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CKD & Nutrition

Chronic Kidney Disease(CKD)

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Fluid Intake and Kidney Disease

Brooke Marsal, MS, RD
3
July 22, 2021

As we age, our kidneys start to wear out, becoming less efficient at filtering out waste and extra fluid from our blood. This tends to happen quickly if you have other conditions like diabetes, high blood pressure, an enlarged prostate, kidney problems, or certain cancers. The result of this is chronic kidney disease (CKD). The more advanced the disease, the more nutritional restrictions you will have, including for fluids. This guide will help you better understand your condition, learn how to stay within your recommended fluid intake, and manage side effects such as thirst and dry mouth.

Do I Need to Limit Fluids?

Fluid is one of the things that will be restricted in the later stages of kidney disease. This is because your kidneys can’t effectively filter out water from your blood. The build-up of fluid in your tissues is called edema.

Your nephrologist will be able to tell if you need to limit your fluid intake and how much liquid you can drink in a day.

Patients usually aren’t put on a fluid restriction until they start dialysis. The fluid restriction amount is determined by how well your kidneys are working and by how much fluid you tend to retain between dialysis appointments. A typical fluid restriction while on dialysis is about 32 oz, but this may vary depending on your unique needs.

Why Limiting Fluids is Important

If your doctor recommends limiting fluids, it’s important to follow their guidance. It might be hard to limit yourself, but in the long run, it will help you feel better and stay healthier. A buildup of excess fluids in the body can lead to:  

  • Swelling of face, hands, and feet
  • Trouble breathing because of fluid in your lungs
  • Heart damage from excess fluid in the heart
  • High blood pressure
  • Headaches
  • Low energy

How to Limit Fluids

Tracking how much you are drinking during the day is the most important thing you can do to prevent fluid build-up. The general recommendation is to limit yourself to 32 ounces of fluid a day.

32 ounces = 4 cups = 1 quart = ~1 L

Anything that is liquid or that can turn into liquid when melted will count toward your fluid intake.

This includes:

  • Water
  • Coffee
  • Tea
  • Soup
  • Milk and milk substitutes
  • Soup
  • Broth
  • Gelatin
  • Ice cream
  • Popsicles
  • Sherbert/ Sorbet
  • Ice cubes

Managing Dry Mouth and Thirst

Limiting yourself to only 32 oz (4 cups) of liquid a day can cause you to feel thirsty or have a dry mouth. The following tricks can help you avoid this discomfort:

  • Avoid salty and spicy foods
  • Stay cool and don’t overheat
  • Drink cold beverages instead of hot drinks
  • Snack on low potassium fruits and vegetables
  • Sip on one beverage throughout the day
  • Quench your thirst using ice cubes
  • Suck on hard candy or a lemon wedge
  • Brush your teeth
  • Use mouthwash
  • Take medications with small sips of water or with applesauce
  • Take your prescribed water pills (diuretics) to help release extra fluid

Takeaways 

Living with a fluid restriction can be challenging, but it can be done. Learning how to manage thirst and stay within your recommended fluid limits makes a big difference in preserving your health and improving your quality of life. Hopefully this article will serve as a useful guide to you as you adapt to living with a fluid restriction.