Overhydration A Dangerous Lesser Known Complication Which Many CKD & Dialysis Patients Are Unaware




"I am a Dialysis patient," a KidneyBuzz.com viewer wrote. "It is hot outside and I am drinking water to cool off. While I am maintaining my fluid restrictions, I feel unusually nauseous and 'out of it' lately. Could I be drinking too much at one time?

While Cardiovascular (Heart and Blood Vessel) Events remain the primary form of mortality (death) in Chronic Kidney Disease patients who conduct Dialysis, few patients account for the impact of Overhydration (Hyponatremia). Overhydration, also called water excess or water intoxication, is a condition in which the body contains too much water which can throw off the balance between water and sodium in a Dialysis patient's body. 

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“So, the biggest complication of Overhydration is a drop in your sodium levels which has more detrimental effects than most people think,” said Dr. Justin Spratt (United Hospital Center). Hyponatermia has been in the news for the past few years after a study in the New England Journal of Medicine listed Overhydration as a serious health concern. Overhydration can happen not only when Chronic Kidney Disease and Dialysis patients grossly over drink, but also when moderately over drinking. 

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Hence, if a Hemodialysis patient finds it extremely hot during one part of the day and decides to drink a large portion of her/his 32 to 36 ounce recommended average daily fluid intake within a short timeframe, then due to limited kidney function and urination, s/he could potentially experience Overhydration. Similarly, if patients regularly exceed their recommended fluid intake and drink a substantial amount of fluid within a short period of time, then they too could possibly be at a greater risk of Overhydration. This is not an issue that is limited to Hemodialysis patients. Research Gate noted, "Overhydration is a prevalent problem in Peritoneal Dialysis patients and is associated with numerous complications."

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While it's not a common condition for most, for those with limited fluid restrictions or even Kidney Transplant patients who find themselves drinking large quantities of water, it's definitely something of which to be aware. With warmer temperatures, it's important to know the signs and symptoms of this dangerous condition such as the following:

  • Nausea and vomiting
  • Headache
  • Confusion
  • Lethargy
  • Fatigue
  • Appetite loss
  • Restlessness and irritability
  • Muscle weakness, spasms or cramps
  • Seizures
  • Decreased consciousness or coma

In general, Chronic Kidney Disease patients may limit their risk by drinking small amounts of fluids at regular intervals. “Sleep is a six- to eight-hour fast, so if you drink three cups of juice or water right away, you’ll trigger the volume response. Sip instead,” Dr. Stacy Sims (Stanford University) encouraged. Patients should never feel "full" of liquid. As most Chronic Kidney Disease patients already know,  coffee, tea, and watery fruits and vegetables count toward fluid intake. If you or someone you know starts to experience any Overhydration symptoms after significant water consumption, call for medical help as soon as possible.

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