Dialysis and Fluid Restrictions – Tips and Tricks

This week, a guest post from Ros Ball, Past President and currently Secretary of DATA, the Dialysis and Transplant Association of Victoria (Australia).  You may remember Ros when I wrote about her in June a couple of years ago.  She and her husband Charlie have outfitted their caravan with a dialysis machine and travel where most BigD-ers fear to tread:  the wide open spaces of the outback.  Ros’s get up and go, regardless of the demands of BigD is an inspiration, and puts the rest of us sometime travellers in the shade.

Ros’s post appeared in the May 2013 edition of the DATA newsletter Shoestring (as in pulling yourself up by).  It is one of three to be published over the next few months with helpful hints to stay on track on a renal diet.

Over to you Ros.

Once kidneys fail, people have limited ability to urinate and hence fluid can build up within the body. This can lead to heart strain (heart attack), fluid on the lungs (difficulty breathing), excess fluid in the blood stream (high blood pressure) and pressure on the brain.

So once we start dialysis, we all have to live with fluid restrictions (more so for haemodialysis – restrictions for peritoneal dialysis are not as strict).

All fluids need to be counted, including, but not just drinks, – custards, yoghurt, ice cream, jelly, soups, and even the juice from canned fruit.  If rice and pasta are eaten frequently, such as daily or every second day, this also needs to be included.

Some hints to make this a little easier:

  • Spread your fluid intake over the day.  For myself,  I have a drink at each meal and one extra if I’ve had no other fluids (such as yoghurt) during the day
  • Know the volume of  your drinking cup.  I use a cup that holds 200mls.  At breakfast I use this drink to have my tablets, saving on another drink.  Often when I have meals with friends I end up with a large glass, but I only drink ½ that glass
  • A good start is to fill a jug with your fluid allowance, and then throughout the day, just drink from that jug
  • Also tip out the equivalent fluid from the jug to keep track of where you’re at with your restrictions, if not drinking from that jug
  • Find the drink that quenches your thirst best and stick to that. For me it is tea and water, and sometimes I will have ginger ale
  • Try chewing gum, or mouthwash to keep your mouth fresh and moist. I often eat an apple, cutting it into 4 pieces and eating it throughout the day
  • Whatever you do, don’t have salty foods
  • Have a craving? Yes, I’m sometimes bad; I will have a pizza, high in salt and potassium.  I do find I’m thirsty afterwards, so I always eat these “bad foods” just prior to dialysing.

With special thanks to Karen Manley Renal Dietician at Austin Health.  Karen was guest speaker at the DATA 2011 AGM.  Remember to always be guided by your renal dietician.

Ros Ball

Thanks Ros.  I have a couple to add:

  • When I’m really thirsty and just about at my fluid limit I suck a few ice blocks.  As a variation, a few frozen blueberries or grapes is are ideal, though you need will power to stop at a few!
  • I sometimes wake up with a dry throat, especially after that bad food that Ros also likes.  I stroll from the bed to the fridge and knock down a Yakult.  Actually, I take it slowly, savouring each sip.  It’s amazing how long 65ml can last.  There’s something about that milky texture that is delightfully wet on my throat.  (One per day.  Phosphate binder is optional.)
  • When I’m driving and thirsty or dry, I dip into my small supply of mints (and now and then boiled sweets) in the glove box.  They work like chewing gum, but with the satisfaction of swallowing!  For diabetics, go for the sugar-free versions.

If you have your very own thirst-breaking technique, please share it with us!

News:  Lab-grown Kidneys

Ros also noticed this exciting article in New Scientist:

It was recently announced that a Boston (USA) research facility had managed to advance the development of laboratory produced kidneys. Rat kidneys were washed in a chemical solution to remove the native cells leaving just the scaffold of the kidneys. The scaffold was then coated with new cells. The resulting kidneys worked in the lab and when transplanted into rats. They filtered out and discharged urine although not as efficiently as natural kidneys.

The breakthrough paves the way for human-scale versions, which could potentially provide an inexhaustible supply of organs, eliminating the need for recipients to wait for a matching donor kidney.

Read more and see some pics and video on the New Scientist website: http://www.newscientist.com/article/dn23382-kidney-breakthrough-complete-labgrown-organ-works-in-rats.html

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