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Polydipsia, reduced water intake. Kidneys slow reaction to water intake. Reduced sodium intake. What can help?

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Nephrologist
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I have a question about my kidney function. I have been unable to quench my thirst for two and a half weeks, because I was told I have polydipsia. So I reduced my water intake to 5 and a half or 6 ounces every half hour and then to 5 or 6 ounces every hour. But there have been times where I have drunk 6 ounces every half hour, and then waited till my clear urine became yellow again to drink. This meant that there were periods of time where I drank less water because I was waiting for my urine to become concentrated - but then in the time I was waiting for that I became dehydrated. In one instance there was a period of 14 hours where I drank only 15 ounces of water. Could I have harmed my kidneys? But on the whole I was usually drinking about 100 ounces in a 24 hour period (though sometimes 70 to 80 ounces). I also reduced my sodium intake. Today in the morning I was dehydrated so I drank 30 ounces of water over a 3 and a half hour period, from 7:30 AM to 11 AM. I did not start urinating until 11 AM. Does that mean that my kidneys were not functioning properly, or does it simply mean that my body needed the water as I was dehydrated? I noticed that my kidneys were still able to produce 6 ounces of urine every half hour, if that was what I drank. If I drank 6 ounces every hour, they produced 6 ounces every hour. But I have noticed today for the first time that my kidneys seem to be slow to react to changes in my water intake. I want to slowly return to my previous pattern of drinking, which was to eat 2000 mg of sodium and drink maybe 200 ounces of water. Should I first eat 1200 mg of sodium and drink 120 ounces of water and then return to my previous intake of water? Is it safe for me to return to my previous intake of water, will my kidneys be able to deal with the greater amount of water if they are reacting more slowly? But they still are able to produce 6 ounces of urine every half hour. Also, when I return to my normal intake of water, after eating a salty meal I need to drink 12 ounces of water and then wait for half an hour or another hour and drink another 5 to 6 ounces of water. Will my kidneys be able to handle 12 ounces of water in one sitting, if I disregarded my thirst for two and a half weeks?
Posted Sun, 6 May 2012 in Kidney Conditions
 
 
Answered by Dr. Sree Bhushan Raju 14 hours later
Hi,

Thanks for your query.

The amount of water which you are drinking per day is sufficient enough, kidney normally produces urine in 15 to 20 mins after drining 1-2 glasses of water but it depends on the hydration status of ur body, ambience temperature and the solid food(which determins the osmolarity) taken along with that kidney function cannot be assesed by the amount of urine it produces in a given time You have stated that you have poldypsia Was it labelled by a nephrologist ,
Did you undergo serum and urine osmolality tests
Do you take any pain killers do you have hypothyroidism
Did you get electrolytes like sodium, k+, calcium, phosphorus etc please clarify, we can discuss more.

Anticipating your response.
Above answer was peer-reviewed by
 
Follow-up: Polydipsia, reduced water intake. Kidneys slow reaction to water intake. Reduced sodium intake. What can help? 14 hours later
My primary care physician told me not to drink too much water, and told me not to drink more than 5 ounces every half hour. He also told me that if my urine is clear I am hydrated and don't need to drink. Now he has told me to go back to my usual drinking pattern, he no longer thinks I have polydipsia. My blood sodium level was always normal. But since I disregarded my thirst for hours after every meal, because I had to wait for half an hour to drink another 5 ounces, I experienced a lot of thirst over a two and half week period. Also, after drinking a lot of water over a four or five hour period, I would wait for the clear urine to become concentrated before I drank again. Could I have damaged my kidneys by alternating between drinking a lot and drinking nothing (waiting till urine became concentrated to drink) over a 2 week period? I want to return to my normal drinking pattern, but am not sure if I can do that, in case the kidneys were damaged by not obeying my thirst in time for two and half weeks and going without water for between 4 and 10 hours after drinking a lot of water (but the total amount of water I drank each day was usually 100 oz). I used to urinate within half an hour after drinking something, but now it takes me four hours to 12 hours to urinate after drinking. Does this mean that the glomerular filtration rate has decreased? My physician told me to return to my normal drinking pattern. Is it safe for me to do that? If my kidneys are damaged they might not be able to handle the amount of water I would have to drink in a short period of time after a salty meal. If I eat a meal with 400 to 500 mg of sodium, I need to drink 10 oz of water immediately, and probably at least another 5 ounces half an hour later. Can I do that? Today I drank 67 ounces of water and ate 750 mg of sodium. I want to shift to 1000 mg of sodium and up to 90 to 120 ounces of water, and from that back to 2000 mg of sodium and whatever amount of water I need to drink (up to 200 oz). I have noticed that I am no longer as thirsty today as I used to be. Is that a sign of kidney damage? Also, when I urinate clear urine it is sometimes foamy (but not the concentrated urine). I have been having high blood pressure sometimes (up to 140 / 90, but it goes down again to 120 / 80), and occasionally some kidney pain as well. Please tell me if it is safe for me to go back to eating and drinking as I did before, drinking whenever I was thirsty without paying attention to how many cups of water I drink per hour.
Follow-up: Polydipsia, reduced water intake. Kidneys slow reaction to water intake. Reduced sodium intake. What can help? 3 minutes later
One other thing - my kidney function and blood sodium level was tested ten days ago and it was normal. But at that point in time I did not have the delay in urination that I now have. Could my kidneys no longer be functioning as they normally did within only a ten day period? Or maybe the damage did not show up until 2 and a half weeks had passed?
 
 
Answered by Dr. Sree Bhushan Raju 6 days later
Hi,

Thanks for writing back.

A change kidney function does'nt manifest in the amount of urine it produces even in the presence of 100% kidney failure, urine can be passed and it is a frequent feature that the patient on dialysis pass good amount of urine. Kidney filters water often like a passive filter but reabsorbs depending on the body requirement. As your kidney function ( creatinine) as you told was normal, you don't have to worry about it.

The amount of urine passed depends on the hydration status of the body and the environment If you are in a AC room , you don't feel thirsty but you will get dehydrated, Hence you need to take water frequently to avoid subclinical dehydratiobn which alo can mae you feel dizzy.

Human beings are not supposed to drink excess water as the brain has been set a threshold for everything ( like appetite, sleep, all desires) it is very well known in the literature that drinking excess water that is more than the required at once leads to fatal outcome.Excess hydration shrinks the brain leading to a stretch in blood vessels in such a way that they bleed. Also, excess water intake also leads to variations in blood pressure It was noted that drinking 2 litre of water over a period of 15- 20 min can raise the BP to higher level and can come down after an hour, as you are manifestation an occasional elevation of BP slightly above the normal, it could be due the same phenomenon

Exces of any thing is called disease. People have to avoid indulging in excess intake of any thing
Urine quantity is not determined by the kidney function rather your requirement determines. Hence you need to drink as per your thirst .The amount of salt also determine the amount of water intake required. As your kidney function is normal, it makes a fine balance between your intake and output If you take less it will retain more If you take an excess, it will try to through more salt and water out of body so please drink and eat as per the requirement of the body, your need and desire.

Hope I answered all your questions. Please accept my answer in case you do not have further queries. Wish you Good Health
Above answer was peer-reviewed by
 
Follow-up: Polydipsia, reduced water intake. Kidneys slow reaction to water intake. Reduced sodium intake. What can help? 7 hours later
Today I accidentally ate more sodium with oatmeal at breakfast than I meant to - between 500 mg and 1200 mg of sodium. I had to drink 72 ounces of water over a six hour period to quench my thirst. At dinnertime I again mistakenly took a bit more sodium than I meant to, perhaps up to 300 mg. Is it okay for me to drink up to 120 ounces of water today, if I only drank 64 ounces of water yesterday?
 
 
Answered by Dr. Sree Bhushan Raju 32 hours later
Hello,

As I told you, you can drink as per the thirst. As your kidney function is normal, even if you take excess salt or water inadvertently, kidney can balance and try to push the excess amount out of the body. You don’t need to calculate the salt and water intake in a day to day basis. It not only disturbs your daily schedule but also XXXXXXX environment (mileau interior).

Hope I answered all your questions. Please accept my answer in case you do not have further queries. Wish you Good Health.

Regards,
Above answer was peer-reviewed by
 
Follow-up: Polydipsia, reduced water intake. Kidneys slow reaction to water intake. Reduced sodium intake. What can help? 15 hours later
Dear Dr. XXXXXXX

I would like to return to drinking about 200 ounces of water a day, to my normal pattern of drinking, so that I don't have to calculate the amount of water or sodium any longer. If I drink 100 ounces of water and eat 700 mg of sodium today, can I go to eating 1500 to 2000 mg of sodium and drinking 200 ounces of water tomorrow?

Thank you very much for your advice.

Noreen
 
 
Answered by Dr. Sree Bhushan Raju 38 hours later
Hello again XXXXXXX

Thank you again for writing back.

Yes, you can drink as much water as needed to quench your thirst, you do not have to calculate the amount of water you drink since your kidney functions are normal.

But it is better to avoid eating extra salt(Sodium), because extra salt means extra water retention in the body and this will become important if you already have elevated blood pressures. So take adequate amounts of water and salt(Around 2 to 3 grams per day) would be sufficient.

Generally the thirst is a very good indicator of our water requirements, so you can drink up to 2.5 to 3 liters (100 ounces). 200 ounces would be a little extra but not harmful.

Hope I have answered your query. Please accept my answer if you do not have any more queries.

Wishing you good health.

Regards.
Above answer was peer-reviewed by
 
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