water/fluids

[Riverwhispering]

I was just curious for those doing in center dialysis.  How much water/fluids is the normal /average amount allowed per day? 

[cassandra]

I think it is a litre a day

[bsmith51]

Greetings,
A few years ago the answer would have been 1.5-2 liters (one liter = one kilogram, so the number's the same as when you weigh in).  Fortunately, this approach has become more adaptable.  The goal used now is fluid (weight) gains between treatments should be between 3% and 5% of your dry weight.  less than 3% may reflect amount you urinate and is not a problem, but it may also reflect decreased intake.  Like everything in dialysis, it's all about trending and watching for out of ordinary results.

So,if a person weighed 70 kg, I would expect the weight gain (fluid intake) to be between 2.1 kg (3%) and 3.5 kg (5%).  A quick way to figure your 5% limit is to take 10% of your dry weight and divide by two, e.g., 10% of 70 is 7 and half that would be 3.5. No calculator! Remember, this is between treatments, NOT daily.

Now, how much is  a liter in daily use?  For practical purposes they are the same (1L = 1.05 qt). Our 70 kg person would want to limit his/her intake to 3.5 qts or 1.75 qts a day (for two days).

I would recommend trying for a goal of 4%.  This would allow a little more for the weekends.

Hope this helps and good luck.
Bruce

[cattlekid]

I found that when I was in center, I needed to stick right around to a liter per day in order not to gain too much between treatments.  I cannot take off more than 2 L per treatment without crashing big time. 

Now that I am at home and doing short daily hemo, I don't pay as close attention to my fluid as I know that dialysis is never more than a day away.  I still don't go too much over a liter to a liter and a half, but I don't measure nearly as closely as I used to.

[lmunchkin]

That is the beauty of doing home D.  You are doing more frequently than in - center, thus less to worry about.  But  anyone with kidney failure, you still must be careful of fluid intake, not to mention the toxins that can build up. When I do J in the evenings after work, he generally meets his UF in 2-2.5 hrs of treatment, then the remaining time is removing toxins.

He use to think, "oh, well I met my goal, now you can stop".  Well at first I was doing that, but then next monthly workup at clinic, nurse told us not to do that and explained why.  Just the mear mention of "Toxins" sounded deadly.  Well quess what, if not removed, it can do just that!! So we have learned, it is not only about fluid, but toxins also.

J & I both have learned alot since doing this NxStage at home.  And Im sure there is still more to learn.  If I didnt have to work, I would do "Extended" NxStage on him.  Im sure he would "Jump Rope" all over the house if I did, but daily is working real well for us, and for that we are greatful.

God Bless,
lmunchkin

[sullidog]

I have been told it's two bottle waters a day.

[jeannea]

They told me when on hemo you can drink 1 liter plus the volume you pee. So if you pee about 300 mL a day you can drink 1300 mL.

[Gandalf]

I was told that the standard is 800ml + whatever you urinate in a given 24-hour period....

[RichardMEL]

Everyone's unit, and personal situation, differs - forexample I was always told down here that it was *500ml*+ your output (500ml is basically what you sweat out daily, pass in number 2, and so on). What I tried to do is look at it a different way and have a "between sessions" gain of 2L/2kg - again a "general rule" down here was that a 2kg change in weight was seen as acceptable and something that worked. Now, you could perhaps push it if you could tolerate more being taken off - I could take 3.5-4.0 before I would cramp up, but I didn't make a habit of that because I also know that taking off more fluid puts more pressure on your system - the UFR goes up, the machine is pulling more, your body has to refill more, and puts more strain on your system - so I tried to keep it to that 2kg change (and yes, that includes over weekends = much harder obviously with the extra day).

Really there's no set rule because I think it can be quite variable across patients in terms of where they are at, what they can tolerate (eg - what if you used my 2kg limit, but couldn't physically tolerate more than 1.5 off? then you'd have to modify as appropriate). I've also tried to apply the percentage rule too, but I found it easier to just go with the overall change between treatments, which you could conert to a "day limit" or whatever, but I tended to weigh myself 3 or so times a day to keep track, plus a mental tally too, and it became second nature after awhile.