When a person is on dialysis, managing fluid intake becomes a crucial part of their treatment. The kidneys can no longer effectively remove excess fluids and waste, requiring strict restrictions on what can be consumed.
This article aims to explain which beverages should be prioritized or avoided by dialysis patients while highlighting healthy options like those offered by eau exquise.
Understanding the Role of Kidneys and Dialysis
The kidneys are vital organs responsible for maintaining the body’s homeostasis by regulating fluids, electrolytes, and removing metabolic waste through urine production. Their primary role is to filter blood through functional units called nephrons, which consist of a glomerulus and a renal tubule. The glomerulus filters blood plasma, while the renal tubule reabsorbs necessary substances and eliminates waste as urine.
Under normal conditions, kidneys regulate essential substances like sodium, potassium, and calcium while maintaining the blood's acid-base balance. They also produce erythropoietin, a hormone that stimulates red blood cell production, and convert vitamin D into its active form.
However, in cases of chronic kidney disease (CKD), the kidneys' filtering function progressively and irreversibly deteriorates. This leads to the accumulation of toxins such as urea and creatinine, as well as severe disturbances in electrolyte balance, causing conditions like hyperkalemia, metabolic acidosis, and fluid overload. When the kidneys can no longer sustain these vital functions, dialysis becomes necessary to substitute for their excretory role.
Dialysis, whether hemodialysis or peritoneal dialysis, is designed to partially replace the kidneys’ excretory functions. Hemodialysis uses a machine, known as an artificial kidney, to filter blood outside the body through a semi-permeable membrane, removing toxins and excess fluids. Peritoneal dialysis, on the other hand, utilizes the peritoneum, an internal abdominal membrane, as a natural filter. A dialysis solution is introduced into the peritoneal cavity, where exchanges between the blood and this solution eliminate metabolic waste.
However, dialysis does not replace all kidney functions, such as hormonal regulation (production of active vitamin D and erythropoietin) or maintaining precise electrolyte balance. Additionally, it cannot continuously remove fluids like healthy kidneys, necessitating strict management of fluid and dietary intake for dialysis patients. Excess fluids can cause circulatory overload, leading to complications such as pulmonary edema or high blood pressure.
Which Beverages Should Be Avoided During Dialysis?
Certain beverages, while common, can be harmful to dialysis patients due to their high potassium, phosphate, or sodium content.
Potassium-Rich Drinks (Fruit Juices, Vegetable-Based Drinks)
Potassium is a mineral that compromised kidneys can no longer effectively eliminate. Fruit juices like orange, banana, or tomato, as well as smoothies, often have high potassium levels. Brands like Tropicana or Innocent offer juices with very high potassium concentrations, making them unsuitable for dialysis patients.
Carbonated Drinks and Sodas High in Phosphates
Carbonated drinks, especially colas like Coca-Cola, Pepsi, Dr Pepper, Orangina, or Schweppes, are rich in added phosphates. These phosphates, often undeclared on labels, are difficult for weakened kidneys to eliminate. Their accumulation in the blood can cause severe mineral imbalances, increasing the risk of bone diseases and vascular calcifications.
Other popular brands in supermarkets, such as Sprite, 7Up, Fanta, Canada Dry, and even some flavored versions of San Pellegrino, may also contain phosphate additives, though in smaller amounts than colas. Dialysis patients must be particularly cautious with these beverages.
Recommended Waters for Dialysis Patients
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Mont Roucous
- Low in minerals: Mont Roucous is extremely low in minerals (22 mg/L of dry residue), making it one of the best options for dialysis patients. It is also very low in sodium (3.3 mg/L).
- Recommended.
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Volvic
- Moderately mineralized: Volvic has a dry residue of 130 mg/L, is fairly low in sodium (11.6 mg/L), and contains little potassium, making it suitable for controlled consumption.
- Recommended in moderation.
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Evian
- Moderately mineralized: With a dry residue of 345 mg/L, Evian has a low sodium content (6.5 mg/L), making it acceptable for moderate consumption under medical supervision.
- Recommended in moderation.
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Arcens
- Low in minerals: Arcens has a dry residue of 78 mg/L and is low in sodium (6 mg/L), making it suitable for dialysis patients.
- Recommended.
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Saint Antonin
- Low in minerals: With a dry residue of 140 mg/L, Saint Antonin is low in sodium (3 mg/L) and potassium, making it a good option.
- Recommended.
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Nordaq
- Purified on-site, extremely low in minerals, and completely free of additives, Nordaq is perfectly suitable for dialysis patients.
- Recommended.
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Vittel
- Moderately mineralized: With a dry residue of 845 mg/L, Vittel has a reasonable sodium content (5 mg/L), but higher levels of calcium and magnesium, which may pose long-term issues.
- To be consumed in moderation.
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Contrex
- Rich in calcium: Contrex contains 468 mg/L of calcium and 84 mg/L of magnesium, making it highly mineralized (2078 mg/L). It should be consumed in moderation by dialysis patients to avoid calcium overload.
- To be consumed in moderation.
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Hépar
- Very rich in minerals: Hépar has high magnesium (119 mg/L) and calcium (549 mg/L) levels, making it unsuitable as it can disrupt the mineral balance in dialysis patients.
- To be avoided.
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Badoit
- High in sodium: Badoit has 165 mg/L of sodium and is highly mineralized (1300 mg/L). It is a sparkling water that may cause sodium overload, which is particularly risky for dialysis patients.
- To be avoided.
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Perrier
- Highly carbonated and rich in sodium: Perrier contains 9.5 mg/L of sodium and is less mineralized than Badoit, but it should still be avoided due to the risk of gas and mineral overload.
- To be avoided.
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Vichy Célestins
- Extremely high in sodium: With 1172 mg/L of sodium and a mineral content of 4368 mg/L, Vichy Célestins is unsuitable for dialysis patients due to its detrimental impact on electrolyte balance.
- To be avoided.
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Rosana
- Rich in bicarbonates and minerals: Rosana has a high calcium and sodium content, making it incompatible with the mineral and fluid restrictions required for dialysis patients.
- To be avoided.
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Courmayeur
- Courmayeur is a sparkling and mineralized water (1072 mg/L of dry residue) with a high sodium content (10 mg/L). It is not suitable for regular consumption by dialysis patients.
- To be avoided.
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Water Kefir
- While popular for its probiotics, water kefir contains traces of fermented sugars and substances that may be difficult for dialysis patients to eliminate. It is not recommended in this context.
- To be avoided.
An informed choice of water greatly contributes to managing fluid and mineral intake for dialysis patients.
Beverages to Prioritize During Dialysis
Water remains the standard beverage for everyone, including dialysis patients. However, water intake must be controlled. Dialysis patients are generally advised to limit their water consumption to approximately 500 ml to 1 liter per day.
Herbal infusions, such as chamomile or peppermint, can be excellent options for dialysis patients. They are caffeine-free and low in potassium, making them a safe and soothing alternative to pure water. However, it is always important to check ingredients, as some herbs may be high in minerals.
Eau Exquise products, particularly their natural water flavorings, are an excellent option for dialysis patients. These sugar-free, sodium-free, and potassium-free flavored waters allow patients to enjoy variety without overloading their bodies with unwanted minerals or fluids.
Eau Exquise offers delicate flavors made from certified organic fruit and plant extracts, transforming tap water into a pleasant beverage with no negative impact on kidney health.
