One of the hardest changes for me to accept since starting dialysis is a daily liquid restriction. It’s had a far bigger impact on my life than any of the other dietary adjustments that were recommended to me. There are days when I feel it is the thing that I’m struggling most with, as I think you’ll see from this article.
Partially, it’s due to the mental shift of what I thought I was meant to be doing. Several years ago, a specialist told me I should consume as much water as I could tolerate, to help both my kidneys and my diabetes. He said I could not harm myself by drinking lots of water. I dutifully started drinking 3 litres of liquid each day.
Clearly, the situation changed over time. At some stage, the amount of liquid I was consuming began to wash beneficial nutrients out of my body, which resulted in my being admitted to hospital back in January this year. The treatment suggested by my specialist (a different doctor) was to limit my liquid intake, and this has continued as part of my dialysis regime.
What this means is that I am limited to 1 litre of liquid each day. That single litre includes every kind of liquid – in my case, water, tea, juice, alcohol, and soup.
To put this into context, the water glasses we have at home are 300 millilitres. The mugs we use to make tea and coffee are 350 millilitres. A glass of wine is typically about 250 millilitres. Which makes that target of 1 litre (1000 millilitres) frighteningly easy to reach during the course of the day.
There is, of course, a very good reason for my restricted fluid. As I’ve said in previous blogs, the dialysis treatment has two basic functions. First, it cleans the toxins from my blood to ensure I remain healthy. Second, the reality is that if the kidneys cease to function, there is no way for the body to naturally remove fluids we consume. If not removed through a medical intervention, the liquid will be retained in the body, which places stress on other organs including the heart. Dialysis removes fluid that is retained by the body.
At this stage my kidneys still function, though not as efficiently as they used to. My body is able to process most of the liquid I consume. Over time, that will probably change, and I will require the dialysis to remove fluid to help keep me healthy. For now, the removal of fluid is only needed to make it easier on my kidneys. Limiting the amount I drink is part of the solution.
If you’re thinking that I’m saying that drinking lots of water may be unhealthy, you’d be wrong. There are numerous health benefits to drinking water. However, for my current situation as a diabetic with chronic kidney disease who is on dialysis, what my doctor has advised me to do does make sense.
But sometimes it is hard to go to a family dinner and not be able to enjoy a glass of wine, or warm myself up with a large bowl of vegetable soup. Not to mention how much easier it was to start the day after two steaming mugs of tea like I used to. Of course, I can still do all of those things, but everything has a cost… and that cost has to be removed from my litre of fluid!
Here are some of the ways I track my fluid intake each day:
1 I fill a 1 litre bottle with water each morning and either use that when I need liquid or remove an equivalent amount of liquid when I drink anything.
2 I bought smaller mugs for when I have tea and fill them only halfway when I use them.
3 I have a liquid level indicator for pouring tea. It’s a tool that is usually used by a visually impaired person to make sure they don’t spill by pouring too much liquid into a mug or glass. It helps me to know that the amount of water I pour out of my bottle is the same amount that I use from the kettle to make tea. Otherwise, I’d have to guesstimate.
So, that’s an insight into one of my new realities. As a comparison, why not add up the total of liquid that you consume in a typical day and consider it against my daily allowance. If you’d like to, I’ be curious to know how the figures differ – why not share them in a comment wherever you’re reading this. I’d honestly love to know.
A final reminder that the content of this blog should not be taken as medical information. If you are experiencing symptoms that concern you or have questions about the amount of liquid you should be consuming, please consult a qualified medical professional.
