Beating the Heat on a Fluid Restriction

Hot summer days are wonderful but can be torture for people who must restrict their fluids. While this generally applies only to dialysis patients or those with congestive heart failure, I thought I’d devote this blog to those who have to try to manage both their fluids and the heat. If you don’t need to follow a fluid restriction make sure you get enough fluids in the summer heat to keep your kidneys working well.

Extra fluid on your body can often be seen as swelling (edema), increased blood pressure, weight gain or shortness of breath and can be quite dangerous. If in doubt see your doctor!

Check with your dietitian to see how much fluid you should aim for every day. As a general rule of thumb you should gain no more than 2-2.5 kg (4.4-5.5 lbs) of fluid between hemodialysis treatments. Remember every 500 ml (2 cups) of fluid not used by the body equals ½ kg (1 lb) in weight gain. Fluid allowance may change depending on your urine output. In general, you may drink 1 litre (4 cups) of fluid per day plus an amount equal to your urine output.

If a food is liquid at room temperature, it is considered a fluid. Fluids include coffee, tea, popsicles, sherbet, ice cream, jello, soup and ice.

To Control Fluid Intake:

  • Drink only to satisfy thirst.
  • Keep cool – stay out of the sun and try to find air conditioned spaces.
  • Choose cool, moist foods at meals.
  • If you avoid high sodium foods, you will be less thirsty.
  • Don’t drink from habit or to be social.
  • Try to get the most nutrition from your allowed liquids. Give up coffee, tea, soft drinks and alcoholic beverages before milk, soups, juices and other nutritious foods.
  • Try having allowed fruits and vegetables ice cold between meals. Frozen grapes or raspberries can be a satisfying way to quench thirst.
  • Try sliced lemon wedges to moisten a dry mouth.
  • Use sour hard candies and chewing gum to moisten mouth.
  • Rinse your mouth with water, but don’t swallow it.
  • Weigh morning and evening and adjust your liquid intake so that you have a fluid weight gain of about 1 kg/day (2.2 lbs/day).
  • Most people find ice more satisfying than the same amount of water. Try putting lemon juice in ice cubes; you’ll use fewer. Use about half a lemon per tray of water. Remember to include ice in your daily fluid allowance.
  • Use small cups and glasses for beverages and other liquids.
  • Freeze allowed fruit juices in ice cube trays to reduce amounts taken.
  • When thirsty, try eating something like bread and margarine with jelly before taking liquids.  Often the sense of thirst is really due to having a dry mouth.
  • If you have diabetes, high blood sugars will increase your thirst. Having good control of your diabetes will help to control thirst.
  • Speak to your pharmacist about trying an oral rehydration solution (treatment for dry mouth).
  • Measure your daily fluid allowance into a jug in the morning. Each time you swallow any fluids pour out an equal amount of water from the jug. When the jug is empty, you have consumed your fluid allowance for the day.

Tired of the usual lunch fare? These cool, refreshing salad rolls are an interesting alternative to sandwiches. Look for the rice paper in the Asian section of your grocery store.

Curried Shrimp Salad Rolls
Per Roll:
4 shrimp
1 tsp mild curry paste
¼ cup bean sprouts
2 peach slices
thai basil, cilantro (to taste)
rice paper

Sauté shrimp in curry paste. set aside to cool. Soak rice paper in warm water. Place rice paper on towel to absorb some of the moisture. Line rice paper with shrimp, thai basil, cilantro, bean sprouts, peach slices, and a chiffonade of lettuce. Roll securely and serve with mint yogurt dipping sauce.

Mint Yogurt Dipping Sauce
¼ cup plain yogurt
½ bunch fresh mint, blanched
¼ tsp honey
1 tbsp milk

Process in blender and serve with salad rolls.

Recipe developed by Chef Leslie Cairns

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