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Fluid Overload in a Dialysis Patient

Having too much water in your body is called fluid overload or hypervolemia. One of the main functions of the kidneys is to balance fluid in the body. If too much fluid builds up in your body, it can have harmful effects on your health, such as difficulty breathing and swelling.

When you are on dialysis, your kidneys are no longer able to keep the right balance of fluid in your body. They cannot remove enough. That’s why it’s so important to limit how much sodium (salt) and fluid you have between dialysis treatments. This helps your body maintain the right amount of fluid, and it makes it easier for your dialysis treatment to remove extra water.

How does fluid overload affect you?

  • Swelling: Swelling in your feet, ankles, wrist, and face is a sign of too much fluid in your body. This is called edema.
  • Discomfort: Cramping, headache and abdominal (stomach) bloating can make you feel uncomfortable.
  • High blood pressure: The excess fluid in your blood stream makes it difficult for your body to keep a healthy blood pressure.
  • Shortness of breath: The extra fluid in your body can enter your lungs, making breathing difficult.
  • Heart problems: The extra fluid can affect your heart rate, the muscles of the heart, and may increase the size of your heart.

How can I avoid fluid overload?

  • Track your fluid. Some patients use a visual to help them see how much fluid they are taking in. Find a container that you can mark or keep a journal of every liquid you have on a daily basis.
  • Follow the fluid guidelines given to you by your healthcare team. Most dialysis patients need to limit their fluid intake to 32 ounces per day.
  • Manage your thirst. Your dietitian can help you find ways to manage your thirst such as sugar-free hard candies, ice chips, or frozen grapes. This will help you avoid drinking too much fluid between dialysis treatments.
  • Manage your sodium. Sodium, in the form of salt, causes your body to hold on to water. Too much salt in your diet will increase your chances of fluid overload and make it more difficult to remove fluid during dialysis.
  • Adjust your dialysis. If fluid overload becomes a concern or issue, talk with your healthcare team about adjusting your dialysis treatment. Often longer or more frequent dialysis treatments are recommended to help remove extra fluid.

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