What is the safest way to replace fluids in a dialysis pt who is having severe diarrhea secondary to opiate withdrawal?

Couple of Choices: You could manipulate the dialysate solution and or vary ultrafiltration to normalize the electrolytes and fluid balance or you could try to manage the withdrawal symptoms. This could be tricky in a esrd patient as the most common rx is Clonidine which can abruptly lower bp. I would opt for a gradual tapering off of the opiates or the use of subutex which has a gentler and slower withdrawal.

If a dialysis : Patient has severe dehydration, he should go to the hospital for evaluation of electrolytes and rehydration. Also, he should be evaluated for possible treatments for the diarrhea.