Water and kidney disease

Drinking water is one of the simplest health tips we often hear, and for good reason. It boosts energy, supports digestion, carries nutrients, and helps regulate our body temperature. For most people, the advice is to drink plenty of water. However, when you are living with chronic kidney disease, it isn’t that simple, as weakened kidneys may struggle to manage excess fluid. So, lets take a look at water and kidney disease.

Water and kidney disease

Everyone with CKD has different needs, so it is important to get personalized guidance from a healthcare provider. That being said, here are some general recommendations based on your stage of kidney disease because your fluid needs are very personal. Too much or too little is not good with water and kidney disease.

Stage 1 and 2:

• You’ve probably heard that you need to drink 8 glasses of water per day. But this recommendation may not be enough. Canadian recommendations for adult woman is 2.7 L (or 11 cups) and men 3.7 L (15 cups) fluids per day.

Stage 3-5 (not on dialysis)

• At this stage, your kidneys may not remove fluid as well, and you may start experiencing fluid retention. Because of this, you may be recommended to cut back. Your healthcare team can give you personalized recommendations.

Kidney Failure (on dialysis)

• Fluid limits are usually more strict
• A common recommendation is around 32 ounces (or 1 L) per day
• If you still produce urine, you may be able to have a little more
  • 32 ounces + the amount equal to how much urine you pass in 24 hours

Facts about fluids

When you think of fluids, water and drinks are probably the first things that come to mind. But fluids go beyond what you pour into a glass. They also include foods that melt at room temperature or have a high water content. This means that items like ice, soups and stews, puddings, gelatin, ice cream, sorbet, and popsicles all count toward your daily fluid intake. Even foods like watermelon, grapes, and cucumbers can contribute to your total since they are packed with water.

Keeping track of these “hidden fluids” is especially important if you have chronic kidney disease, because your fluid allowance may already be limited.

Too much water and kidney disease

Your kidneys act like natural filters, clearing waste and excess fluid from your blood and sending it out of the body through urine. But when chronic kidney disease progresses to more advanced stages, the kidneys can’t keep up. This can cause fluid, electrolytes, and waste products to build up in your body, which may harm your health.

Too much water and kidney disease leads to:

• Swelling in the feet, ankles, hands, face, and lower back
• Shortness of breath
• Cramping
• Headaches
• High blood pressure
• Stress on the heart

Water and kidney disease

Water is the best choice of fluid for kidney health because it is free of calories, sodium, and phosphorus. Still, you may want some variety in your day. The good news is there are other kidney-safe options to enjoy in moderation:

• Smoothies
  • A small glass of smoothies can be a refreshing change
  • Aim for 1/2 cup fruit, 1/2 cup vegetables, your choice of water or non-dairy beverage and add some extra mixins like in this blog post

• Plant-Based Milks
  • These are often a better choice than regular dairy milk because they contain less protein
    • Choose unsweetened varieties with no phosphate additives for the most kidney-friendly option
    • E.g., Almond and coconut milk
• Flavoured water
  • Add lemon or lime slices 
  • Add cucumber and mint
  • Add orange slices with basil
  • Add strawberry and mint
  • Add frozen fruit cubes
    • Freeze berries in ice trays and add it to water

What to do if you’re following a restriction of water and kidney disease

• Eat less salt and avoid salty foods
  • The less salt you consume, the less thirsty you will become
• Suck on mints or sour balls
  • Can aid in reducing thirst
• Put grapes in the freezer
  • Eat frozen grapes when thirsty
• Swallow medications with soft foods such as apple sauce 
• Suck on a lemon wedge or use lemon in water
  • The sour taste helps to quench thirst
• Rinse your mouth with ice-cold water
  • Without swallowing

Right amount of water and kidney disease

Depending on your stage of chronic kidney disease, the right amount of water and kidney disease will look different. Some people may be encouraged to drink more, while others may need to carefully limit their intake to avoid complications. Because every case is unique, it is important to remember that the recommendations shared here are general guidelines and not a substitute for personalized advice. If you are looking for more support, book a free intro call with our team.

This article was written by Kimia Oshagi, Nutrition Student Volunteer.
This article was reviewed by Emily Campbell, RD CDE MScFN.