COPING WITH A FLUID RESTRICTION

WHY DO I HAVE TO BE CAREFUL WITH HOW

MUCH I DRINK?
One of the main functions of the kidney is to balance fluid in
the body. In kidney failure a common problem is not getting
rid of excess fluid. Which causes fluid overload. This can
cause high blood pressure, long-term damage to blood
vessels and even damage to the heart.
Your fluid restriction depends on your urine output which
may decrease as time goes by. Your care team will tell you
how much you can drink.
To help keep thirst under control spread your fluid evenly
through the day by using small cups. You can also gargle with
iced water, suck ice cubes (still contain 10-15mls of fluid per
cube), or chewing gum.
Avoid salt and salty foods, e.g. crisps, bacon, and soup, as this
will increase your thirst.
Remember to be careful of hidden fluids, e.g. water for
tablets, gravies, custards, and milk on cereal.
WHY DO I NEED TO BE ON A FLUID
ALLOWANCE?
The fluid allowance for each patient is calculated on the basis
of urine output, plus 500mls in a 24-hour period. The 500ml
approximately covers the loss of the fluid through the skin
and the lungs.

The weight gains between dialysis sessions should be no more

than 1-1.5 kg on a one day gap and 1.5-2.5 kg over 2-3 days.
Generally speaking the smaller you are the less weight you
should gain.

If large amounts of fluid need to be removed during dialysis it

can make you feel ill. Your blood pressure may fall, and you
may feel light headed or sick. This is called hypotension (low
blood pressure). It is therefore important to always keep to
your fluid allowance.
WHAT DO YOU MEAN WHEN YOU TALK ABOUT
MY DRY WEIGHT?
When you start dialysis you will hear about your dry weight.
This is the weight your body should be without excess fluid. It
is also the weight we use to calculate how much fluid you
have put on between dialysis sessions and therefore how
much we need to remove each dialysis session.

You dry weight can change over time. It may need to be

increased after a few months if you start eating more now
that you are on dialysis and feeling better. However, it could
also need to be decreased if you have been unwell and lost
weight.
WHAT HAPPENS IF I DRINK TO MUCH?
If the water content of the body reaches high levels, the
accumulating fluid causes the body to swell usually
starting at the ankles, due to gravity and may spread up
the body. If not treated, the excess fluid will settle in the
lungs causing a life-threatening condition called
pulmonary oedema. Shortness of breath is one the main
symptoms of this. Several episodes will cause damage to
the heart.

We can try to remove the excess fluid with dialysis, but if

you keep drinking too much the damage will eventually
become permanent and may leave you with chronic
breathing and heart problems.
DEHYDRATION
If you find that youre feeling faint (hypotensive, low blood
pressure) at home after your dialysis please mention it to
your treatment nurse as this may mean we need to
increase your dry weight.

You may also become dehydrated in very hot weather.

In the summer you will be given advice on what is safe to
drink, and your fluid restriction may need to be increased.
HOW CAN I MANAGE WHAT I DRINK?
The fluid restriction is one of the most difficult aspects of
dialysis for many patients to cope with, and is not easy. But
there are a number of tips you can follow to help you
throughout the day.

Make sure you know what your fluid restriction is

Avoid eating salty foods as this will make you thirsty
Use a smaller cup or glass. It feels better to have a full
small glass than half a large glass!
If you use the same cup then you know how many you
can have in a day. But make sure you know how much
it holds.
Some people suck on ice cubes (but remember this is
part of your fluid restriction), or suck on boiled sweets
if they feel thirsty (be careful if you are diabetic!)
Be aware of hidden fluids in foods such as melons,
watermelon, soup, gravy and frozen treats like ice
cream. This is all fluid.
SO WHAT NEXT?
Now you have read through this a nurse or doctor will come
back to answer any other questions you might have.
Remember, you can ask questions at any time.

There will be other booklets for you to read later that will
include the following topics:

Hemodialysis a brief introduction

How does hemodialysis work?
Looking after your vascular access
Managing you fluid intake
The dialysis diet
Increasing your independence
Transplantation

We hope that this will help you to adapt to dialysis, helping

you to feel better.

Remember, you can ask questions about your treatment at

any time.
B. Braun Avitum AG | Schwarzenberger Weg 73-79 | 34212 Melsungen |
Germany

Phone +49 5661 71-2624 | Fax +49 5661 75-2624 | dialysis@bbraun.com |

www.bbraun-dialysis.com