Soup, sauces, gelatin, fluids add up

SURVIVAL TIP: Manage your fluid intake to feel your best between treatments.

Chicken SoupMost dialysis patients make little or no urine. Reduced urine output is often the first symptom people notice as they suffer kidney failure. Other patients, especially those diagnosed early from blood work, might notice no real change in their bathroom visits. The latter group has dialysis more for the purpose of cleaning the blood than removing fluid that fills the tissues and causes swelling.

Watching your fluid intake has two parts: first, how much you drink and second what you eat.

Water is devoid of many minerals and chemicals that sodas, tea, coffee and juices contain. Therefore, the kidneys don’t have as much work to process water. With the kidneys not working, water introduces fewer “toxins” into your body.

Water is not the drink of choice for many. Water has no carbonation, no caffeine, no taste. So we add powders, flavoring drops or fruit to enhance the taste. Did you know that powdered flavors often are LOADED with phosphorus? In the resource articles below you will find phosphorus content in individual servings. The individual packets of flavor enhancing drink mixes for water consider a half packet to be a serving. Be aware of how many servings you drink.

As fall arrives, you might think you’ll be less thirsty. But when you’re cold, don’t you want warm foods and drinks? Soup, broth, sauces (like spaghetti sauce), and even stewed vegetables can contain more fluid than you think.

Fluid intake is usually limited to 32 oz., or 1 liter, per day. But subtract the amount of liquid food, ice cream, gelatin and soup you consume in ounces from that number. You are not left with much to drink. Sweets seem to make the thirst worse.

Although scientific data available to the public is slim on this issue, consensus is that sweets make you thirsty. The biologic reason is that the sugar in your blood pulls sugar from your cells, triggering your brain with a message of dehydration. So you feel thirsty, drink, and start the unhealthy cycle again. Artificial sweeteners might help reduce sugar in the bloodstream, but that introduces phosphorus, magnesium, and other minerals to the mix.

Coffee and cocoa are one of the first things dialysis patients learn to limit when reducing phosphorus. Some sources cite high phosphorus content in black tea, as well.

I still drink way too much sweet tea. Fortunately, I don’t have to contend with diabetes, but I need to reduce fluid intake. One way to eliminate sweet drinks is to begin watering down the flavor. Increase the water portion every day or so until the flavored drink is no longer palatable or you get to 100% water.

DID you know “the ‘off’ taste of tap water is the chlorine; if you refrigerate it in a container with a loose-fitting lid, the chlorine taste will be gone overnight?”
– WebMD

Cold Lemon WaterAnother way to make water taste better is to chill small slices of fruit in your allotted water each day. Good options include lemon, lime, watermelon (which is quite flavorful!), orange, and raspberry. These fruits are high in potassium, so if you need to reduce potassium, drinking naturally flavored water is a winning option! You get the flavor without consuming high levels of potassium.

You can even add a splash of fruit drinks to the water to enliven the flavor.

These mild taste modifiers should not increase your thirst.

Did YOU KNOW that bottled waters have added salts, potassium and even sugar?

Most nutritionists recommend a single pitcher or bottle with each day’s permissible fluid intake. Others recommend a few chilled cups (8 oz. each) of water in the refrigerator. Some people like sucking on frozen grapes then spitting them out to avoid the fluid in the grape. I like frozen strawberries. Small amounts of ice are also refreshing. Rinsing your mouth with cool water and spitting it out is another good plan to reduce intake. You get the experience of a cool mouth without the added fluid.

Whatever you do to reduce the fluid you consume, and therefore carry around in your tissues between treatments, the task is difficult. With too much fluid, or fluid overload, excess fluid leaves the bloodstream and settles into the tissues. in this case, one treatment is not sufficient to pull the excess fluid from your bloodstream and the tissues. Often, pulling all of the available fluid from your veins and arteries results in a plunging blood pressure. Or the machine pulls fluid, but not as much as you had hoped. The scale will tell you that you have fluid in your tissues that is not yet available in the bloodstream because you will still be over your goal weight after treatment. Be diligent in limiting the amount and kind of fluid intake before the next treatment so that you can give up the excess fluid a couple of days later.

Share with our readers what you do to reduce your fluid intake or to feel less thirsty.

Dialysis isn’t easy. Walking a difficult road alone also is not easy. But when you know others have walked the same path and face the same health challenges, the situation seems less daunting. You are not alone. The community on is here to support each other, ask questions, and offer options.

I encourage you to look at where you are in your dialysis journey. You might find writing down where you were and where you are enlightening. You might realize the needles don’t bother you like they did. Or that you learned to limit your coffee to one cup each morning. Maybe you found that the key to your high phosphorus or potassium was linked to one particular thing. Write down your challenges and your wins often, even daily. Date your entries. What have you overcome or learned to accept? What great ideas have you implemented to meet challenges? Share them with us here so we can all cheer you on and benefit from your insights!

If you or someone you care about is facing dialysis, share your experiences and concerns. This is a forum for learning and inspiration where we can ask questions and be honest with others in the same situation. We are going through the same experience with different outcomes. What are your experiences and challenges with dialysis?



About dialysisgal

When I joined the 450,000 Americans on dialysis, I wondered what "normal" would be. Would people stare at my access and ask what was wrong? In this blog, I hope to save other patients and their families from the difficulties I have faced. I want to share my experiences, what I learned, had to ask and was shocked to find. I am not a medical professional, but I hope we can have a conversation to help you better understand what you or someone you love with chronic kidney disease (CKD) might expect while living with dialysis.
This entry was posted in Uncategorized. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s