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Can you drink Coke while on dialysis?

Dialysis is a treatment that filters waste products and excess fluid from the blood when the kidneys are no longer healthy enough to do this on their own. During dialysis, a machine called a dialyzer, or an artificial kidney, is used to clean the blood. There are two main types of dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis involves filtering the blood through a dialyzer machine. Blood flows from the body into the dialyzer via tubes, and a special filter called a dialyzer membrane filters out wastes and extra fluid. Clean blood then flows back into the body. Hemodialysis is usually performed at a dialysis center or hospital 3-4 times per week, with each session lasting 3-5 hours.

Peritoneal dialysis uses the lining of the abdomen (the peritoneal membrane) to filter blood inside the body. A cleansing fluid called dialysate is drained into the abdominal cavity and absorbs wastes and excess fluid from the blood vessels in the peritoneal membrane. After some time, the dialysate is drained out along with the filtered wastes. There are a few different types of peritoneal dialysis, but it generally needs to be performed 4-6 times per day.

While on dialysis, patients need to follow a special renal diet to limit fluids, control minerals like potassium and phosphorus, and get proper nutrition. But many people wonder if they need to give up all their favorite drinks while on dialysis, especially commonly consumed beverages like soda.

Can You Drink Coke on Dialysis?

Coke, or Coca-Cola, is a popular carbonated soft drink containing caffeine, sugar, and phosphoric acid. The question of whether it is ok to drink Coke while on dialysis comes down to a few key considerations:

Fluid Intake

One of the main goals of dialysis is to remove excess fluid from the body. Dialysis patients are usually placed on a strict fluid restriction, typically limiting intake to around 32-48 oz per day depending on urine output.

Drinking large amounts of any fluid, including Coke, can contribute to fluid overload between dialysis sessions. Excess fluid increases blood pressure and puts strain on the heart and lungs. For this reason, intake of Coke and other beverages needs to be limited and accounted for as part of the total daily fluid allowance.

Caffeine Content

Coke contains caffeine, with around 34mg per 12oz can. Caffeine acts as a stimulant and can increase blood pressure. Since fluid restriction leads to lower overall blood volume, the effects of caffeine are enhanced in dialysis patients.

Caffeine can also interfere with sleep and cause jitteriness, anxiety, and gastrointestinal issues. For these reasons, intake may need to be reduced for those who get dialysis. Moderation is key, but avoiding caffeine may be better for some.

Sugar Content

Coke has a very high sugar content, with around 39g per 12oz serving. The kidneys normally regulate blood sugar levels by filtering out excess glucose from the bloodstream and eliminating it in the urine.

In people with kidney failure, blood sugar management is impaired. Diabetes is also a leading cause of kidney disease. For these reasons, monitoring carbohydrate and sugar intake from drinks is especially important for dialysis patients to help control blood sugar and prevent complications.

Phosphorus Content

Phosphorus is a mineral that is normally filtered out by healthy kidneys. In kidney disease, phosphorus blood levels tend to become elevated. High phosphorus can cause bone disease and calcification of vessels and tissues when left uncontrolled.

Beverages like Coke contain phosphoric acid, used to provide tangy flavor, which can add to the dietary phosphorus load. Managing phosphorus levels through medication, diet, and dialysis is vital for bone health. Limiting intake of phosphorus-containing sodas can help keep levels in check.

Potassium Content

Potassium is another electrolyte that can build up between dialysis sessions as the kidneys fail. High potassium (hyperkalemia) can cause dangerous heart rhythm problems.

While Coke itself does not contain much potassium, consuming large amounts of Coke or other sugary drinks in combination with certain high potassium foods could result in potassium overload. Careful monitoring of potassium levels with dietary adjustments as needed can help minimize risks.

Recommendations for Drinking Coke on Dialysis

Based on the considerations above, here are some recommendations regarding Coke consumption for dialysis patients:

– Limit portion sizes to 4-8oz per day and account for all fluids as part of your daily allowance

– Avoid drinking Coke and other caffeinated beverages too close to bedtime

– Monitor blood sugar closely and limit intake if experiencing hyperglycemia

– Be mindful of phosphorus load from colas and balance with low phosphorus foods

– Watch for signs of fluid overload like sudden weight gain, edema, shortness of breath

– Consider caffeine-free or non-carbonated beverage alternatives to get the flavor without the caffeine or carbonation

– Check with your care team about your individual fluid, diet, blood sugar, and electrolyte needs

– Use portion control and don’t let Coke or other drinks dominate your fluid intake

With some precautions and moderation, an occasional small serving of Coke can likely be incorporated into a dialysis diet. But it is important to follow medical advice and watch for signs of any problems caused or exacerbated by Coke or excess fluid consumption. Staying adequately hydrated with the right fluids is key.

Benefits of Fluid Restriction on Dialysis

Maintaining proper fluid balance through fluid restriction provides several important benefits for dialysis patients:

Prevents Fluid Overload

Limiting fluid intake prevents fluid from accumulating between dialysis sessions. This avoids symptoms like shortness of breath, edema (swelling), congestive heart failure, and pulmonary edema (fluid in the lungs). Preventing fluid overload reduces cardiovascular strain.

Allows More Effective Ultrafiltration

Ultrafiltration is the process of removing excess fluid from the blood during dialysis using the dialyzer machine. Sticking to fluid restriction allows more efficient fluid removal during dialysis sessions.

Maintains Dry Weight

Dry weight is the ideal weight for a dialysis patient when they are not carrying any excess fluid. Staying at dry weight through fluid control prevents the strain of edema and congestion.

Controls Blood Pressure

Excess fluid leads to increased blood pressure in dialysis patients. Fluid restriction helps keep blood pressure at healthier levels, reducing strain on the heart.

Reduces Hospitalizations

Fluid overload is a common cause of hospitalization in dialysis patients. Adhering to fluid restriction can prevent emergency hospital visits and admissions for issues like fluid in the lungs or heart failure.

Supports Heart Health

Fluid restriction along with dialysis helps prevent fluid accumulation around the heart. This reduces the risk of problems like pericarditis or pericardial effusions (fluid around the heart).

Avoids Thirst and Symptoms Between Sessions

Spreading fluid intake evenly over the day prevents thirst and fluid-related symptoms from building up between dialysis sessions.

Allows Dietary Freedom

Since thirst is reduced, more dietary freedom is allowed in terms of foods like fruits and vegetables if fluid intake is well-controlled.

Improves Quality of Life

Closely following fluid restriction enables dialysis patients to feel better and engage in normal day-to-day activities without fluid-overload symptoms that can severely limit mobility and enjoyment of life.

Tips for Fluid Restriction

Here are some tips to help dialysis patients successfully restrict fluids:

– Weigh yourself daily to check fluid status and watch for sudden gains.

– Spread fluid intake evenly throughout the day – don’t drink most of your fluids all at once.

– Sip small amounts frequently instead of drinking large volumes at once.

– Choose low-sodium foods to support thirst control.

– Limit fluid intake a few hours before dialysis to avoid ultrafiltration symptoms.

– Be aware of hidden fluids in foods like gelatin, ice, popsicles, and gravy.

– Carry a bottle to mark and track daily fluid intake.

– Opt for smaller cups and utensils to control portion sizes.

– Stock up on non-fluid options for flavor like lemon, lime, mint, and chewing gum.

– Keep your mouth moist with lip balm.

– Limit high fluid content foods like soup, watermelon, and ice cream.

– Avoid high salt foods that increase thirst like chips, cold cuts, and canned foods.

– Drink slowly to prevent drinking more than needed to satisfy thirst.

– Consider setting a daily fluid limit alarm on your phone as a reminder.

Non-Fluid Drink Alternatives

To add more variety and flavor without excess fluid, consider incorporating these non-fluid or lower fluid options:

Flavored Ice Cubes

Add lemon, lime, mint, fruit essence, or herbs to water then freeze to create flavorful ice cubes.

Sparkling Water

The carbonation and flavors give sensory satisfaction with lower fluid consumption than soda.

Flavored Waters

Opt for low-calorie versions with natural flavors added like lemon, berry, or cucumber.

Diluted Juices

Add just a splash of your favorite juice to water to get the flavor with less fluid volume.

Decaf Iced Tea

Brew decaf tea then chill for a lightly flavored lower fluid option.

Sugar-Free Drink Mixes

Add a squeeze of lemon and a no-calorie drink mix like Crystal Light for light flavor.


Carbonated water gives sensory pleasure similar to soda with zero calories or sweetness.

Unsweet Tea

Brew weak tea then chill for light flavor without caffeine or added sugar.

Sugar-Free Lemonade

Make refreshing lemonade using a no-calorie sweetener and diluted lemon juice.

Diet Sodas

Limit intake and beware caffeinated options, but an occasional diet soda can add fizz.


Dialysis requires closely restricting fluids to avoid the dangers of fluid overload. An occasional small serving of Coke or other soda may be permitted, but intake must be moderate and accounted for given the high fluid content. While limiting fluid sources like Coke is challenging, the health benefits make it well worth the effort for dialysis patients. Following medical advice, tracking fluid intake, and incorporating lower fluid drink alternatives can help restrict fluids while still allowing for flavor and variety. With smart strategies, fluids can be controlled to make dialysis more effective and avoid complications.