Water balance during hemodialysis
Water balance is closely related with the optimal body weight maintenance. Since the amount of urine (diuresis) is reduced up to a complete lack in patients on hemodialysis, a strict self-control of fluid intake is required. Super hydrogenation may provoke intensification of the peripheral edema, ascites (leakage of fluid in the abdominal cavity), hypertension, pulmonary congestion and life-threatening complications such as brain and pulmonary edema.
The basic rule for calculating the quantity of the fluid intake is: fluids (for 24 hors) = diuresis /ml/24 hours + 500 up to 800 ml. The increase in weigh must not overcome 1kg per day. All soups, any yoghurt, sauces, stewed and bottled fruits, fruits, vegetables, etc. that are included in the daily menu must be calculated as liquids.
Dietary recommendations: Table salt consumption to be reduced and other seasonings to be used instead; any food with high content of water to be avoided [soups, sauces, water-melon, ice-creams], any dry air spaces to be avoided, when one feels thirsty, not to drink water but to suck a lemon or a cube of ice.
The role of proteins in hemodialysis
Goal: To maintain all vital metabolic processes in normal levels, to ensure muscle growth and recovery.
Proteins are essential for the diet since the need of them is higher for dialysis patients. Proteins are divided in two basic groups: such with high biological value and such with low biological value. 1.2 gr./kg./24hs is considered to be the optimal protein intake. Half of this quantity should be the so called complete proteins (of higher biological value), that may be found in meat, eggs and milk. That is why appropriate meats, poultry, fish, egg protein or cottage cheese must be consumed at least once a day. It is recommended 100-200 gr. meat to be involved at least once per day during eating. The way of cooking meat may vary depending on the taste preferences of the patient, however for those who have a limited diuresis a dry cooking of meal (excluding sauces) is recommended. Low-value proteins include bread, pasta, fruit and vegetables.
Nausea, vomiting, confusion, itching, bad breath are observed upon excessive protein import. The symptoms of insufficient import are muscle mass decrease, lack of strength, weight loss, difficult wound healing.