Discussed water consumption with my kidney doctor

[RickHow]

I'm 72, stage 3 (sometimes a, sometimes b). I see my kidney doctor every few months. Not much purpose to see more often as there really are no medications, tests, etc., that are going to change anything. She just likes to test my urine and blood every few months to see how things are going. This last visit as usual she asked how I was doing, etc. Just generally. Told her status quo watching my protein intake and trying to drink at least 80 - 100 ounces a day. She kind of surprised me when she said "why so much water?" She told me it does nothing to improve kidney function. The "benefits" are that it simply flushes out more toxins that MAY be accumulating (i.e., Creatinine) that my kidney (i only have one) is not handling normally. She said just watch your urine. Drink enough to stay hydrated. That is what is important. If my urine is too yellow I'm not drinking enough. But to drink to excess and get almost clear urine is NOT going to improve my kidney. She told me people drink to excess and see improvement in their egfr. But in fact it is only improvement because excess fluids have flushed out additional creatinine. But the filtration of the kidney (function) is really unchanged. She likened it to when you get blood tests for cholesterol, etc. The doctor has you fast for 10 to 12 hours. Because they want to see your true function. Not test results that are influenced by water and food consumption. She said there is no need to fast for renal panel blood tests, but just drink normal amounts (to stay hydrated) to get true kidney test results. Was interesting discussion.

[Darlenia]

Hi RickHow. In my personal opinion, there's a lot to be said for this approach. I've seen posts regarding the "masking" of a situation by contrived means. And drinking inordinate amounts of water seems to fit into that situation. I grew up with adage of "please live life in a normal fashion; that's crazy enough." Appreciate you letting us know of your conversation with your doctor.

[orangecity41]

Here is a link to interesting article on "water wise" from NKF. I wonder too if your BMI could be a factor in water amount. kidney.org/content/6-tips-b...

[5usie47]

Pretty much what my GP said to me. My low egfr was an incidental finding in A&E after a cardiac episode. When I asked how much water I should drink, she said "enough" and that was the end of it. I'm not even followed up on a regular basis as she refuses to acknowledge the term CKD as a medical condition and says its just an arbitrary name.

[RickHow in reply to 5usie47]

I see a few doctors of different specialties. Oncologist, Kidney, Heart, Urologist, Primary Care. They all, even the kidney doctor, seem to have a similar opinion about "CKD" as does yours who calls it an arbitrary name. It is NOT that don't believe kidney disease is a real thing. It seems to be more the entire approach given with the EGFR formula, and categorizing and worrying people with such labels as Stage 1,2, 3a kidney disease. In one breath a patient is told as long as your egfr is over 60 it is normal, but at the same time for many patients saying this is kidney disease of some stage. Of finding your Creatinine level is in the normal category, but again the egfr formula labels you as kidney disease. Even my own kidney doctor tells me not to monitor my egfr but instead monitor my Creatinine level. And watch it over time, as an average, because at any particular test it may be higher than "normal" by a tenth, but then next time 2 months later, be well within normal. And again I am like you in that my kidney doctor does NOT follow up with me very regularly. She schedules my blood and urine tests about every 9 months to a year now. As I also have written tells me water consumption has no need to be excessive (enough like you were told)To try to keep protein within normal recommended daily allowances and avoild NSAIDS.

Coincidentally my primary care doctor does blood test for cholesterol, etc., every six months. Part of the test of course is Creatinine and EGFR. Just yesterday we reviewed the results together. Creatinine 1.7 (as it has been for many, many months since I had one kidney removed due to cancer), egfr 43. Of course that is labelled as HIGH. He didn't even mention the egfr, until I asked, and he said basically "who cares. Your Creatinine is steady".

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[travelmoe]

Love your common sense approach to all the concerns people have that show up on this site. I hope you know that your well thought out answers along with personal stories of your journey with kidney disease do bring a lot of comfort to anyone dealing with these issues. Thank you.

[RickHow in reply to travelmoe]

How very nice of you to say. Thanks.

[citruskayaker]

So recent studies say excess water does not help with CKD, but for years doctors said drink lots of water. Now as far as meds go, there is no cure. However, there are many things you can do to help via dietary change and possible a few supplements. The NKF came out with new clinical guidelines in 2020 for different stages of the disease. To slow progression of the disease, you need to unload the kidneys and the primary focus is on a low protein diet. However, that might not apply if you have diabetes. If you get a renal dietician who knows nutrition though a GP or nephrologist, you can change your diet for your particular needs. Exercise is really important as it reduces the waste kidneys have to process. The sooner you address this the greater the chance to prevent dialysis in the future. I regret not knowing this sooner. Not feeling symptoms is one reason people tend to write this off, as often happens with diabetes. You are the only one who can make this happen.

[Willowdene]

RickHow I totally agree with comment above. Your a great addition to this team . Amazing information and great relief to many people . Thank you all for you participation on these sights.