One of the main functions of healthy kidneys is to balance fluid in the body. When a person is on dialysis, their kidneys are unable to keep the balance and a fluid restriction is needed to prevent fluid overload. The American Kidney Fund (AKF) breaks down fluid management and control for dialysis patients, including the consequences of excess fluid and tips on how to control your fluid intake.* 

Why do dialysis patients need to limit fluid?

Dialysis treatment is typically for kidney disease patients with end-stage renal disease (ESRD), also referred to as end-stage kidney disease (ESKD). At this disease stage, the kidneys are unable to remove fluid that builds up in the body. Dialysis allows fluid to be removed, but it’s not the same as two healthy kidneys working 24 hours a day. This is why most dialysis patients still need to restrict their fluid intake.  

What are the consequences of excess fluid?

When you drink too much fluid or miss a dialysis treatment, fluid can build-up can cause serious problems.

Some of the signs and symptoms of fluid build-up include:

• feeling tired,
• headaches,
• swelling from fluid retention (feet, ankles, wrist, and face),
• stomach discomfort or bloating,
• high blood pressure,
• shortness of breath, and/or
• heart problems.

How can you determine your daily fluid limit?  

Most dialysis patients have a fluid limit of about 32 ounces (or 4 cups) per day. A doctor can recommend your fluid allowance based on the type of dialysis you receive, your body weight, and the amount you typically urinate. 

What are some tips for thirst and fluid control? 

1. Keep track of each fluid you drink throughout the day. If you have trouble remembering, write it down, or use an app on your phone.
2. Be careful with foods known to increase thirst, such as coffee/caffeinated products, alcohol, salty foods, and sugary foods.
3. Limit going outside when it’s hot. In the summer, try to go out in the mornings or evenings.
4. Be mindful of fruits and vegetables with a lot of water content, such as watermelon, tomatoes, and grapes.
5. Anything that melts at room temperature is a fluid. Be careful not to overindulge on ice cream and popsicles.
6. Sugar-free gums and candy can help to make more saliva and prevent thirst. 
7. Use small 8-ounces glasses or water bottles in place of larger ones.
8. Suck on an ice cube or frozen fruit to help satisfy thirst.
9. Speak to your doctor if you have a dry mouth, as it is a common side effect of medicines. 

Additional information can be found at “10 Tips to Help Decrease Thirst” by DaVita Kidney Care and “Fluid Overload in a Dialysis Patient” by the National Kidney Foundation.

*American Kidney Fund [kidneyfund]. (2020, Apr. 13). Fluid management and control for kidney disease patients on dialysis [Video file]. Retrieved from https://www.youtube.com/watch?v=IwKiJSO2zG4