WHEN IT IS A 'SIN' TO DRINK EXTRA WATER

By Zulkiple Ibrahim

KUALA LUMPUR, March 9 (Bernama) -- During the current extreme hot spell,
people are advised to drink at least eight glasses or two litres of water a day.

However not everybody can enjoy this 'luxury'.

"Doctors advised me to drink only about 500 ml of water a day, for the whole
day and this include the major meals and whatever snacks that I take in between.
Just imagine this is the only amount of water that I can drink particularly whe
the weather is hot and dry right into the night," a kidney failure patient who
wished to be known as Siti told this writer.

(500 ml is the content of a small mineral water bottle).

Siti, 56, has been undergoing haemodialysis three times a week for 18 years.
Each haemodialysis session lasts four hours. According to the housewife, doctors
told her that her kidneys failed due to chronic diabetes, an endocrine disease
she had suffered since her early 20s.

What happens if she exceed her daily water-consumption limit?

"Then, my face would be puffy and swollen while my body would get bloated
and I start to have watery cough incessantly as the extra water would get into
my lungs. My legs would start to swell and my breathing would get labourious. I
would have to undergo immediate dialysis to clear the fluid retention within my
body," she said.

Otherwise the situation could have a fatal outcome, she added.

Doctors would describe this situation as 'fluid overload'. It is common
among kidney failure patients if they failed to regulate their daily fluid
intake.

Why?

"In end stage renal failure patients, the urine production is minimal and
almost zero. Hence the water can only be cleared from the body through
dialysis," said a nephrologist.

END STAGE KIDNEY FAILURE

According to the health authorities, it is estimated that one in 10 adults
has some form of kidney damage with about 3,500 cases of end stage kidney
failure (ESRF) among Malaysians every year.

ESRF is where the kidney fails completely, thus creating a lot of waste
products' accumulation in the body. It is fatal within weeks unless life-long
dialysis treatment or kidney transplant is provided.

According to nephrologist Dr N. Chan, those who require urgent dialysis were
already at an advanced stage of end-stage kidney failure showing symptoms such
as shortness of breath, nausea, vomiting and lost of appetite.

She said patients need to watch their water and food intake once they start
dialysis treatment to prevent too much water in their body as this may lead to
difficulty in breathing and may cause water to enter their lungs.

“They should eat moderately as well because should there be an increase of
potassium and phosphate (found in majority of food), these may lead to heart
problems, particularly for dialysis patients.”

RENAL REPLACEMENT

Dr Chan said patients with severe renal failure cannot live long unless they
have a replacement for their kidneys.

"Renal replacement takes the place of the kidneys or their functions. There
are two ways to replace the kidneys, by dialysis or kidney transplant," she
said.
There are two kinds of dialysis, haemodialysis and peritoneal dialysis.

Haemodialysis is when the blood from a renal failure person is cleaned
with a special kind of filter, known as a haemodialyser, via a haemodialysis
machine. When the blood is cleaned, water, salts, and wastes are taken out of
it. This must be done three times every week and takes four hours each
time.

"After patients have started haemodialysis, they should not skip even one
haemodialysis session as if they did so, the wastes would accumulate and this
would not be good to the body," she said.

Peritoneal dialysis is when doctors put a 'tenckhoff' catheter into the
patient's abdomen. Every day the person fills the abdomen with 'dialysate'
fluid. The extra salts, waste, and water that the body does not need goes into
the fluid. Then the fluid comes out and takes the wastes with it. This functions
like the kidney used to do.

RENAL TRANSPLANT

A better way in renal replacement therapy to do the kidneys' work is to give
the person another kidney. This is called a renal transplant. Kidney transplants
are the most common organ transplant that happens.

"People need only one kidney to live. People who are alive can donate a
kidney to another person," said Dr Chan.

However in the words of Siti: "Hemodialysis and peritoneal dialysis are not
perfect. They do some of the work of the kidney, but it is not as good as a real
kidney".

Take care of your kidneys.

-- BERNAMA