There are many reasons why a fluid restriction is recommended, but it boils down to the issue of fluid balance, which is fluid intake vs. fluid output. It is like a balance scale, and they are on opposite sides. When there is swelling or too much fluid in the body, fluid intake is more than fluid output.
A diuretic, commonly referred to as a “water pill,” is often used to increase urine output. However, if fluid intake is not limited, fluid intake can still be more than fluid output, causing the water pill to appear not to work. So, almost everyone on a diuretic should also be on a fluid restriction.
Ideally, the two sides are in balance, and a person has just the right amount of fluid in his/her body. Usually, the doctor will ask for daily weight-ins. As much as weight is thought to reflect the amount of muscle and fat in the body, it also shows how much fluid is in the body. In fact, day-to-day weight changes are usually due to fluid changes from one day to the next.
Steps To Help You Achieve Fluid Limitation:
- Follow a lower sodium/salt diet. The primary way the body holds onto fluid is by holding onto sodium. A lower sodium diet is part of a healthier diet and will keep your blood vessels, heart, and kidneys in better shape. It will also reduce how much fluid the body will hold onto.
- Measure fluid intake. Know the size of the cup or glass and how many are allowed in a day.
- Monitor how much fluid is left in a day. It may help to fill up a container of water in the morning, and every time you drink a cup of coffee, for example, fill the cup from the container and pour it out (or better yet, use the water to make the cup of coffee). This way, it is easy to see how much fluid is left in the container for the rest of the day.
- Suck on hard candy. One of the reasons people feel thirsty and drink more fluid is because their mouth is dry. Hard candy will keep the saliva moving and avoids a dry mouth.
- Review medications with your doctor. Some medications can cause a dry mouth, and it may be possible to switch to a different medication that can avoid that side effect.
- Avoid “juicy” foods. All foods contain some amount of fluid, but some contain more than others, such as watermelon or jello. Avoid these foods or try to account for them in the daily fluid limit.
- Avoid ice. The main issue is people tend to take in more fluids than they realize. And, once people start crunching on ice, their fluid intake begins to increase.
Always Contact Your Doctor
How much of a fluid restriction is warranted should be a conversation to have with your doctor because every person’s situation is unique. It is hard to change a lifetime of behaviors, which is one of the reasons this issue is so difficult. Your doctor understands this and believes the investment of time and energy on both sides will improve your health and reduce problems in the future.
At The Kidney and Hypertension Center, we provide consultation and ongoing care for the prevention and treatment of kidney-related diseases. Schedule your appointment today!
Written by: Dr. Ed Sha