My husband is 65 years old and has had an ileostomy for 50 years. He has always been told to drink a lot and use salt to prevent dehydration. He has had kidney disease for the past 2 years and just went on dialysis Feb 21st. It seems that having an ileostomy and kidney dialysis is not a common condition. Now he must limit fluids and salt. We are concerned that there is a conflict. He is often very sleepy. His doctors are not very informed about the combination of his conditions. Can you recommend anyone?

I and the National Kidney Foundation do not make referrals. Your primary care physician and your nephrologist may have to communicate with each other about the differing requirements for fluid and arrive at a compromise. In general, your husband should try to gain about one or two kilograms (2 to 4 pounds) between each dialysis session. He should weigh himself and if he is gaining less than this prior to his next dialysis session, he could drink more fluids.

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