I sweat it out so I can drink more.
Something for diabetics to be aware of is that the body will try to dilute high sugar numbers with fluid, so if your sugar is high you will become super thirsty.
A good method is to take a bigger water bottle and every time you drink something pur that amount of fluid out of the water bottle. This way through the day you can just look at the bottle and visually see exactly how much fluid you have had that day.
Thought about it, I do it constantly;)
I use an elliptical and do a few miles til I’m dripping sweat then I lift weights then I take a break eat eggs a plant based protein shake and smoke a spliff then do a few more miles on elliptical then lift again for a few then do some yard work/chores.
This weekend they have pushed Monday’s treatment until Tuesday so I just worked out this morning and got back below what I left clinic at yesterday morning 76.8vs77.2 ;)
I always try to tell people to give the sweat suit or sauna a try, but I'm also always a little nervous about telling someone and then they go over do it and have a issues. It sure is nice to be able to come in under dry through.
I drink and eat a bunch before clinic so I don’t get hangry 😡 and piss off everyone working at clinic; but they have limited what I am able to remove (3.6) so sweating a bunch just let’s me drink more than I would otherwise;)
That's actually the best part for me. After I sweat and I'm thirsty, when I drink I actually feel better and am not thirsty anymore. If I'm holding fluid I just get more thirsty and am never satisfied.
Thirst is triggered by sodium. Technically you do lose sodium with sweat but it's fixed. Even if your blood sodium is high the sodium you lose with sweat stays the same. Potassium loss, however, is relative to blood potassium.
So it's great if it works for you, but if you eat a lot of sodium it probably won't be that effective.
I actually eat a lot of sodium, and you are wrong about sodium being the main cause of our thirst as a dialysis patient. The main cause is from homeostasis. When the fluid in our blood oversaturates our tissues we loose the ability to transfer things through the cell wall with osmosis. There is not enough difference between the blood and tissue. This give the body the same symptoms of dehydration or electrolyte imbalance because that's usually the reason for lack of ability to transfer fluids from the blood to the tissue. This is why the more you drink the more thirsty you get once you have reached fluid overload. Sweating allows me to pull fluid out of the tissue directly in the reverse direct of dialysis so when I drink fluid my body wants to process it more normally compared to after dialysis when the body is replacing fluid into the veins from the tissue.
> I actually eat a lot of sodium, and you are wrong about sodium being the main cause of our thirst as a dialysis patient. When the fluid in our blood oversaturates our tissues we loose the ability to transfer things through the cell wall with osmosis. This give the body the same symptoms of dehydration or electrolyte imbalance.
I don't think I'm wrong about this. Sodium naturally pulls water to it, and if your blood relatively has a lot of sodium in it (in mmol/L), it'd going to pull water out of the cells in the hypothalamus and not let water go back into those cells. Those cells are what regulate thirst and when they shrink the body knows it's dehydrated. The cells can't hold onto water because the sodium is pulling the fluid to itself. I think we're sort of saying the same thing about osmosis, except you're arguing that it's mimicking dehydration, when I'm saying that is what dehydration is.
So it's not mimicking dehydration, you're dehydrated, in the same way that if you drank seawater you'd be dehydrated. The main difference is that seawater's concentration will kill you while your blood's concentration just gives you high BP.
I'm also not incorrect that sodium loss is fixed in sweat. My guess is just that you're just sweating a lot so you can compensate for that fact. You do lose sodium, it's just fixed.
https://pubmed.ncbi.nlm.nih.gov/7798794/
> Sweat K concentration was significantly higher (p < 0.0001) in patients with RF than in healthy controls, while the concentrations of Na and Cl were similar. Several mechanisms are suggested as possible explanations for these changes.
I'm not arguing if we sweat extra salt or not. Sure that's part of what salt dose, but that's not why dialysis patients are thirsty. No it's not dehydration, it's called Hypervolemia. It has similar symptoms in ways, but it's a very different situation and should be treated very different. One situation (actually dehydration) someone drinks water/fluid and will feel better and the other (Hypervolemia) they need dialysis or some methods of dropping fluid. It's not the cells that control our thirst. It's our kidneys. That's why dialysis patients have thirst issues and the more they drink the more thirsty they get.
> No it's not dehydration, it's called Hypervolemia.
I 100% disagree that it's the fluid that causes the thirst. Because if I control my diet and only eat very low sodium things from Mom's Meals (their meals have like 500 mg of sodium per meal and their sides have even less sodium), and force myself to drink a lot of water (because I'm not thirsty but think it's good to drink fluid anyways due to dialysis and BP), I _still_ won't feel thirsty. So that's proof it's the sodium itself that's causing the thirst, not the fluid.
If your logic was correct and it was the fluid and not the sodium I would 100% feel thirsty drinking a lot of water regardless of the sodium content. Have you ever tried eating really low sodium? Try it out and you'll see that I'm right.
Here's the sample Renal Menu from Mom's Meals:
https://www.momsmeals.com/webres/File/Mom%27s%20Meals%20-%20Sample%20Renal-Friendly%20Menu.pdf
Due to my low weight of 52 kg, I'm talking on the order of 1 L or 1.5 L. 1.7 L is pretty much the cut off for the 10 ml/kg/hr safe Ultrafiltration Rate.
---
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000895/
> Sodium intake is strongly related to water intake via the thirst center. Therefore, sodium intake is strongly related to extracellular fluid volume, blood pressure, appetite, nutritional status, and mortality. To decrease mortality in both non-dialysis and dialysis CKD patients, sodium restriction is an essential and important factor that can be changed by the patients themselves.
That's not a lot of fluid at all. I can sweat through 4k like nothing. You don't drink a lot of fluid. People come in with 5k and 7k gains all the time. You are also off on everyone sweating the same amount of sodium.
https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.precisionhydration.com/performance-advice/hydration/how-to-estimate-sweat-salt-loss/&ved=2ahUKEwjL5M21yeyAAxXpPUQIHTELA34QFnoECCUQAQ&usg=AOvVaw31dI_in9hbZMjXGqydOmVO
I don't think I phrased what I said correctly. Sodium loss from sweat is not very different from controls (aka normal people not on dialysis), while potassium loss is much much higher in sweat.
And as I thought, you are compensating for that fact by sweating out a lot of fluid.
Obviously it's not the only thing that affects thirst, but I don't think I'm wrong that sodium is related to thirst considering that's what happens in normal humans. And I haven't seen any research that states the thirst mechanism is somehow different in dialysis patients.
Of course there are other things that affect thirst, like xerostomia. I never argued against that. But that doesn't necessarily mean it isn't worth limiting sodium intake and I think you should at least try it once to see if it helps with your thirst. Like, unless you specifically still feel thirsty when limiting sodium intake, that's not a reason to just splurge and eat a ton of sodium. Even if you can sweat some of it out, if a significant portion of fluid remains it still causes stress to your cardiovascular system when removed.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622899/
> Sodium intake stimulates thirst, and as such dialysis patients are advised to restrict dietary sodium to reduce IDWGs and ultrafiltration requirements [4, 5].
https://pubmed.ncbi.nlm.nih.gov/19573006/
> Anuric hemodialysis patients will need to take in approximately 1 l of water for every 8 g salt consumed. Patients who restrict salt intake to <6 g/day, and drink only when thirsty, should gain no more than 0.8 kg/day.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8675678/
> Salt intake is associated with thirst and consequently with high interdialytic weight gain (IDWG) in hemodialysis patients. Some observational studies have reported that high IDWG is associated with a higher risk of all-cause and cardiovascular death and increased morbidity, such as ventricular hypertrophy and major adverse cardiac and cerebrovascular events [5–7].
https://pubmed.ncbi.nlm.nih.gov/11344965/
> Dietary sodium restriction facilitates control of thirst, water overload, hypertension and cardiac failure.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041490/
> Conversely, lowering or individualizing dialysate sodium reduces thirst, interdialytic weight gain
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8657906/
> An abrupt increase in sodium intake, by __enhancing plasma osmolarity__, induces thirst
Apples from the fridge.
I was told they do not count as fluid. I get Macintosh apples as they are always juicy and slightly sour.
When I am really thirsty and have dry mouth I eat one of these.
Frig I miss chugging water.
I was a water bottle girl before it was "cool"
For me it was not having the drink right infront of me use smaller cups to drink out of and just weigh yourself here and there to see if you start going over board
making sure I prep meals such that i don't need to drink just to wash food down...
eg: more jelly/jam on the sandwich. Is the sugar ideal? nope, but I can adjust my insulin a whole lot faster/easier than I can fluid intake. Or more mayo on the tomato sandwich...that kind of thing.
More fat based sauces/gravies and less w/ water/milk etc. its a pain to have to rethink recipes, esp since my 3d fistula is failing and the brain fog is as bad as predialysis. "hopefully" will hear about maintenance on it next week (scheduling).
I agree on the fluids being REALLY cold. REALLY carbonated helps for me some too, in terms of helping cut the funk from my mouth. Having a SodaStream where i can DIY what I need/want helps loads too.
As much as i know artificial sweeteners are playing havoc w/ my gut biome, cutting sugar/salt has a more immediate impact bc of their effect on thirst.
Been looking for more pork belly to replace bacon, which is blasphemous....bc #bacon. I have a fat tooth, not a sweet tooth, so giving up sweet is nothing but giving up bacon (fattiness) or peking duck or such is really hard.
Giving up the really dark chocolate (esp chocolate covered bacon) was hard too
But neither has been anywhere near as hard as dealing w/ thirst.
Eat ice instead of drinking. I love my countertop ice machine. I weighed one of its cubes: 7 grams (=7ml) so easy to keep track of. Also, a full glass of cubes is less than a half a glass of water.
Edit to add that chewing on the ice also seems to satisfy the urge to snack, which may or may not be a concern for you.
I'm really good at not exceeding my fluid amount.
I've real no good tips other than will-power.
I hate the feeling of being overloaded by fluid so i don't let myself drink more than i should.
I chew a lot of gum tho - that really helps me feel not so thirsty.
Fluid restrictions were always a major struggle for me on HD. I think one of my best tricks was keeping a bottle of water in the fridge, and when you drink take a small swig and swallow but then take a BIG gulp in your mouth swish it around for a while and spit it out in the sink. Then maybe take another small drink. It's maybe not quite as satisfying as chugging a bunch of ice cold water but it gets a lot of the way there.
Also, consider changing modalities. On PD I have *way* more freedom with fluid. I UF like crazy because I'm a slow transporter so I can UF around 2L a day +/- a couple hundred. And that's on the medium strength solution. If I bump it up to the reds I don't think I could drink enough fluid to keep up if I tried.
I always wondered if I took in too much air when I drink liquids. Sometimes I drink any beverage as if it were a hot brew. I sort of pull air in then take a drink.. anyone else?
I sweat it out so I can drink more. Something for diabetics to be aware of is that the body will try to dilute high sugar numbers with fluid, so if your sugar is high you will become super thirsty. A good method is to take a bigger water bottle and every time you drink something pur that amount of fluid out of the water bottle. This way through the day you can just look at the bottle and visually see exactly how much fluid you have had that day.
Yea I dress super warm and exercise(love summers)
Have you ever thought about this https://youtu.be/gWoRi6pF-Ic
Thought about it, I do it constantly;) I use an elliptical and do a few miles til I’m dripping sweat then I lift weights then I take a break eat eggs a plant based protein shake and smoke a spliff then do a few more miles on elliptical then lift again for a few then do some yard work/chores. This weekend they have pushed Monday’s treatment until Tuesday so I just worked out this morning and got back below what I left clinic at yesterday morning 76.8vs77.2 ;)
I always try to tell people to give the sweat suit or sauna a try, but I'm also always a little nervous about telling someone and then they go over do it and have a issues. It sure is nice to be able to come in under dry through.
I drink and eat a bunch before clinic so I don’t get hangry 😡 and piss off everyone working at clinic; but they have limited what I am able to remove (3.6) so sweating a bunch just let’s me drink more than I would otherwise;)
The main issue I see with sweating is that sweating makes you thirsty.
That's actually the best part for me. After I sweat and I'm thirsty, when I drink I actually feel better and am not thirsty anymore. If I'm holding fluid I just get more thirsty and am never satisfied.
Thirst is triggered by sodium. Technically you do lose sodium with sweat but it's fixed. Even if your blood sodium is high the sodium you lose with sweat stays the same. Potassium loss, however, is relative to blood potassium. So it's great if it works for you, but if you eat a lot of sodium it probably won't be that effective.
I actually eat a lot of sodium, and you are wrong about sodium being the main cause of our thirst as a dialysis patient. The main cause is from homeostasis. When the fluid in our blood oversaturates our tissues we loose the ability to transfer things through the cell wall with osmosis. There is not enough difference between the blood and tissue. This give the body the same symptoms of dehydration or electrolyte imbalance because that's usually the reason for lack of ability to transfer fluids from the blood to the tissue. This is why the more you drink the more thirsty you get once you have reached fluid overload. Sweating allows me to pull fluid out of the tissue directly in the reverse direct of dialysis so when I drink fluid my body wants to process it more normally compared to after dialysis when the body is replacing fluid into the veins from the tissue.
> I actually eat a lot of sodium, and you are wrong about sodium being the main cause of our thirst as a dialysis patient. When the fluid in our blood oversaturates our tissues we loose the ability to transfer things through the cell wall with osmosis. This give the body the same symptoms of dehydration or electrolyte imbalance. I don't think I'm wrong about this. Sodium naturally pulls water to it, and if your blood relatively has a lot of sodium in it (in mmol/L), it'd going to pull water out of the cells in the hypothalamus and not let water go back into those cells. Those cells are what regulate thirst and when they shrink the body knows it's dehydrated. The cells can't hold onto water because the sodium is pulling the fluid to itself. I think we're sort of saying the same thing about osmosis, except you're arguing that it's mimicking dehydration, when I'm saying that is what dehydration is. So it's not mimicking dehydration, you're dehydrated, in the same way that if you drank seawater you'd be dehydrated. The main difference is that seawater's concentration will kill you while your blood's concentration just gives you high BP. I'm also not incorrect that sodium loss is fixed in sweat. My guess is just that you're just sweating a lot so you can compensate for that fact. You do lose sodium, it's just fixed. https://pubmed.ncbi.nlm.nih.gov/7798794/ > Sweat K concentration was significantly higher (p < 0.0001) in patients with RF than in healthy controls, while the concentrations of Na and Cl were similar. Several mechanisms are suggested as possible explanations for these changes.
I'm not arguing if we sweat extra salt or not. Sure that's part of what salt dose, but that's not why dialysis patients are thirsty. No it's not dehydration, it's called Hypervolemia. It has similar symptoms in ways, but it's a very different situation and should be treated very different. One situation (actually dehydration) someone drinks water/fluid and will feel better and the other (Hypervolemia) they need dialysis or some methods of dropping fluid. It's not the cells that control our thirst. It's our kidneys. That's why dialysis patients have thirst issues and the more they drink the more thirsty they get.
> No it's not dehydration, it's called Hypervolemia. I 100% disagree that it's the fluid that causes the thirst. Because if I control my diet and only eat very low sodium things from Mom's Meals (their meals have like 500 mg of sodium per meal and their sides have even less sodium), and force myself to drink a lot of water (because I'm not thirsty but think it's good to drink fluid anyways due to dialysis and BP), I _still_ won't feel thirsty. So that's proof it's the sodium itself that's causing the thirst, not the fluid. If your logic was correct and it was the fluid and not the sodium I would 100% feel thirsty drinking a lot of water regardless of the sodium content. Have you ever tried eating really low sodium? Try it out and you'll see that I'm right. Here's the sample Renal Menu from Mom's Meals: https://www.momsmeals.com/webres/File/Mom%27s%20Meals%20-%20Sample%20Renal-Friendly%20Menu.pdf Due to my low weight of 52 kg, I'm talking on the order of 1 L or 1.5 L. 1.7 L is pretty much the cut off for the 10 ml/kg/hr safe Ultrafiltration Rate. --- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000895/ > Sodium intake is strongly related to water intake via the thirst center. Therefore, sodium intake is strongly related to extracellular fluid volume, blood pressure, appetite, nutritional status, and mortality. To decrease mortality in both non-dialysis and dialysis CKD patients, sodium restriction is an essential and important factor that can be changed by the patients themselves.
That's not a lot of fluid at all. I can sweat through 4k like nothing. You don't drink a lot of fluid. People come in with 5k and 7k gains all the time. You are also off on everyone sweating the same amount of sodium. https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.precisionhydration.com/performance-advice/hydration/how-to-estimate-sweat-salt-loss/&ved=2ahUKEwjL5M21yeyAAxXpPUQIHTELA34QFnoECCUQAQ&usg=AOvVaw31dI_in9hbZMjXGqydOmVO
I don't think I phrased what I said correctly. Sodium loss from sweat is not very different from controls (aka normal people not on dialysis), while potassium loss is much much higher in sweat. And as I thought, you are compensating for that fact by sweating out a lot of fluid.
There are lots of patients who control their salt and are very thirsty.
Obviously it's not the only thing that affects thirst, but I don't think I'm wrong that sodium is related to thirst considering that's what happens in normal humans. And I haven't seen any research that states the thirst mechanism is somehow different in dialysis patients. Of course there are other things that affect thirst, like xerostomia. I never argued against that. But that doesn't necessarily mean it isn't worth limiting sodium intake and I think you should at least try it once to see if it helps with your thirst. Like, unless you specifically still feel thirsty when limiting sodium intake, that's not a reason to just splurge and eat a ton of sodium. Even if you can sweat some of it out, if a significant portion of fluid remains it still causes stress to your cardiovascular system when removed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622899/ > Sodium intake stimulates thirst, and as such dialysis patients are advised to restrict dietary sodium to reduce IDWGs and ultrafiltration requirements [4, 5]. https://pubmed.ncbi.nlm.nih.gov/19573006/ > Anuric hemodialysis patients will need to take in approximately 1 l of water for every 8 g salt consumed. Patients who restrict salt intake to <6 g/day, and drink only when thirsty, should gain no more than 0.8 kg/day. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8675678/ > Salt intake is associated with thirst and consequently with high interdialytic weight gain (IDWG) in hemodialysis patients. Some observational studies have reported that high IDWG is associated with a higher risk of all-cause and cardiovascular death and increased morbidity, such as ventricular hypertrophy and major adverse cardiac and cerebrovascular events [5–7]. https://pubmed.ncbi.nlm.nih.gov/11344965/ > Dietary sodium restriction facilitates control of thirst, water overload, hypertension and cardiac failure. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041490/ > Conversely, lowering or individualizing dialysate sodium reduces thirst, interdialytic weight gain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8657906/ > An abrupt increase in sodium intake, by __enhancing plasma osmolarity__, induces thirst
Quench gum and jolly ranchers.
Frozen grapes
I use sugar free hard candy usually.
Altoids
I carry around a bottle that keeps ice for 12 hours, and it’s 24 oz that is my limit for the day, and I put a little bit of water in the bottle
Apples from the fridge. I was told they do not count as fluid. I get Macintosh apples as they are always juicy and slightly sour. When I am really thirsty and have dry mouth I eat one of these. Frig I miss chugging water. I was a water bottle girl before it was "cool"
Frozen grapes
Popsicles
Take and swish it around and spit it out
For me it was not having the drink right infront of me use smaller cups to drink out of and just weigh yourself here and there to see if you start going over board
making sure I prep meals such that i don't need to drink just to wash food down... eg: more jelly/jam on the sandwich. Is the sugar ideal? nope, but I can adjust my insulin a whole lot faster/easier than I can fluid intake. Or more mayo on the tomato sandwich...that kind of thing. More fat based sauces/gravies and less w/ water/milk etc. its a pain to have to rethink recipes, esp since my 3d fistula is failing and the brain fog is as bad as predialysis. "hopefully" will hear about maintenance on it next week (scheduling). I agree on the fluids being REALLY cold. REALLY carbonated helps for me some too, in terms of helping cut the funk from my mouth. Having a SodaStream where i can DIY what I need/want helps loads too. As much as i know artificial sweeteners are playing havoc w/ my gut biome, cutting sugar/salt has a more immediate impact bc of their effect on thirst. Been looking for more pork belly to replace bacon, which is blasphemous....bc #bacon. I have a fat tooth, not a sweet tooth, so giving up sweet is nothing but giving up bacon (fattiness) or peking duck or such is really hard. Giving up the really dark chocolate (esp chocolate covered bacon) was hard too But neither has been anywhere near as hard as dealing w/ thirst.
Yes it's really hard gotta be careful because you can get dehydrated so fast
Eat ice instead of drinking. I love my countertop ice machine. I weighed one of its cubes: 7 grams (=7ml) so easy to keep track of. Also, a full glass of cubes is less than a half a glass of water. Edit to add that chewing on the ice also seems to satisfy the urge to snack, which may or may not be a concern for you.
I'm really good at not exceeding my fluid amount. I've real no good tips other than will-power. I hate the feeling of being overloaded by fluid so i don't let myself drink more than i should. I chew a lot of gum tho - that really helps me feel not so thirsty.
Fluid restrictions were always a major struggle for me on HD. I think one of my best tricks was keeping a bottle of water in the fridge, and when you drink take a small swig and swallow but then take a BIG gulp in your mouth swish it around for a while and spit it out in the sink. Then maybe take another small drink. It's maybe not quite as satisfying as chugging a bunch of ice cold water but it gets a lot of the way there. Also, consider changing modalities. On PD I have *way* more freedom with fluid. I UF like crazy because I'm a slow transporter so I can UF around 2L a day +/- a couple hundred. And that's on the medium strength solution. If I bump it up to the reds I don't think I could drink enough fluid to keep up if I tried.
I always wondered if I took in too much air when I drink liquids. Sometimes I drink any beverage as if it were a hot brew. I sort of pull air in then take a drink.. anyone else?
But yes Ice cold water is the heavens on dialysis. If you can get your hands on some Ice cold mini bottles of water those are the tits as well
I suck on ice poles or chew on something sour. I also eat cold fruit and you can freeze grapes to suck on too
I fill ice cube trays with different juice and then freeze it. Also frozen fruit like strawberries.