Written by Dr. Julie Highfield - Clinical Psychologist
and Beverley Beynon-Cobb, Senior Dietitian

One of the most difficult problems with living with a chronic condition is that it never goes away, it has a constant impact upon daily life and may even change the direction that the person living with the condition hoped that their life would go in. The great challenge is to make sense of the condition and find a way to adapt to it and make life fit around it.

It is the people who struggle to adapt to a chronic condition who often end up distressed.

In particular, the life of a renal patient is often made difficult by the various restrictions imposed by the illness. Pre-dialysis patients may manage their diet and lifestyle to lengthen the health of their kidneys, dialysis patients are asked to manage diet and fluid as well as dealing with a frequent dialysis regime. Transplant patients are still not out of the woods and need to be consistent with daily medication as well as looking after their health and drinking enough water.

People often talk of feeling that others do not understand and they feel different. They might do whatever they can to “fit in”.

One of the ways individuals look to manage this balance is through alcohol intake. In British culture alcohol may be part of many social acitivities; the local pub quiz night, a Sunday afternoon family meal, dinner out, family parties, and so on. For a renal patient trying to balance a fluid intake and having restrictions upon the alcohol they can drink, these social events can become difficult. For instance, others who may not understand or may question a person who is not drinking much and put pressure upon that individual to “join in”. Some find alcohol helps them

to relax in social situations and find without alcohol they feel less enjoyment. Unfortunately, it is problems like these that may discourage people from going to such events. This then has an impact upon that person’s social life, and then upon how that person feels. Most people do well when they have others around them for support but also when they are involved in the kinds of activities that help them to feel “normal” – a person first, and a renal patient second.

Therefore, we have collated a few tips from renal patients about managing alcohol and social situations :

For alcohol limitations:

• How close is the friendship/social group- can they be supportive or is it a "beer" culture?
• Try shandy- with half the alcohol content this helps reduce overall alcohol intake.
• Choosing lower-alcohol or alcohol - free drinks.
• Alternating alcoholic and non-alcoholic drinks
• Avoid the bargain "doubles"
• Drive so there is no alcohol and it's just a social experience. That way you can leave when you want to and have complete control over your drinking.

For fluid restrictions :

• Drinking slowly and taking small sips, rather than having no drink at all- try having a drink that can me sipped not gulped - ie not beer.
• Not having ice cream and the extra fluid that it brings.
• Missing every other "round" of drinks.
• Save as much fluid as possible by drinking minimum amounts that day prior to pub trip.
• Avoid salty snacks which may drive thirst.
• Extra lemon may help with thirst

It may also be a good idea to encourage your friends and family into social activities where alcohol is not central.
Remember that all people, not just renal patients, have recommendations for restricting alcohol intake and there is nothing wrong with being the healthier one in the group. Some individuals put social pressure upon others to drink to justify their own intake and you do not need to give in to this pressure.

General Advice with Alcohol

Remember to follow the individual advice set for you by your Consultant and Dietitian. Be aware of the particular medication you are on and how this may limit the alcohol you are allowed.

Certain types of alcohol contain more potassium than others, so if you are following a potassium restriction ask your Dietitian for more details about the types and amounts of alcohol you can have per week. Alcohol contains a lot of energy so an excessive alcohol intake might result in unnecessary weight gain.

Try to spread your drinking throughout the week and have at least 1-2 alcohol-free days per week.

From our experience with individuals living with kidney failure the key is to live first and be a patient second.

By Dr. Julie Highfield – Clinical Psychologist and Beverley Beynon-Cobb, Senior Dietitian

More information can be found at www.drinkaware.co.uk

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ad this Information PDF The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.