fluid overload

[raramorgan]

 I have a question. I am not on a restricted fluid intake. Is everyone on dialysis on a restricted fluid intake. From reading on this site and others it seems everyone has a lot of fluid when going on dialysis. Am I going to start having fluid problems as my GFR goes down.  Thanks 

[PrimeTimer]

Each person is a little different so I'm sure your Neph and/or nurse will evaluate you and help determine your dry weight, etc. Because my husband dialyzes 5x a week (home-hemo, NxStage) his fluid intake is not as restricted. He loves that. He also has some residual function left. But it doesn't mean that he can have as much as he wants, he does have to monitor and be careful. He checks his ankles and legs for signs of edema every day and if his BP and weight are up, it's pretty much a clue that he needs to further restrict his intake and remove more fluid during dialysis. In that case, we do it in small increments or what they call "challenge" his dry weight a little at a time over a course of a few treatments until we see a more normal BP for him. Then we know we are close to his "new dry weight". We do it this way to avoid BP crashes and cramping during treatment. We never just say "oh, you gained a few pounds so let's take it all off during today's session". And he never tells himself, "oh hey, think I'll drink a gallon of water today because heck, I can just take it off tonite during dialysis". Doesn't work that way.

[Michael Murphy]

I understand the rule is 32 oz. of fluid over what you urinate.  After 3 years on dialysis I am lucky that I still put out what I take in.  But fluid control is important so once a month I measure my input and I have a digital scale so I weigh my output in grams.  As long as the numbers match or are close I am good for another month.

[traceww]

Hi fellow Texan!  It's correct that everyone is different, but generally as the kidneys lose more function then the urine output will slowly decrease.  I am blessed and grateful to be an exception to that.  My dialysis clinic every few months measures urine output by having us collect it (fun) over a 24 hour period, so I would suggest such a test for you to keep on top of it.  Have you noticed any dropoff in urine output?

[raramorgan]

Thanks everyone for answering That all makes good sense to me. Yes my urine output has gone down.  My GFR was at 34 a month ago but I know it is lower now than it was a month ago because I can tell in my output and how  tired I get and the nausea has gotten worse. I know I will be one dialysis because of the disease I have. It is very rare and there is no stopping it or slowing it down. I do not have to restrict my fluid now. I do not drink that much anyway. sometimes I have to make my self drink My mouth does get very dry. Do most people have  a lot of fluid build up when they start dialysis. I have never had a problem and it worries me that it will be really bad. Some of the things I read people are so swollen they can not walk or breath and that is scary to me.

[kickingandscreaming]

Do most people have  a lot of fluid build up when they start dialysis. I have never had a problem and it worries me that it will be really bad. Some of the things I read people are so swollen they can not walk or breath and that is scary to me.

Before my kidneys finally crashed (at 6%) up until then I had not  noticed any swelling or nausea or typical symptoms except reduction in stamina that I figured was from anemia. Then I got a seemingly minor but persistent case of Pneumonia and that landed me in the hospital. Just before I entered the hospital, I couldn't breathe when I took more than a few steps. And I felt quite heavy (didn't weigh myself so didn't know the numbers). My legs were like tree trunks, filled to the brim and hard.  I attributed my breathing issues to Pneumonia--and it's possible it was both that and fluid overload. I put on 6 kg in a short time and felt awful.  That was the end of my dialysis-free days.