Amount of liquid in early stages of CKD

[AguynamedKim]

I know restriction of liquids is something that generally needs to happen as CKD progresses, but what about the earlier stages, e.g. Stage 2?  I have read that I should drink plenty of water to help my kidney's "lighten their load".  Not sure how that's the case, especially since more water means more volume means higher blood pressure and I'm trying to keep mine as low as possible (aiming for 110/70 since I have protein in my urine).  I assume if I drink a lot of water that if my kidney's are still at eGFR > 59, will the blood pressure regulate appropriately?  Considering I have a mild dieuretic in my blood pressure medicine, water tends to go through me pretty quickly, especially after a workout where I take in about a liter of water (I sweat a lot).  My blood pressure has been pretty good as long as I keep working out.

More water?
Less water?
"Normal" amount of water?

P.S. Happy New Year everyone!  May it be as great as Murf's optimism!  http://ihatedialysis.com/forum/index.php?topic=21389.0

[MooseMom]

No, no fluid restrictions at CKD2.  My egfr is only 15, and I asked my neph this specific question, and even at late CKD4, there are no fluid restrictions in general.  However, I'd ask your own neph just to be sure about YOUR body.

[Deanne]

I second what MM said. My neph told me before my last bloodwork to make sure I was well hydrated before I had my blood drawn. I'm CKD4 at about 20% function.

[Desert Dancer]

I drank whatever I wanted - in whatever quantity I wanted - right up until I started dialysis (eGFR , and had no problems.

[Stoday]

You can still enjoy a skinfull from time-to-time. Enjoy now, whilst you still can.

Fluid restrictions are for when your kidneys can't excrete enough liquid. You'll be motivated to restrict fluids because of the discomfort when water's pumped out of you during dialysis. For me, the limit's 3 liters but any more than 2.4 or so means discomfort.

[jbeany]

Yup, double check with your doc, but as long as you aren't retaining fluid in your tissues, they generally think more is better in the early stages. 

[kristina]

In the beginning I was also confused at the amount of water,
or liquid, to drink each day in ESRF (10-12% kidney function, no Dialysis).

I came across many different suggestions,
but I thought the level of liquid intake per day
must be relative to one’s size of bodyweight.

So, I can only tell you what I take.

I weigh 52.5 kg & I am 165 cm & a female.
And I find it perfectly manageable to have about 2 liters of liquid per day,
but not 2.5 or 3 liters and not as low as 1.5 liters.

So, you will notice people giving you different amounts
and you will have to make the judgement yourself.
Perhaps your nephrologist can guide you.

Good luck from Kristina.

[AguynamedKim]

Thank you everyone for your responses.  I haven't been limiting my fluid intake but then again, I don't generally drink a lot of fluids during the day.  Generally I have coffee and cereal with rice milk in the morning, some water at lunch, water when I work out (I sweat - a lot, and I mean a lot) and maybe some at dinner.  I was reading about RichardMEL's new intake of 3L+ of water a day (go Richard!) and it got me thinking back on comments made by people who have asked me if I was drinking a lot of water to help out my kidneys - granted these are not IHD people but friends of mine.  I know Richard's is for a very specific reason (go little Danny).  I was just wondering if drinking a bit more water (not to excess) is something I should do to help my kidneys.

New project for the new year - get an good idea of how much I drink per day.

[Bruno]

Mate, I could not stop drinking in the early stages. I was up 3 to 5 times a night as it came back out again. I was rather relieved (sorry about that) when I went on dialysis and my interrupted nights stopped.
In a way, that is...now they've been replaced by insomnia. But that's life and,hey, I'm still around so mustn't complain.

[Michael Murphy]

The major problem I had starting dialysys was fluid intake.  To start off with I am, well fat.  I was 150 kilos to start dialysis. As  a fat guy my nephologist set my dry weight 5 kilos lower than I was at the time.  In addition I was told to limit my fluid to 32 oz. a day.  This started my 2 months of hell.  I tried to stick to 32 oz but usually did about 40. But I left dialysis feeling like I was at deaths door cramping, tired, cold, and dizzy, then after a real rough session I went to a nephologist visit and when the PA took my BP she ran out of the room to get the doctor.  My BP was 75 over 45 and I was rushed to the urgent care center for 2 liters of saline.  The urgent care doctor wanted to give me more saline but all I wanted was to go home to bed.  The next day I went to work, at the next dialysis session my PA showed up and told my dry weight was only 1 kilo lower than what I weighed and I was no longer fluid restricted. My kidneys were still functioning well enough to process fluid just not all the toxins.  Every patient is unique and even a small amount of existing kidney function should be protected as long as possible since there contribution to fluid removal increases the quality of life for the patient.  I realize how lucky I am and monitor my output dreading the day I need to watch my fluid again.  I also make sure I don't do things that may damage my currently limited kidney capacity.