Fluid gain on nocturnal

I’m on nocturnal, 6 nights a week, 7-8 hours each time.

I gain a minimum of 3 kg when I don’t skip a night and much more - sometimes even 8 kg when I skip a night.

I think this is a problem. And I think it is psychological.

When I was on PD, I rarely checked my weight and I used to get about 2 litres of UF cumulative in a day. And I never thought about the water and weight gain because I did not put on fluid weight at all. And I never had a problem with fluid overload. And I drank all I wanted.

Now, on nocturnal home hemo, I check my weight everyday and I’m all the time thinking about fluid. I tend to drink even when I’m not thirsty.

I feel that inspite of doing nocturnal home hemo, my heart is being effected. Recently, I was diagnised with a heart problem (Left ventricular dysfunction). I’m not sure its because of the extra fluid.

I keep myself busy in a software development job but even on the job, whenever I take a break, I drink water even without feeling thirsty.

I know for a fact that I drink more fluid than someone without renal failure.

Does anyone face a similar problem?

Any suggestions on how to deal with this?


It sounds like you might benefit from cognitive behavioral counseling to help you figure out how to think about something other than fluids and do something else besides drink fluids.

If you’re drinking because you’re thirsty, your dietitian could help you review what you’re eating to see if you’re getting hidden salt in your food. Your doctor or nurse could help you by reviewing your medicines to see if any of them have a side effect of dry mouth or thirst.

However, if you’re drinking out of habit instead of drinking from thirst, then you need to find something else to substitute. Here are some tips for breaking a habit:

If you know you drink a lot every time you have a break, plan ahead. Instead of heading for the coffee machine or water fountain, walk around the building (figure out a path away from water sources). This will not only keep you away from the source of the problem, but increase your exercise to sweat off fluid that you’ve swallowed as well as build strength and endurance. Plan things to do at home so your hands are busy and you don’t have time to drink.

Here are some tips to help you control your fluid gains:

Thanks so much Beth! I will try some of the things listed in the links you’ve given.

What kind of doctor do I need to see for cognitive behaviour counselling?

Most cognitive behavioral counseling is done by clinical psychologists and clinical social workers, however it’s possible that a psychiatrist would do it if the psychiatrist does “talk therapy” instead of just prescribing medications. You might want to call the local mental health center to find out if they have someone skilled at doing this type of therapy.

I had this problem too at one point. This is what you must find out–ARE YOU GETTING DRY? really think about this because I was carrying about 10 kilos that i didn’t know about because i gained them gradually by missing treatments here and there and i was extremely thirsty because of this so really find out if you have extra fluid on.-by the way i eventually had so much on i began snoring - which went away after i figured out it was fluid and removed it

I must be dry at the end of each tx because there are no symptoms of having excess fluid on me - puffiness of legs, breathlessness etc.

Is there any way to know my dry weight?


I went to some of the links posted by Beth. There was one that made a lot of sense. It said fix up the time and quantity when you are going to have fluids and stick to that.

I did that and fixed up a total of 1500 ml. I stuck to that yesterday and day before. But guess what, I still ended up with a 3 kilo gain each day!!

I did have 2 small oranges sometime in the afternoon but the fluid ffrom 2 small oranges can’t be 1.5 kilos!

I have no idea from where this excess fluid is coming.

Any suggestions?


[QUOTE=kamalshah20;12894]I must be dry at the end of each tx because there are no symptoms of having excess fluid on me - puffiness of legs, breathlessness etc.

Is there any way to know my dry weight?


I would advise you to go to Hemametrics.com to learn how a device called Critline accurately determines dry weight and allows one to remove the correct amount of fluid each tx. I have used the device and gotten accurate fluid removal. I felt wonderful afterwards! There is a lot of education at the site and if you contact them they will provide you with even more info.