Managing your fluid restriction from a dialysis patient’s perspective

Zandria Richard’s personal experience of dialysis gave her great insight into the burdens experienced by kidney patients, including in dealing with the restrictions imposed by dialysis. She spoke with great authority and humanity at a National Kidney Federation conference about the challenges of living with a dialysis fluid allowance, sharing practical advice with her fellow kidney patients. She also wrote an article on this topic for Kidney Talk, which we are proud to reprint in her memory.

Small things done consistently, produce extraordinary results

For patients on haemodialysis managing your fluid is the most difficult aspect for many of us. In our diet if a favourite food is restricted, we can often find an alternative. However, when it comes to fluid, there is ONLY fluid! In dialysis patients, an excessive fluid intake puts a huge amount of strain on the heart causing it to expand in order to pump the extra fluid around our bodies, and over time enlargement of the heart can lead to heart failure.

A major contributing factor to drinking too much is salt intake. Eat less salt and you will find that you need to drink less. Three quarters of our salt intake comes from processed foods so try to avoid tinned soups, processed meats and ‘ready meals’, etc.

No one gets it right all of the time, but the ones who get it right a lot of the time, are the ones who try most of the time.

To help us dialysis patients manage our fluid restrictions, I decided to put together this hints and tips guide:

  • Use large pieces of ice so it’s less fluid than the smaller pieces and lasts longer. Wait for it to melt instead of crunching through it.
  • Never finish a drink, leave a couple of inches, or throw the remainder away. Alternatively share drinks.
  • When socialising, go for a spirit rather than a pint.
  • Reduce your salt and sugar intake and watch your thirst reduce drastically.
  • Larger supermarkets sell small 150mls cans of fizzy drinks – get the fizz without the volume!
  • Measure out your total allowance for the day in the morning and keep a record of your entire fluid intake including the hidden fluid in foods.
  • Don’t leave drinks in arm’s reach: ‘out of sight out of mind’.
  • Buy the smallest cups you can find.
  • Urges last seven minutes; try waiting and you may forget you wanted a drink.
  • For a special event try and restrict your fluid intake the day before.
  • Eat a few grapes or cut up a piece of fruit, bearing in mind your potassium levels or eat sugar-free sweets.
  • Avoid foods with hidden fluid such as rice, custards, jellies and soups.
  • Eat soup or cereal with a fork instead of a spoon.
  • If your mouth is dry, brush your teeth, rather than have a drink.
  • Weigh yourself regularly to keep an eye on your fluid gain.
  • Create a fluid schedule i.e. a drink after a meal or when taking medication.
  • Get physical and keep busy

More information

Download the ‘Managing your fluid and salt levels’ patient leaflet HERE.

Lastly, ask yourself, ‘am I really thirsty?’