Patient not drinking any fluid

I am a newbie on this Board, and just had a question about home Peritoneal Dialysis. My father has just switched to home PD, doing 4 fluid exchanges per day (after being on haemodialysis for about 5 months).

Since he started doing PD he has been very dehydrated and with very low blood pressure…and he has been told by the Nurse that he must drink more fluid. But he is not doing so, and we are all confused as to why (the Nurse and our family have warned him of the dangers of becoming severely dehydrated).

I just wondered if any patients of PD could shed any light on this? As I think it could be more psychological? Perhaps a way of having some kind of “control” or rebellion…I really don’t know but I am really worried about him and don’t know what is making him not want to drink?

Any advice would be very very welcome…:slight_smile:

Hi Unregistered,
This isn’t something I’ve heard of before, but I guess I’m wondering about everyone “warning” your father that becoming dehydrated is bad. (Usually that becomes pretty evident once someone is dehydrated–it feels pretty awful). Have you or your mom just tried asking him why he doesn’t seem to be drinking anything? Since he was on hemo before, he may well have gotten used to NOT drinking (and even been yelled at for gaining too much water weight), and it can be hard to change that habit. Even folks who have transplants and need to drink can have a tough time doing it after getting into the habit of watching every sip.

When I started PD I thought the same thing but then i started draining too much water from my body and started getting leg cramps real bad… I now drink so much water to avoid the cramps and it works fine…

You dad will change his mind real soon…

Hello, guest. Please, please, please talk to your father about this and find a way to get him to drink. I had a similar experience with my dad, who was on hemo for several months before switching to PD. I understand exactly what you are saying about it seeming like a control thing or rebellion. I was very confused by my dad’s refusal to drink (or eat) enough, despite being constantly pressed by family and his nurse. He had a lot of dietary and fluid restrictions while on hemo and he never seemed to understand that he didn’t have those same restrictions on PD, no matter how many times he was told.
It was very bizarre and painful to see him go from fear of retaining fluid before dialysis to being so dried out that it made him weak and miserable and made his blood pressure so low that ultimately his heart weakened and he died.
I hate to scare you but this is something I can’t get over and I want to let others know just how serious the dehydration and low blood pressure issues can be. Maybe people who switch from hemo to PD need some specific education to help them understand their new situation? My dad was of completely sound mind and I believe there was some fear/psychological thing inflicted by the restrictions of hemo, that made PD unsuccessful for him in the end.
Please feel free to contact me by pm if you’d like. My dad has been gone six months but I still read this board seeking peace or understanding or to help others.

Hi Babboo,
I’m sooo sorry to hear about your loss of your father–and it is so kind of you to share his story here to help others.

Hi to the first person who posted and started this thread. I was on Peritoneal Dialysis before and I have had both dehydration and edema (fluid over load). It really is a balance that is perfected with time and knowing how you feel / knowing ones body. I was always worried about fluid gain that I was surprised when my dialysis nurse told me to have a bowl of chicken noodle soup! The salt would help raise my blood pressure and gain a little (needed in that case) fluid on my body.

Just like having too much fluid on the body is bad, the body also needs a certain amount of fluid too. Too little is just as bad as too much! It effects the other organs (such as heart) negatively.

maybe explain to him the details and how he is in control … but also maybe he just doesn’t feel thirsty or hungry (typical if anemic which is common in Kidney Disease). Perhaps discussing this with the medical staff could find some sort of solution to help. I know the first time around for me on dialysis (when I was a teenager) my doctor had prescribed my mom a powder to put into my food to make me gain weight (however when I had my first kidney transplant my family had a hard time getting in their head that I now had to watch my weight and not try to gain anymore).

It is hard with Kidney Disease how depending on stage the diet changes. It is a lot to learn. But many patients don’t know the details or why but just go by how they feel and he simply might not watch to drink because he doesn’t feel well. I am sorry if this is the case and suggest discussing your concerns with his medical staff. They might have some suggestions you have not thought of.