Cross-linked polyelectrolyte polymers with bound counterions that absorb about 20-fold or more of their mass in saline such as physiological saline a with the proviso that sodium does not exceed 60% of total bound counterions when hydrogen is the sole other counterion, are disclosed. Methods of preparing the disclosed polymers and for treating subjects such as patients in need of fluid removal and/or modulation of ions (e.g., sodium and/or potassium) are provided.