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Ask the Dietitian: How much fluid can I have while on dialysis?

Question:

I am new to dialysis, and I keep hearing about my fluid weight gains in-between treatments. How do I know how much I can drink?


Answer:

By the time you start dialysis your kidneys are producing little to no urine which means you cannot get rid of all the fluids you consume. Some of the fluids we consume will be eliminated when we have a bowel movement or sweat, but you get rid of most of the excess fluid from urine.


Dialysis helps to remove excess fluid from your body, but drinking too much can make it more difficult to remove the excess fluid and can contribute to cramping during treatment. If you cannot get rid of the excess fluid you may start to notice swelling in your legs, arms, under your eyes, and/or have difficulty breathing from the fluid building up around your heart.


The best way to manage excess fluid is by monitoring how much fluid you consume and attending each dialysis treatment for the full session. Your provider will let you know how much fluid is best for you. Many patients are limited to about four, 8-ounce glasses of fluid per day. We also get up to 20% of the fluids we consume from the foods we eat. One other key part of managing fluid is reducing salt and sugar. Both will make you thirsty and too much salt will make you retain more water. Cook more at home using herbs and spices instead of salt and choose whole fruit for a sweet treat instead of a sugary dessert.


What Counts as Fluid?

  • Soup

  • Gravy

  • Beverages, including water

  • Ice cubes (1 cup cubes = ½ cup of water)

  • Popsicles

  • Sherbet, sorbet, ice cream

  • Protein shakes

  • Gelatin

Check Out These Links for More Information and Tips to Manage Fluid


Got a question for Dr. Melissa Prest?

Send it to her at mprest@nkfi.org and she may answer it on the blog!

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