The current heatwave in Europe poses a challenge particularly for dialysis patients. Rising temperatures increase the risk of dehydration and patients are tempted to drink more than the limited fluid intake. Prof Giovanni Strippoli, Senior Vice President Scientific Affairs at Diaverum and Chairman of the Diaverum Academy and Dr. Paul Stroumza, Country Medical Director in Diaverum France, explain the main problems and provide tips for patients on how to handle the hottest time of the year.
- Many countries in Europe are currently facing more than 30°C. Why can this be dangerous for dialysis patients?
Dr. Paul Stroumza: Dehydratation is a big risk for the general population as well as for dialysis patients. A common cause of dehydration is heatwaves, which are associated with significant loss of fluid through perspiration. In dialysis patients, it is generally recommended to limit the intake of fluids to control the dry weight. If the dry weight is not properly achieved during dialysis, dehydration can be caused by the dialysis itself. For this reason, high temperatures pose a serious problem for dialysis patients, who are thirsty and aware of their dialysis needs, as they know they should control the amount of fluid they drink. In general, dehydration is manifested by intense thirst and a low voltage. On the skin, the ‘fold test’ is a clinical indication of a state of dehydration: in normal conditions, if we slightly pinch the skin it immediately resumes its original state due to its elasticity; on the contrary, if the skin remains wrinkled for a short period of time, a state of dehydration is suspected. If it is determined that the patient is dehydrated before or after dialysis, we generally administer an infusion containing physiological saline solution (isotonic sodium chloride). To avoid dehydration, the patient must be able to adapt their behaviour to certain situations, e.g. drinking more although in a balanced way, when the weather is hot. It is important to discuss with the nephrologist how to handle these particular situations, because the recommendations vary widely from patient to patient. When in doubt, patients should never hesitate to tell their doctor, because some states of dehydration can worsen within 24 to 48 hours and become very dangerous.
- What can dialysis patients do to cool down?
Prof Giovanni Strippoli: There are a number of things I would recommend to do:
- Talk to your doctor and dietician to be absolutely clear on how much fluid you can drink every day, how to limit or not limit fluid intake and what signs and symptoms you should look for, if too much fluid is building up.
- Ask your doctor if it is possible to decrease the dialysate temperature.
- Brush your teeth more often, to feel refreshed.
- Suck on a lemon wedge. You can freeze it first if you like.
- Add lemon to water and ice for a thirst-quenching effect.
- Suck on a few ice chips. Ice stays in your mouth longer than water.
- Eat sugar-free sour candy or chew a gum to wet your mouth.
- Take frequent showers and/or cooling misting ventilation.