Dialysis: Manage Your Fluids

Q. My dialysis nurse keeps telling me my dialysis treatments will be easier if I don't drink as much fluid between treatments. But I'm thirsty all the time! Doesn't that mean that I need to drink more? 

A. Fighting thirst and reducing fluid weight gain between treatments can be hard. Your dialysis team knows this and can help you find ways to manage your fluid intake.
If you gain a lot of fluid weight between hemodialysis treatments, your thirst will increase. When more fluid has to be removed per hour, you may have low blood pressure and/or cramping. Your dialysis team tries to use lower levels of sodium for your dialysis treatment, but higher levels may be needed to remove extra fluid and to keep you comfortable during your treatment. Higher sodium levels and low blood pressure can both lead to increased thirst. A longer treatment may be required to avoid these complications.
A person on peritoneal dialysis will need to use exchanges with higher amounts of dextrose (sugar) to remove large amounts of fluid, which may cause increased thirst.
Gaining less fluid weight between treatments causes less stress on your heart. It also helps to prevent buildup of fluid that can cause shortness of breath.
Discuss the amount of fluid you should have with your dietitian and other members of your healthcare team. Your kidneys used to work non-stop to keep your sodium and fluid in balance, but now this is done less often with dialysis. Take control of your fluid intake between treatments and your treatments will be easier.