How much water should you drink if your kidneys are failing?

While drinking more water can help boost kidney function, there is no evidence that suggests that an increase in water consumption will prevent the progress of kidney failure.
The National Kidney Foundation recommends for people with stages I and II chronic kidney disease (CKD) to consume 8 glasses of water per day and those with stages III, IV, and V CKD to limit water consumption. It is best to discuss your water and salt consumption with your doctor.
Under normal circumstances, daily water requirements are based on factors such as age, climate, and exercise intensity, as well as conditions such as pregnancy, breastfeeding, and illness.
What are the main functions of your kidneys?
Kidneys are a pair of bean-shaped organs located below the rib cage on either side of the spine. Their main functions include the following:
- Water balance
- Electrolyte balance
- pH balance
- Removal of toxins
- Excretion of waste products
- Blood pressure control
- Production of erythropoietin, which stimulates red blood cell production
- Activation of vitamin D
What causes kidney failure?
Kidney failure or end-stage renal disease occurs when the kidneys are unable to filter toxins and waste products, working less than 15% of their normal capacity.
Chronic renal failure causes
A gradual loss of kidney function may be caused by:
- Uncontrolled diabetes
- High blood pressure
- Chronic glomerulonephritis
- Polycystic kidney disease
- Kidney stones
- Nephrotic syndrome
- Interstitial nephritis
Acute renal failure causes
A sudden loss of kidney function occurs due to the following:
- Pre-renal causes
- Dehydration due to excessive diarrhea, vomiting, and sweating
- Hypovolemia due to heavy blood loss
- Decreased fluid intake
- Medications such as diuretics
- Obstruction in the renal artery
- Renal causes
- Sepsis due to infections and inflammations
- Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics
- Rhabdomyolysis
- Multiple myeloma
- Systemic lupus erythematosus
- Hemolytic uremic syndrome
- Post-renal causes
- Prostatic hypertrophy or prostate cancer
- Kidney stones
- Obstruction of the bladder or ureters
- Sudden blood flow loss
- Heart attack
- Burns
- Liver failure
- Allergic reactions
- Metal poisoning

SLIDESHOW
Kidney Stones: Symptoms, Causes, and Treatment See SlideshowWhat are the signs and symptoms of kidney failure?
Kidney failure can be asymptomatic initially, and if left untreated, can lead to life-threatening conditions:
- Whole body edema (swelling)
- Inability to pass urine or very little urine output
- Shortness of breath
- Weakness
- Lethargy
- Loss of appetite
- Abnormal heart rhythms
- Anemia
- Nausea
- Fatigue
- Hyperkalemia (high blood potassium level)
- Hypocalcemia (low blood calcium level)
- Metabolic acidosis (excessive amount of acids in the body)
- Congestive cardiac failure
- Uremia (high blood urea level)
- Drowsiness
- Itchy and dry skin
- Muscle cramps
What is the treatment for kidney failure?
If you have kidney failure, a healthy lifestyle, diet modifications, regular follow-ups, and appropriate medications may improve your quality of life and extend your lifespan:
- Dietary modifications such as the DASH diet (low-sodium) and renal diet (low-sodium, low-protein, and low-potassium, with controlled water intake)
- Managing blood pressure and diabetes
- Antibiotics for infections as needed
- Corticosteroids for immune-related conditions (nephrotic syndrome)
- Blood transfusions for anemia
- Intravenous fluids, if needed
Acute renal failure or end-stage renal disease is the most severe stage of kidney failure, with no cure. The only treatment options are:
- Hemodialysis: Machine that regularly (three to four times per week) filters the blood to remove toxins and waste products
- Peritoneal dialysis: Treatment that uses a catheter through the abdominal lining for blood filtration
- Kidney transplant: Only long-term solution in most cases
"Kidney Failure." Cleveland Clinic. <https://my.clevelandclinic.org/health/diseases/17689-kidney-failure>.
"Kidney failure (ESRD) - Symptoms, causes and treatment options." American Kidney Fund. <https://www.kidneyfund.org/kidney-disease/kidney-failure/>.
United States. National Institute of Diabetes and Digestive and Kidney Diseases. "What is kidney failure?" <https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/what-is-kidney-failure>.
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