Fluids
The fluid restriction is one of the most difficult parts of dialysis. When you're on dialysis, you may not urinate as much as you used to, or you may not urinate at all. Our kidneys remove the additional fluid and water we drink each day, in addition to clearing our blood of waste and poisons.
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Your kidneys filter 180 liters of blood per day when they're performing properly. The blood flow of our entire body is filtered roughly 20-25 times every day. Every day, you produce 1 to 2 liters of urine during filtration.
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It's more difficult than it appears to determine what constitutes a fluid. Anything that turns to liquid at ambient temperature is considered a fluid, not only water.
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Examples of fluid:
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Ice
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Soups and stews
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Pudding
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Ice cream, sherbet, sorbet, popsicles, etc.
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Protein drinks (Nepro, Novasource, Ensure, etc.)
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All beverages (water, soda, tea, coffee, milk, non-dairy milk, etc.)
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Jell-O® other gelatin products and gelatin substitutes (pectin, arrowroot powder, etc.)
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Some fruits that have a high water content, such as watermelon and grapes, do not count toward your daily fluid amount, but you should limit your daily servings of these fruits if you have fluid restrictions.
What exactly is a Fluid?
Kidney disease stages 1-2
It's critical to drink enough water if you have kidney disease stages 1 and 2—roughly 64 ounces or eight glasses per day. This will keep your kidneys hydrated and functioning properly.
Kidney disease stages 3, 4 and 5 (not on dialysis)
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You may need to decrease your fluid intake after you reach the latter stages of kidney disease—stages 3, 4, and 5 (not on dialysis). Inquire with your doctor and nutritionist about how much liquids you should drink.
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You may develop fluid retention throughout certain stages of renal disease (too much fluid buildup in your body).
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If you detect any of the following indicators of fluid retention, contact your doctor straight away:
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Swelling in your feet and ankles
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Difficulty breathing or shortness of breath when walking short distances, such as one to three blocks
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Difficulty breathing or shortness of breath when walking up one flight of stairs
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Difficulty breathing or shortness of breath when lying flat on your back. You may need one or more extra pillows to help you breathe.
Kidney failure (on dialysis)
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When you're on dialysis, you'll need to keep your fluid intake to a minimum.
The amount of fluid you should drink will be determined by your nephrologist and renal dietician, but the usual recommendation is 32 ounces per day.
If you still urinate, drink a little more fluid—32 ounces plus the quantity you urinate in a 24-hour period.
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For example, if you urinate 1 cup (8 ounces) every day, you can drink 40 ounces (32 ounces + 8 ounces) per day.
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It's possible that your daily pee output will decrease with time. Every three months, your doctor and nutritionist may ask you to measure your urine output for one day.
Some people collect their urine in a disposable cup that holds 20 ounces. To make measuring easier, mark your cup or other container in half-cup intervals before you begin. Write down how much urine is in the cup or container after you've collected it for 24 hours and share that information with your doctor and nutritionist.
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Having too much fluid in your body can be harmful since it causes your blood volume to rise. If your kidneys are unable to cope with the increased blood volume, you may have issues such as:
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Swelling (edema)
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Poor nutritional status
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High blood pressure
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Lung infections (i.e., fluid)
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Heart failure
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Difficulty breathing or shortness of breath
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Decreased blood proteins, which could impact how effective your dialysis treatments are