Top Summer Tips For Dialysis Patients. Flip flops, sunglasses, and starfish in background with Dialysis Dietitian logo.

Top Summer Tips For Dialysis Patients

It’s that time of year again! Longer days, warmer weather, barbecues, and celebrations. Summertime can be full of fun activities and fun food. There are certain considerations for people on dialysis, however, to ensure that you stay safe and healthy during these warmer months. Below are some Top Summer Tips For Dialysis Patients.

Top Summer Tips For Dialysis Patients

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Protect Your Skin

Picture of woman in hat applying sunscreen to her shoulder. Protect Your Skin. Top Summer Tips For Dialysis Patients.

Spending time outdoors being physically active is a great way to relieve stress and boost your vitamin D levels. It only takes about 10-15 minutes of sun exposure to boost your vitamin D levels.

However, in advanced CKD, your kidney’s ability to activate vitamin D into its active form so your body can use it becomes compromised. For this reason, most people on dialysis take a vitamin D supplement (already in its active form) to avoid vitamin D deficiency.

Having chronic kidney disease (CKD) does increase your risk for developing certain cancers, including skin cancer (1). Beyond 10-15 minutes of sun exposure it is best to protect your skin from over-exposure to ultraviolet (UV) light.

Protection from UV rays is not only important during the summer months, but all year long. UV rays are still present on cloudy days and can reflect off of surfaces like water, sand, cement, and snow. In the United States, UV rays tend to be strongest between 10 a.m. to 4 p.m.

Choose a natural sunscreen formulated with mineral or physical sunscreen ingredients, like zinc oxide and titanium dioxide with a SPF of at least 30, which blocks 97 percent of the sun’s UVB rays. A couple of good ones are BurnOut* and Badger*. Make sure to re-apply every two hours or after swimming or exercising.

Fluid Balance

Picture of rocks balancing on a stone scale with the ocean in the background. Fluid balance. Top Summer Tips For Dialysis Patients.
Hydration vs. Fluid Overload

This is probably the toughest part about the summer months! The weather is warmer and you are typically more physically active outdoors making managing your fluid intake even more difficult.

When you are on dialysis your ability to make urine gradually declines and you become more dependent on dialysis to remove the fluids you drink. However, your body can only handle so much fluid being removed during a short treatment time before your blood pressure drops and you start cramping and having symptoms.

Long term, carrying around too much fluid in the body (fluid overload) puts a big strain on your heart and can cause congestive heart failure. This is why following your fluid goals are so important. Notice I said goals instead of restrictions. Let’s face it, managing your fluid intake is not easy but necessary. Putting a more positive spin on it might help change your mindset a little.

If you are exercising and sweating more, you might be able to increase your fluid intake a little. Just keep track of any signs of fluid retention (edema) and adjust your fluid and sodium intake accordingly. Ask your dietitian what your daily fluid goals should be.

Thirst Tips For Dialysis Patients:

  • Avoid Gatorade and sports drinks. You may think drinking a sports drink with electrolytes is what you need, however since your body is already retaining more sodium and your kidneys do not excrete potassium as efficiently, this is usually not a good choice for people on dialysis.
  • One of the top things you can do is really watch your sodium intake and avoid salty foods. This will make sticking to your fluid goals much easier. Look for unsalted or low sodium on your food labels. Foods that contain 140 mg of sodium or less per serving is considered low sodium. Your total daily sodium goal is 2000 mg per day.
  • Decrease the amount of sugar you eat and drink as this can also make you thirsty. If you have diabetes, controlling your blood sugar levels is also very important.
  • Squeeze fresh lemon into your water. You can also make fruit water by adding things like watermelon or cucumber and mint to make it more refreshing.
  • Freeze grapes, berries, or pineapple chunks and suck on one. Having something cold in your mouth can help.
  • Brush your teeth and tongue regularly and use non-alcohol mouthwash for dry mouth. Keeping it in the refrigerator can keep it nice and cold. There are products specifically made for dry mouth such as Biotene*, OraCoat XyliMelts*, and Act Dry Mouth Moisturizing Gum*. If you tend to have dry mouth, give these products a try and see if they help!
  • Chew on sugar free gum and suck on sugar free hard candies.
  • Freeze your favorite beverage and sip on it as it melts.

Move!

Picture of woman and man stretching in front of the ocean.

I can’t stress how important it is to incorporate movement and exercise into your daily or weekly routine. In fact, if you have CKD, more physical activity may reduce mortality by 50% (2).

Summertime brings us warmer weather which gives us more of an excuse to get outdoors and get moving. Of course, you don’t want to go out during the hottest portion of the day. Early morning or in the evening are usually great times to get out and walk, bike, do yoga or Tai Chi. I touch on dialysis and exercise in another blog if you’d like to learn more > click here.

Whatever you enjoy doing, make movement a goal. The more you do it, the easier it becomes to make it a healthy habit. Make sure to check with your doctor on what exercise is appropriate for you.

Swimming And Protecting Your Access

Swimming is a common, healthy summertime activity which you might be able to do depending on what type of dialysis access you have. Below is a breakdown of recommendations based on type of access:

  • Hemodialysis Catheter: No swimming is allowed with this type of access, unfortunately. It is important to keep your catheter clean and dry to avoid infection.
  • Hemodialysis Fistula or Graft: You are usually able to go swimming! First, get your doctor’s OK. Sometimes it is recommended to cover your access with a protective dressing, but you may not need to. Ask your dialysis nurse or doctor to find out.
  • Peritoneal Dialysis (PD) Catheter: You may be able to go swimming with a few conditions. Only swim in the ocean or a private chlorinated pool. Avoid swimming in fresh water, such as lakes, rivers, hot tubs and spas, which can be a breeding ground for bacteria and can infect your access. The PD catheter and exit site should be covered with either a clear waterproof dressing or colostomy bag. Routine exit-site care should be performed after swimming. If you are thinking about swimming, make sure you talk with your dialysis nurse first to find out the appropriate steps to take to ensure your access stays healthy.
Time To Swim. Picture of goggles, flip flops, swim cap, and towel. Swimming  And Protecting Your Access. Top Summer Tips For Dialysis Patients.

Protect Your Eyes

A no-brainer, right? Not only is it important to protect your skin, but also your beautiful eyes from those UV rays. UV exposure can contribute to the development of certain types of cataracts, growths on the eye and possibly macular degeneration, so a good protective pair of sunglasses are in order!

Look for sunglasses that block 99% to 100% of both UVA and UVB rays. You can choose wraparound sunglasses or close fitting sunglasses with wide lenses to provide more protection for your eyes from every angle. 

Adult Libations

Picture of friends eating and drinking at an outdoor barbecue.

With any celebration, get-together, or BBQ, there are usually alcoholic beverages involved. It can be awfully tempting and easy to over-consume in these types of environments, making it tough to stick to your fluid goals.

In addition, alcohol can increase your blood pressure, affect your blood sugar, potassium and phosphorus levels (depending on what you’re drinking), and impact your overall health if consumed in excess. Alcohol may also interfere with your medications.

That being said, light alcohol consumption may not pose a risk for CKD patients. If your doctor has given you the OK, then consume wisely and make sure you include it in your total daily fluid goals.

I would avoid mixed drinks due to the potential sugar and potassium content. Red wine would be your best bet if you are going to consume any alcohol due to the antioxidant properties and proven health benefits if consumed in moderation. Beer contains a good amount of phosphorus, so if you choose to have a beer you might need to take a phosphorus binder with it.

Remember to talk to your doctor beforehand to know if it is safe for you to fit an adult libation into your summertime plans.

Dialysis Friendly Picnic, BBQ, And Potluck Ideas

Woohoo! Fire up the grill and get this party started! But, what are good options for dialysis patients?

BBQ Sauce

A common marinade or sauce used for grilling is barbecue sauce. However, most BBQ sauces are loaded with sodium and sugar (high fructose corn syrup), and can also be a source of potassium from the tomato paste and often added potassium sorbate (preservative), making it a not so great choice.

There are a few, though, that are low in sugar and sodium, contain an acceptable amount of potassium per serving and are still full of flavor. Check out Good Food For Good Organic Classic BBQ Sauce. Not only does this sauce contain awesome ingredients, for every product sold, Good Food For Good donates a meal to feed someone in need. How cool is that?

Sides And Snacks

Protein

Choosing lean cuts of meat and staying clear of added sodium nitrates and phosphates in your meat and poultry will give you a healthier grilling base. Below are a few protein ideas:

  • Honey Chicken Kabobs. Sub the soy sauce with one of these options: Coconut Secret Coconut Aminos Variety Pack* for lower sodium with all the flavor. Instead of vegetable oil, use olive oil.
  • Grilled Salmon or Chicken
  • Burgers made with ground beef (ground round and sirloin have the lowest fat content), turkey, or bison. I would recommend choosing grass fed and grass finished beef instead of getting your meat from cattle raised on factory farms which are fed grain and often hormones and antibiotics. Your meat will be higher in nutrients and will have a better omega 3 to omega 6 fatty acid profile. Top with fresh or grilled onions, lettuce, some no salt mustard* and a little sweet or jalapeño relish. Try Woodstock relish for better ingredients.
  • Beyond Burger. If you’d like to try a veggie burger packed with protein this is a good alternative that does well on the grill. Beyond burgers do contain a fair amount of fat, but it is an acceptable high protein meat alternative when eaten on occasion.
Picture of red checkered table cloth with utensils, plate, and a grill on green turf. Top Summer Tips For Dialysis Patients.

Top Summer Tips For Dialysis Patients Recap

Now, you should have everything covered to enjoy a fun and healthy summer! Your skin is well protected using the right kind of sunblock. You have a good pair of sunglasses protecting your eyes from UVA and UVB rays.

If you have the option to go swimming, you are prepared to protect your dialysis access. You are getting outside and exercising more, making movement a healthy habit.

You’re also sticking to your daily fluid goals for healthy weight gains and utilizing tips to help quench your thirst. And finally, you are enjoying good food and drink dialysis friendly style.

Get out there and enjoy your summer!

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