Could Sweating in a Sauna(Diaphoresis) Spell the End of Dialysis?

How much sweat is produced in a 30-minute sauna session?

The amount of sweat produced during a sauna session can vary widely between individuals and depends on a number of factors, including the temperature and humidity of the sauna, the individual’s physiology, their acclimation to the sauna, and personal hydration levels before entering.

On average, a person might sweat out approximately one pint (which is roughly 16 ounces or about 0.47 liters) of fluid during a typical 30-minute sauna session. However, some people may sweat out more than this—up to 2 pints or more, especially in an intense sauna environment or if they are particularly sensitive to heat.

It’s important to note that the primary purpose of sweating in a sauna is to cool the body down, but it also has the effect of increasing blood circulation and can help with relaxation and detoxification. Due to the significant loss of fluids through sweating in the sauna, it is crucial to rehydrate before, during (if possible), and after the sauna session to prevent dehydration. Users are often advised to drink water or electrolyte-replenishing drinks after using the sauna to replace lost fluids and minerals.

Can diaphoresis be used as an adjunct with dialysis?

Diaphoresis, or excessive sweating, is not currently a treatment modality used in conjunction with dialysis. Dialysis is a medical procedure that primarily acts as a substitute for the normal function of the kidneys, removing waste products and excess fluid from the blood when the kidneys can no longer perform those functions effectively.

While sweating also removes waste products through the skin, it is not currently considered a therapeutic adjunct in the context of kidney failure or dialysis. Diaphoresis is not currently considered efficient or reliable for this purpose, especially considering that many patients on dialysis have limited fluid removal capabilities, and inducing sweat could potentially lead to dehydration and electrolyte imbalance.

However, maintaining a healthy fluid balance is crucial for patients undergoing dialysis, and avoiding excessive fluid gain between dialysis sessions is an integral part of managing their condition. It’s always best for patients with renal issues to follow the fluid intake guidelines provided by their healthcare team.

How many ounces of plasma are removed from the human body during a dialysis session?

In hemodialysis, the process primarily removes waste products and excess fluid from the blood; it doesn’t typically remove plasma as a separate component. The amount of fluid removed during a dialysis session can vary greatly depending on the fluid status of the patient, which is influenced by their fluid intake and residual kidney function.

The amount of fluid targeted for removal is called the “fluid removal goal” or “ultrafiltration goal,” and it is customized for each patient depending on their needs. This can range from less than a liter to several liters during a single session. Since there are about 33.8 ounces in a liter, removing 2 liters of fluid would equate to approximately 67.6 ounces.

It’s important to note that this fluid is not just plasma but all extracellular fluid, which includes interstitial fluid as well. Plasma volume is only a part of the total blood volume, and the primary aim is to balance the fluid status, not to remove a specific amount of plasma.

Is sweat taken from our extracellular fluids?

Yes, sweat is primarily composed of water and electrolytes, such as sodium and chloride, and it comes from the body’s extracellular fluid. Specifically, the fluid that comprises sweat is initially taken from the plasma in the blood. As blood circulates through the sweat glands, these glands filter the plasma, removing some substances and adding others to produce sweat, which is then secreted onto the skin’s surface. Sweat production can lead to a minor loss of extracellular fluid, but it is not a significant route for fluid clearance compared to renal filtration as occurs in the kidneys.

Is interstitial fluid extracellular fluid?

Yes, interstitial fluid is a type of extracellular fluid. Extracellular fluid (ECF) refers to all body fluid outside of cells, and it is divided into several compartments, including:

  1. Interstitial fluid, which bathes and surrounds the tissue cells. It’s found in the spaces between cells and is directly involved in the exchange of nutrients and waste products between blood and tissue cells.
  2. Intravascular fluid, which is the fluid within blood vessels, consisting mainly of plasma. Plasma serves as the carrier for blood cells and nutrients within the circulatory system.
  3. Transcellular fluid, which is the fluid contained within specialized body spaces, such as cerebrospinal fluid in the central nervous system, ocular fluids in the eyes, synovial fluid in joints, and pleural, pericardial, and peritoneal fluids in the respective cavities.

The distinction between these types of extracellular fluids is important because they each serve different physiological roles. However, they are all outside of and surrounding cells, thus they are considered part of the extracellular space.

What does plasma consist of?

Plasma is the liquid component of blood, in which blood cells are suspended. It makes up about 55% of the total blood volume and is composed of roughly 90% water. The other 10% consists of various substances vital to the body’s functions, which include:

  1. Proteins: Plasma proteins are the most abundant solid components of plasma, comprising 6-8% of the plasma volume. These proteins include:
    • Albumin, which helps maintain blood’s osmotic balance and transport substances.
    • Globulins, which are involved in immune responses and also act as transport proteins.
    • Fibrinogen, which is essential for blood clotting.
    • Regulatory proteins, including enzymes and hormones.
  2. Electrolytes: These charged particles are crucial for maintaining the body’s pH balance, transmitting electrical charges necessary for muscle contraction and nerve impulse transmission, and regulating fluid balance. They include:
    • Sodium
    • Potassium
    • Calcium
    • Magnesium
    • Chloride
    • Bicarbonate
    • Phosphate
  3. Gases: Plasma transports respiratory gases. Oxygen is bound to hemoglobin in red blood cells, but some is also dissolved in plasma. Carbon dioxide is also carried in plasma, partly dissolved, partly as bicarbonate, and partly in association with blood proteins.
  4. Nutrients: These are substances absorbed from the digestive tract and transported to the tissues for use or storage. They include:
    • Glucose
    • Amino acids
    • Fatty acids and triglycerides
    • Cholesterol
    • Vitamins
  5. Waste Products: These are substances produced by the body that need to be excreted. They include:
    • Urea
    • Creatinine
    • Bilirubin
    • Ammonia
  6. Hormones: Endocrine glands secrete hormones directly into the bloodstream, and plasma carries them to their target organs.

Thus, plasma serves as a transport medium for these components and plays a crucial role in maintaining homeostasis, defending against disease, and healing injuries through blood clotting mechanisms. The composition of plasma makes it critical for supporting cell function and allows it to serve as a medium for exchanging substances between blood and body tissues.

What does extracellular fluid consist of?

Extracellular fluid (ECF) refers to all body fluids outside the cells and is a significant component of the body’s fluid environment, ensuring that cells are bathed in a medium that allows them to survive and function. The ECF comprises several components:

  1. Interstitial Fluid: This is the fluid that surrounds body cells and provides the immediate microenvironment that allows for movement of ions, proteins, and nutrients across the cell membrane. It is similar in composition to plasma but has lower concentrations of proteins because the capillary walls are generally less permeable to large molecules like proteins.
  2. Plasma: As the liquid component of blood, plasma carries the blood cells and is rich in nutrients, hormones, proteins, and waste products. Its composition is more complex than interstitial fluid due to the higher protein content.
  3. Transcellular Fluid: This includes the specialized fluids that are contained in body spaces, such as cerebrospinal fluid, synovial fluid, aqueous humor, saliva, bile, and fluid secreted by the digestive tract. Although these fluids may have distinct compositions specific to their locations and functions, they are also part of the ECF.

The composition of extracellular fluid is maintained by various physiological processes and typically includes:

  • Water: As the primary solvent in which all the solutes are dissolved.
  • Electrolytes: These are important for maintaining membrane potentials and fluid balance and include ions such as sodium, potassium, calcium, magnesium, chloride, bicarbonate, and phosphates.
  • Nutrients: Like glucose and fatty acids, which are delivered to cells for energy and growth.
  • Oxygen and Carbon Dioxide: Gases that are critical for cellular respiration.
  • Waste Products: Such as urea, which cells need to dispose of.
  • Proteins: Although the protein concentration is much lower in the interstitial fluid than in plasma, some proteins are present in all compartments of the ECF.

The balance of the ECF composition is crucial for various physiological processes, including osmoregulation, pH balance, and the proper functioning of cells. The kidneys play a significant role in maintaining this balance by adjusting the volume and concentration of urine excreted, which in turn regulates the composition of the ECF.

What does interstitial fluid consist of?

Interstitial fluid, which is part of the extracellular fluid, surrounds the cells of tissues. This fluid provides a medium for the exchange of substances between the blood and cell environment, enabling the transport of nutrients, oxygen, and waste products.

The composition of interstitial fluid is similar to that of blood plasma, but it generally contains lower concentrations of proteins because the capillary walls are semi-permeable and restrict the passage of large molecules. Here are the key components of interstitial fluid:

  • Water: The main component, acting as a solvent for other molecules.
  • Electrolytes: Including ions such as sodium, chloride, bicarbonate, potassium, magnesium, calcium, and phosphate. The concentrations of these ions are similar to those in plasma but can vary depending on tissue activity and capillary exchange dynamics.
  • Nutrients: Glucose, fatty acids, amino acids, and other small molecules that have passed through the capillary wall are present and available for use by the cells.
  • Gases: Oxygen and carbon dioxide diffuse between the blood and interstitial fluid based on concentration gradients.
  • Waste Products: Metabolic wastes like urea and lactate are present before they are carried away by the blood to be processed or excreted by the body.

Because proteins are present in lower amounts in the interstitial fluid than in the plasma, the oncotic pressure (colloid osmotic pressure) is lower in the interstitial space than in the blood vessels. This difference in oncotic pressure is one factor that allows for the osmotic exchange of water and solutes across the capillary walls.

The lymphatic system also plays a crucial role in the management of interstitial fluid. It drains excess fluid and proteins from the interstitial spaces and returns them to the bloodstream, maintaining fluid balance and preventing edema, which is the accumulation of excess fluid in tissues.

 

The Water of Life

Our bodily fluids. The fluid within our body is a miraculous thing that makes our life possible. It is the fluid that circulates the red and white blood cells throughout our vascular system. Our arteries and veins. That same fluid leaks out of our vascular system at the capillary beds into the interstitial spaces where our arteries and veins meet. It is also called tissue fluid. A solution that bathes and surrounds the cells of multicellular animals. As interstitial fluid begins to accumulate, it is gathered up and removed by minute lymphatic vessels and returned to the blood. As soon as the interstitial fluid enters the lymph capillaries, it is called lymph. Same thing, different space. Returning this fluid to the blood prevents edema and helps to maintain normal blood volume and pressure. During this three-part transitional phase, this fluid bathes our cells in oxygen and nutrients while also picking up cellular debris for clearance back into our general circulation where it can be filtered by our lymph nodes and filter organs like the liver, kidneys, and spleen.

What is the difference between our blood, interstitial fluid, and lymphatic fluid? Nothing but location, purpose, and small amounts of other minute contents.

It is also the yellow part of our urine, the fluid that bathes our brain, fills our eyes, and we swim around in it while developing from embryo to newborn child.

-Michael J. Loomis