Fluid restrictions

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Fluid restrictions

Postby Jack » Mon Jun 21, 2004 3:41 am

i would just like to know on how much fluid restrictions you are
because i have had no problem but when i was on HD the guy next to me
drank 7 liters i mean thats a whole lot
i myself was on HD and had 2000 ml restriction
now im on CAPD and im on 1500 ml restiction and i asked to have a higher concentration of dextrose since i was on 2*2.5% and 2*1.5%
now im on 4*2.5 and 1*1.5% i have gone to 5 times a day since my kt/v and the other test showed that i wasnt getting enough dialisys

and im planning on starting school this comming agust again since i had to leave since my prob ,
hopefully im getiing my apd(ccpd) machine soon

one more question is there any difrences between apd & ccpd
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Postby Rik » Mon Jun 21, 2004 8:26 am

Hi Jack ...
on average I was still drinking ten or so litres a day whilst on HD ... some days more some days less ... more than my output was thats for sure ... though I never normally measured my intake/output except when I was on a 24 hour collection ...
due to my illness my intake couldnt be limited...

ones liquid intake varies considerably between patient to patient ...
there are too many variables as no two patients are alike ... although people say that your intake can be roughly worked out as your output plus 500ml ... this is not always the case ... your docs will look specifically at your records when working out your safe level of liquid intake ...

I'm sure people like Amanda or Hal will be the better ones to explain APD and CCPD to you ... I'm still trying to work out HD means!!! ;)

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Postby Hal » Mon Jun 21, 2004 10:07 am

Hi Jack,

Firstly, before you get worried, can I just say that in my experience Rik is an unusual case being able to drink so much on dialysis, due to the condition he suffers from.

Your fluid restriction will depend a lot on your urine output - how much you still pee. I pee absolutely nothing. The more you pee, the more you will be allowed to drink extra.

I am on APD and I have been given a restriction of 1500mls. Most people in my hospital are on this restriction, unless they pee a lot. Recently I have been better at sticking to this and usually use 1.36% bags each night. I use 3 x 5 L 1.36% bags and an extraneal bag for the day. The extraneal is fluid which you cannot absorb and it usually takes a lot of fluid off you - sometimes up to 1000mls for me.

I can always use one or 2 2.36% bags if I want to pull more fluid off - I will get around 2200mls if I use 2 2.36% bags in place of 2 1.36% ones.

When you ask is there a difference between APD and CAPD, what do you mean ? Do you mean how it works or how much your fluid restriction will be ?

If you mean fluid restriction, it will depend on how your body works with each. Some people dialyse better with long dwells like CAPD, some better with short dwells on APD.

If you have any more questions please let me know, good luck with school

Best Wishes,

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Postby Pam » Tue Jun 22, 2004 4:28 am

I have to say that you guys are drinking a LOT! :wink: Seriously, though,-when I was on dialysis, I was allowed 240 ml per day-I was pleasantly surprised to find that when we took a trip to Florida (1976) the unit there let their patients EAT and DRINK on dialysis! I was floored! :shock: Nothing like that was ever done at my unit. I guess we were just backward or something... :wink:
Fluid restrictions are awful! To me, they were worse than food restrictions, but if you overdo it on the water you will feel bad on dialysis, so you do have a reason for sticking to it. On the renal floor in our hospital, they removed the water fountains-this is probably true of most. People who are not renal go around asking, "Why don't you have water fountains?" They even lock up the room with the ice machine. Back in the day, a lot of people used to cheat-it's not worth it though.
Makes you upset though when others can drink all the water they want! :x Take care of yourselves...
32 yr cadaver transplant recipient, now on peritoneal dialysis with the help of Audrey, my Homechoice machine... as of 4/3/09
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fluid restrictions

Postby Gil » Tue Jun 22, 2004 12:28 pm

Most patients and dialysis centers get it all wrong.
It is not how much you drink but how much you gain between HD treatments or how much you can safely remove by PD.

With HD, fluid gain of 3% of body weight can be removed easily.
Some people can stand a little more.
With PD, prolong use of high dextrose is not good for the peritoneum.

So if you make urine or sweat you can drink more.
Fluid is also removed by breathing, up to 1 kg/day in dry weather.
And if you do daily HD you naturally accumulate less and it can hardly be called fluid restriction.

While I was on HD (with no kidneys) I drank about 1.25 L/day (5 cups) and 1 liter during the treatment.
Now with a working transplant I drink 2 liters a day :D

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Postby Rachel in NY » Tue Jun 22, 2004 2:06 pm

When I was on HD and not peeing anything, I was limited to just about 20oz a day. 20oz equals to about 600ml. I know its not alot but that's what it was.

However, while ON dialysis, the first hour of the actual treatment I was allowed to eat/drink - and that's not counted in my restrictions. This post is taking me back to memory lane.. those hot summer days, stopping off in a Gas Station/Rest Stop on the way in to the hospital for the dialysis, and choosing an ice cold bottle of Diet Snapple (American Drink Brand). Yes, an entire 16oz bottle, for me. It took me about 10 minutes each day to choose the flavor I wanted. But what a treat.

Once I got to the hopsital, and I was weighed, they'd say "the usual?" and I'd say "yup"! You see, they'd set the machines to pull off that extra 16oz.

Anyway, that 1st hour I got to drink it, and it was an extra, a treat, that wasn't counted. Its like taking a math test (that you didn't study for) and then finding out that it won't be marked. :)

THere IS controversy with drinking during treatment and I'm aware of that. The first few times I went overboard, and would drink alot. That causes a rapid increase in fluid, and a very rapid decline in fluid, and if you're prone to "crashing" (ie low blood pressure, dizzyness, etc) then this will only make it worse. But one drink - well you couldn't take taht away from me even if you use steel jaws.

Anyway.. (and yes, i realize I'm off on a ramble here) now I'm post tx and can drink pretty much whatever I want. I handle fluid well, and don't seem to have any retention. Occasionally I'd wake up with slightly puffiness from fluid, and I'd pop a lasix (furosimide.. diuretic) which does the trick. But for the most part, I consider myself with NO water restrictions, as I can drink as much as my body dictates.

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fluid restrictions

Postby amanda in CA » Wed Jun 23, 2004 4:28 am

I really wouldn't recommend using stronger bags to get more fluid off just because you want to drink more. Stronger solutions damage the peritoneum and thus shorten the time that you are able to continue doing PD. I tend to use the minimum strength bags that I can get away with for that reason. As long as my blood pressure is ok and I don't feel breathless, I would rather be a little on the 'wet' side than use stronger bags. From a therapeutic viewpoint there is little difference between APD and CAPD although with APD the strength of the solution can be modified since the machine draws from the bags during the night. I use 2 six liter bags a night but when I change the set I connect up three, with a 2.5% on the warmer and two 1.5% bags for later. that way I get a stronger first dwell and then a progressively weaker dwell as the night goes on as the 2.5% bag is emptied. The next night I connect up a 2.5% to the same set on the spare prong (the only reason that I do it this way is because I don't have the space to put on all 4 at once). So the second night I start with a weak solution and work up to a stronger one. this seems to work quite well. I never have been an excessive drinker so I don't tend to take too much notice of what I am drinking and just drink what I want to. Amanda
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Postby George » Wed Jun 23, 2004 7:06 am

Hi I am new to dialysis, I am on HD. At the moment I am not on any restriction, I think this because my output is reasonable...but declining. At my unit we get 2 small cups of tea (at different times) with biscuits and a sandwich.
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Postby Pam » Fri Jun 25, 2004 4:55 am

I can really relate to what you said about your "treat"! Some days I would not drink anything all day just so I could "spend" my 240 ML (about a cup) of fluid allowance on a strawberry soda-I would put it in the fridge early in the day so it would be nice and cold and savor it that evening!
When the doctor told me after my txplant that I could have all the water I wanted to drink, I almost wept for joy! :D I still enjoy every drink of water that I swallow and give thanks for the fact that I CAN drink water again! I am sure that most txplant recipients are the same in this...isn't it funny how we learn to compensate when we have to?
32 yr cadaver transplant recipient, now on peritoneal dialysis with the help of Audrey, my Homechoice machine... as of 4/3/09
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Yes Pam

Postby Rachel in NY » Fri Jun 25, 2004 3:36 pm

Renal Patients will never take "liquids" for granted anymore. A drink will always be a treat. Even now.. we'd sometimes do stuff and someone would say "lets go out for ice cream", etc.. and me? I'd just pick a big cup of soda and ice. A drink is & always was my most preferred "snack". I savor every drop, every day. Its funny bc since I was very very young I used to dream drinks. I'd dream of bathtubs and lakes overflowing, and me trying to drink it. At some points it was a nightmare... bc there was uncontrollable forces of water, drowning me. As I got older it wasn't a nightmare anymore. Sometimes it'll be orange soda in the bathtub, sometimes its grape juice waterfalls, but for the most part, it was "alot of liquids" & I was drinking as much as I can. So that was BEFORE my kidney issues, BEFORE restrictions. So just imagine how much more it means to me now. You know. :D
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