Administration of fluid therapy depending on kidney function

Jürgen Floege, MD, is a senior professor at the RWTH Aachen University Medical School, Germany. He served as head of the Division of Nephrology and Immunology at Aachen for 24 years. He coordinates the worldwide KDIGO guidelines on the management of glomerular diseases. His research interests encompass both basic research and clinical research.

How to manage fluid therapy depending on the patient’s renal function?

That’s a very good question, and the basic rule is, look at your patient. Obviously, if you’re full of edema, it makes little sense to push fluid. In fact, sometimes, in particular if a patient has chronic kidney disease (CKD) and heart failure, a very common combination, it makes sense to keep them low with their fluid intake.

In addition, we have learned that the common belief that if you have a CKD, you should drink a lot, is probably nonsense. They should drink like you and me, 1.5 to 2 L/d, and nothing more.