste from the body, it is not as effective as healthy kidneys that work 24 hours a day, seven days a week. Most people on hemodialysis have sessions three times a week, lasting about four hours or more. This means that on the days between dialysis sessions, the body retains excess fluids and waste that the kidneys cannot remove, especially if you do not urinate.
Exceeding the recommended fluid intake can cause swelling and increase blood pressure, which makes the heart work harder. Excess fluid can accumulate in the lungs, making it difficult to breathe, among other complications.
Hemodialysis removes fluid as blood is filtered through the dialysis machine. However, there is a limit to the amount of fluid that can be safely removed during a dialysis session. If you exceed your fluid allowance, an extra dialysis session may sometimes be necessary to remove all the extra fluid.
Determine fluid restriction
Fluid restriction varies greatly between patients. Factors such as weight gain between treatments, urine output, and swelling are taken into account. If you are on hemodialysis, your weight will be recorded before and after the dialysis session.
Sudden weight gain may indicate that you are consuming too many fluids. Your dietitian, together with the rest of the clinical team, will guide you on individual targets for proper fluid intake.
For patients on hemodialysis, the complications of excessive weight gain between dialysis sessions are:
- High blood pressure;
- Shortness of breath (and in some cases, fluid in the lungs)
- Heart problems, which may include rapid pulse, weakened heart muscles, and an enlarged heart
If you wish to start an exercise plan, inform your doctor and clinical team. Exercise can affect your fluid needs, especially if you are exercising and sweating heavily. Your dietitian, together with the rest of the clinical team, can guide you on how much fluid you should drink.
