Thirsty! Can Dialysis-patients exceed their fluid-intake-allowance on hot days?

[kristina]

Many of you already know that I am not yet on Dialysis and I am asking a few questions which come to mind in order to prepare myself. As I write it is a very hot day indeed and this made me wonder how Dialysis-patients manage their fluid-intake through very hot periods when I imagine they might become extra thirsty? I know that Dialysis-patients are restricted and have to keep an extremely careful control over their fluid-intake-allowance. So how does this work through hot periods? Do Dialysis-patients have to adhere to the same level of fluid-intake throughout the year? And, do they have little tricks to quench their thirst? We have all experienced going out on a hot day and whilst we have started off the day with our usual liquid-intake when it gets into the hot afternoon we can consume a great deal of liquid very easily, but surely this is impossible when on Dialysis. I am totally ignorant of this particular point so I would appreciate any experienced views on this. It might be people in constantly hot climates become used to the heat, but in Temperate climates where there are extremes of hot and cold periods, nobody can get used to anything and when it is hot people get very thirsty. Do Dialysis-patients feel they need more to drink on a hot day?  So, how does this fluid-intake-business resolve itself when it is hot?

[RichardMEL]

Well if it's a pretty hot day we've been advised we can have an "extra drink" (what exactly that means is unclear, but I guess they mean say 200ml). If it's that hot you will lose a little extra fluid via sweating, so yeah you can drink a little more, but not a lot. I suppose it is all about being sensible. When I visited Singapore in the humidity there I walked the streets for 3-4 hours and lost a few kilos from sweat (yeah, that sounds gross I know!) but meant I could enjoy a very large cold beer when I got to the airport! What I do on a daily basis is weigh myself at home so I have a fair idea how much weight I have put on and use that as a guide, along with how much I have ingested, as to how much fluid I could have before my next session.. that way I can keep it down to a manageable level (eg: around 2kilo)

[kristina]

Thank you, RichardMEL, for your answer.
I couldn't quite believe that Dialysis-patients
only stuck rigorously to their fluid-intake restriction
on a hot day like this. I appreciate very much
how you explain the logic
of being sensible about fluid-intake,
sweating and weighing yourself etc.,
I am doing that as well
and have started to learn from it.
Thanks again.

[Rerun]

Richard it is a good idea to have your own scales.  I sweat very easily on hot days and I know I can drink extra, but it is very disappointing when I get to dialysis and am .5 under what I usually am.  I hit my head and say "I could have had a glass of water".

[KICKSTART]

I also think it depends on what type of dialysis you do. Because i do dialysis every day i think i can get away with it more , but its such a fine line between drinking and being overloaded that sometimes its not worth it , no matter how thirsty you are. The thing is, i think you want to drink more knowing you are restricted as well and i seem to have more of a thirst than i normally did. If you watch an animal it will drink and drink if it has kidney failure (its one of the symptoms) and i pretty much feel i could do the same given chance!

[Romona]

It is important to stay hydrated. If you feel dizzy, lightheaded, headaches or nausea be careful.

[Wallyz]

I'm working on a deck outside today (Sunny, 80's F) and I am drinking an extra liter per hour.  I sweat a lot in hot weather.

[jbeany]

Getting a good scale is important.  If you work up a sweat exercising, or just because of the heat, then yes, you get more fluids.  The scale helps you judge how much.

There are plenty of tricks to fighting thirst.  A low salt diet is the biggest one.  Having ice cubes to suck on helps.  I like to keep frozen fruit in the house.  Frozen grapes and strawberries are very good for stopping thirst.  Hard candy can help.  Chewing gum, too.  Diabetics need to keep tight blood sugar control, since high sugar can make you thirsty, too.

[celtic warrior]

Don`t know about anyone else, but my Wife Maria (the one undergoing dialysis) does not REALLY stick to the fluid level
After 2 and a half years of Haemo, in center, she drinks to the level she feels  COMFORTABLE with. She has got to know when she is gong "over the top"
like most of you do. there is no hard and fast rule! everyone is different. It does not matter if it is hot or cold weather, when she is thirsty she is THIRSTY.
Someimes I feel as if I am talking to a brick wall when I try to advise her on the fluid intake (but it works for her)

Tony

[serpico]

 T have been on Dialysis for two and a half years. I pretty much do what I feel like doing . I love my beer during the summer months and I do not let a little kidney failure get in the way! Back in March I went to Las Vegas for five days and a total of six days without a treatment. I actually felt better, because it was the closest I have come to normalcy in the last couple of years.

This might not be good for everyone, but what is the sense of Dialysis if you are not going to enjoy yourself to some extent!

 I must tell you that I do believe GOD has the final word and not a machine!

 Good luck to you! 

[Hanify]

I'm on PD so I have a bit more flexibility.  However, it is difficult at the beginning of summer when you get a few hot days and just want to drink all day.  However, with pd you can drink more, and adjust your % of bags to take off the extra fluid.  I would say though, that the fluid issue is probably the worst bit of dialysis.  Sometimes I'd just love to have a big cold drink of orange and drink it all in one go!

[celtic warrior]

Passes Hanify a 2 litre jug of ice cold orange......THERE YOU GO!!!!

[aharris2]

T have been on Dialysis for two and a half years. I pretty much do what I feel like doing . I love my beer during the summer months and I do not let a little kidney failure get in the way! Back in March I went to Las Vegas for five days and a total of six days without a treatment. I actually felt better, because it was the closest I have come to normalcy in the last couple of years.

This might not be good for everyone, but what is the sense of Dialysis if you are not going to enjoy yourself to some extent!

 I must tell you that I do believe GOD has the final word and not a machine!

 Good luck to you! 

Taking six days off from dialysis is dangerous. Another member of our IHD family made comments like this one, he's dead now.

We talk all the time about dry weight, too much fluid, phosphorus, pth, calcium - these are all issues, but they are not going to cause sudden death (even fluid - you will become very uncomfortable before it becomes life threatening). But there is one out there - POTASSIUM which, too high, will stop your heart BAM! GOODBYE! This is why you should never skip dialysis particularly in the beginning and particularly if your potassium runs high. (I know I've seen this info posted recently, perhaps by jbeany in another thread.)

Answering your question, fluid - what you put in has to come out by peeing if you still pee, by dialysis, or by sweating. Sweating is kind of a bonus. If you sweat a lot, all other things being equal, you can drink enough to make up for it. Others have made good suggestions on combating thirst.

Interesting comment about God. I thought God said that we each have the final word - we each choose our own path. God knows how it's going to turn out, but the choices are all still ours. My own path... take advantage of what has been made available... or not.

Alene

[RichardMEL]

Just on sweating... for about a year I used a sauna maybe weekly on my "weekend" to help with the fluid take off. I'd spend around an hour in there and take off around 500-600ml in sweating.... It was quite relaxing but I exchanged it for a long sunday walk which made me feel a bit better. I only would take off around half(maybe less) but that was OK because I have gotten used to drinking less on my weekend. It did help though.

[serpico]

I

T have been on Dialysis for two and a half years. I pretty much do what I feel like doing . I love my beer during the summer months and I do not let a little kidney failure get in the way! Back in March I went to Las Vegas for five days and a total of six days without a treatment. I actually felt better, because it was the closest I have come to normalcy in the last couple of years.

This might not be good for everyone, but what is the sense of Dialysis if you are not going to enjoy yourself to some extent!

 I must tell you that I do believe GOD has the final word and not a machine!

 Good luck to you! 

Taking six days off from dialysis is dangerous. Another member of our IHD family made comments like this one, he's dead now.

We talk all the time about dry weight, too much fluid, phosphorus, pth, calcium - these are all issues, but they are not going to cause sudden death (even fluid - you will become very uncomfortable before it becomes life threatening). But there is one out there - POTASSIUM which, too high, will stop your heart BAM! GOODBYE! This is why you should never skip dialysis particularly in the beginning and particularly if your potassium runs high. (I know I've seen this info posted recently, perhaps by jbeany in another thread.)

Answering your question, fluid - what you put in has to come out by peeing if you still pee, by dialysis, or by sweating. Sweating is kind of a bonus. If you sweat a lot, all other things being equal, you can drink enough to make up for it. Others have made good suggestions on combating thirst.

Interesting comment about God. I thought God said that we each have the final word - we each choose our own path. God knows how it's going to turn out, but the choices are all still ours. My own path... take advantage of what has been made available... or not.

Alene

I have seen people that never miss Dialysis and they die to!

[monrein]

We're all going to die, I think it's just a question of not flirting too often or too strenuously with death.  Of course we are all individually responsible for the choices we make and if you are fully aware of the risks involved with fluid build up (strain on your heart and vascular system) or potassium overload (sudden death when the heart stops beating) or long term phosphorus mismanagement (confinement to a wheelchair and bone fractures from severe osteoporosis) then you can choose to "enjoy yourself" to any extent you wish.

My personal understanding of going 6 consecutive days without D is that it can be extremely dangerous and possibly fatal.  Funnily enough, that always has an impact on me and helps me to govern my choices accordingly. 

[aharris2]

Serpico, don't misunderstand my intent. I am concerned for those who are approaching dialysis or are only just beginning dialysis. I want to be sure that they don't casually decide that they want a few days off from dialysis too. It is your right and their right and the right of any competent adult dialysis patient to make that choice.  But it should be a fully informed choice.

Alene

[RichardMEL]

I agree with Alene - very good point.

It is your decision whatever you do or don't do in life absolutely but most of us agree that six days without is asking for trouble. I first read the post and was very concerned!!! Still, it's your life and if it works for you - half your luck!!

[serpico]

  After I thought about some of the responses to my post,I should have been more considerate of a person just trying to get some answers to a serious question! I do apologize if I offended anyone and I do appreciate the concerns!

  That is just my style. Sometimes I act like everything is normal ,that is the only thing that keeps me in the game!

[glitter]

My husband used to use sauna suits to sweat extra- one thing the neph said was -use it a bit- fine- too much, and you will upset the delicate electolyte balance in your body- which could also cause death so use sweating in moderation too. My husband DID drink gatorade in moderation when he was sweating like that- it did eventually)after 4 months) cause his phos. to get too high. (thats what they blamed it on anyway)

[jbeany]

  After I thought about some of the responses to my post,I should have been more considerate of a person just trying to get some answers to a serious question! I do apologize if I offended anyone and I do appreciate the concerns!

  That is just my style. Sometimes I act like everything is normal ,that is the only thing that keeps me in the game!

I agree with Alene - very good point.

It is your decision whatever you do or don't do in life absolutely but most of us agree that six days without is asking for trouble. I first read the post and was very concerned!!! Still, it's your life and if it works for you - half your luck!!

Serpico may also have more kidney function left than some.  If your kidneys are still running at 12-15%, and you still have an ability to urinate, then a couple days off would be less strain on the body than someone who has single digit function and no urination. Personally, I'm more than ready to see that chair when Monday morning rolls around again, so I wouldn't even be able to consider it!