Fluid Control for Haemodialysis and Peritoneal Dialysis Patients

Fluid Control During Renal Treatment

One of the key functions of the kidneys is to balance fluid in the body. But for dialysis patients, when they are going through treatment, their kidneys are no longer able to keep on the right balance of fluid in their body. They are unable to remove enough if their fluid intake goes beyond the recommended allowance. This can cause serious consequences on their health, such as difficulty breathing and swelling in different areas of their body.

The fluid control is different between haemodialysis and peritoneal dialysis patients and we are going to explore the difference.

Fluid control for haemodialysis patients

During a treatment session, the patient’s blood is removed from the body and filtered through a man-made membrane called a dialyzer, also known as an artificial kidney. The filtered blood is then returned to the body.

For patients who go over the recommended fluid allowance, swelling and increased blood pressure can be expected. Also, in this condition, it makes the heart work harder. All the fluid build-up in the lungs will also make it difficult to breathe.

The treatment, as it filters the blood through the dialysis machine, removes fluid. But there is a limit to how much fluid can be removed safely. If the patient exceeds their fluid allowance, an extra dialysis session may be required to remove all the extra fluid. Patients might experience a sudden drop in blood pressure, which usually happens towards the end of their dialysis treatment session.

Fluid control for peritoneal dialysis patients

People on peritoneal dialysis treatment may not be as limited with their fluids as people on haemodialysis treatment. This treatment is performed every day, unlike haemodialysis, which is only done several times a week. However, patients are still encouraged to keep track of their fluid intake and the amount of fluid removed in their dialysis exchanges.


This really depends on the patient and it differs for every individual patient based on their body size, medical condition, the treatment they are going through and how much urine they pass out. If their fluid control is not managed well, these are some factors they might see and go through:

  • Weight gain between treatments
  • Urine output
  • Swelling in their feet, ankles, wrist and face (a sign of too much fluid in your body)
  • Increase in blood pressure
  • Breathlessness
  • Damages one’s heart over time

Exercising may also change your fluid requirements as you are perspiring heavily. Consult your doctor and healthcare team so that they are well aware of your exercise routines and are able to advise you accordingly. Your dietitian can also coach you on how much fluid to drink.

Thirst management tips

These can help avoid drinking too much fluid between dialysis treatments:

  • Suck on sugar-free hard candy or chew sugar-free gum.
  • Ice chips (freeze your allotted amount of water or approved fruit juices)
  • Frozen fruits such as frozen grapes and strawberries.

Daily habits to create and follow:

  • Limit the amount of sodium and spicy foods in your diet so you do not get thirsty. (sodium causes your body to hold on to water and increase chances of fluid overload and make it more difficult to remove fluid during dialysis.)
    • Consuming less salt will keep your heart stronger, help you breathe easier and help you avoid swelling ankles, fingers, waist or under eyes.
    • Cook with herbs and spices for flavour instead of salt. (such as chili powder, paprika, oregano etc.)
    • Look at labels on food items for the amount of sodium.
    • Cut back on junk and convenience foods.
  • Be aware of hidden fluids in foods (high water content) such as gelatine, watermelon, soup, gravy and frozen treats such as ice popsicles and ice cream.
  • Sip your beverages instead of downing or gulping them. Or use small cups instead of big cups where you will be prompted to drink more.
  • Take your medicines with your meal, try swallowing pills with fluid-like food such as soup or sauce.
  • If you have a dry mouth, try rinsing your mouth with mouthwash or brushing your teeth.
  • Stay cool. Keeping cool will help reduce your thirst. Try drinking cold liquids instead of hot beverages.
  • Wait it out, about 10 minutes, for your fluid craving to pass – distract yourself with other things such as calling a friend, playing with your pets, reading the newspaper or count to 100.

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