Fluid, salt and thirst

Haemodialysis patients need to be very careful about their liquid intake so that they do not become 'overloaded with Fluid between dialysis sessions.

It is recommended that no more than 1.5 to 2 kilograms should be gained. Fluid 'overload' can result in breathlessness, swelling particularly of the ankles, high blood pressure and eventually enlargement of the heart.

A few ideas that may help:

Fluid consumed does not all come from the obvious sources such as drinks of tea, squash etc.. It also comes from foods that have a high water content:

  • Ice cubes
  • Ice lollies
  • Ice cream
  • Custard
  • Milk pudding
  • Jelly
  • Soups
  • Sauces
  • Gravy
  • Other similar food types

You may need to cut down or even avoid these foods if fIuid gains are a real problem.

Use a smaller cup mug or glass for your drinks and divide your fluid allowance out over the day.

Don't forget that your 1/2 pint daily milk allowance forms part of your fIuid intake.

The following measures will help you to add up your fluid intake each day:

  • A mug = 300 mls
  • A glass = 200 mls
  • A small cup = 150 mls
  • A tablespoon = 15 mls
  • A small ice cube = 15 mls

Suitable fluids - add them to the daily fluid total:

  • Tea
  • Fruit squash (not Hi Juice type and blackcurrant)
  • Fizzy drinks such as: lemonade, tonic water, bitter lemon, ginger beer, soda water
  • Water and mineral waters (most are fine but if in doubt ask the Renal Dietitian)
  • 'Camp' coffee - 1 or 2 cups per day
  • Alcoholic drinks - spirits such as gin, vodka, brandy, rum, whiskey are suitable but be careful as alcohol can cause thirst.

Fluid to avoid - too much potassium, Salt or phosphate:

  • Coffee - instant, ground, percolated, decaffeinated
  • Fruit juices and vegetable juices
  • Beers, lager, cider, wines, sherry, and port
  • Oxo, Bovril, Marmite and other meat and vegetable/extracts
  • Cocoa, drinking chocolate, malted milk drinks - Ovaltine, Horlicks, Bournvita
  • Evaporated and condensed milk.

Stimulate saliva production by:

  • Sucking a small lemon wedge

  • Sucking sherbert sweets e.g. Sherbert lemons, Refreshers

  • Chewing a piece of bubble or chewing gum.

Reduce your intake of salt:

  • Reduce the amount of salt used in cooking - cut it out altogether if you can
  • Avoid adding any salt at table.

Cut down or even avoid salty foods - they can cause thirst:

  • Bacon, ham; tinned meat e.g. corned beef;sausages, beef burgers
  • Smoked fish, fish tinned in brine
  • Salted biscuits
  • Salted crisps and nuts ( avoided by most Haemodialysis patients anyway for other reasons )
  • Meat extracts e.g. Bovril; packet and tinned soups
  • Most cheeses - but cottage and cream cheeses are fine

See also: The treatment of kidney failure