World Kidneyday

On World Kidney Day, we want to educate you as a pharmacy about how to prevent dehydration and thus protect your kidneys and heart. Your kidneys filter waste products from your blood and play an important role in your overall health. Dehydration can lead to serious problems, especially if you have heart problems or are taking medications that affect your kidney function.

What is dehydration and why is it dangerous?

Dehydration occurs when your body does not have enough fluids. This can happen through high temperatures, fever, diarrhea or vomiting. Signs of dehydration include:

Less and darker urine
Loss of weight
Dizziness or fainting when standing up
A noticeable thirst and dry mouth
Suffering or confusion

With (impending) dehydration, your medications may not work as well, or may even lead to electrolyte disturbances and acute kidney damage. This is especially important to monitor if you already have impaired kidney function or are taking medications that affect it.

Risk patients: take extra care!

People older than 70 and patients with chronic kidney damage are at higher risk for dehydration. Dehydration can also cause problems if you take RAAS inhibitors, diuretics, metformin or SGLT2 inhibitors. When exposed to high temperatures - such as during a heat wave - or with intercurrent illnesses such as fever, diarrhea or vomiting, it is especially important to be alert.

Think about the following situations

More than 3 times vomiting in one day
More than 3 times water-thin diarrhea per day
Fever for more than 2 days with temperatures above 38,5°C
More than 5 days of temperatures above 25°C, including at least 3 days above 30°C

If you recognize any of these situations, you may need to temporarily adjust your medication. Sometimes you may even have to skip certain medications for a while.

Medications and Kidney Function

As a pharmacy, we see daily that medication use and impaired kidney function can go hand in hand. In patients taking medications such as:

RAAS inhibitors and diuretics (including aldosterone receptor blockers): With dehydration, it may be wise to cut the dose in half.
Metformin and SGLT2 inhibitors: These medications can lead to complications with dehydration. With SGLT2 inhibitors, it is important to take extra fluids, i.e. an extra half a liter, so that you drink at least 2 to 2.5 liters daily.

If you notice that you do not experience any improvement after one day of extra fluid intake, contact your treating physician immediately. For heart patients, depending on the severity of dehydration, the medication regimen may be temporarily adjusted. For heart failure, despite any fluid restrictions, you often need to take in an extra half liter of fluid.

The role of the pharmacy

As a pharmacy, we are here for you with advice and support. Our role is to help you:

Preventing problems: We provide preventive education, for example at the second consultation after you have started risk medication.
Explanations and instructions: We always give both oral and written explanations.
Medication check: We check if your medication is well adapted to your situation and inform you about any temporary adjustments.

It is important that you carefully follow the instructions on the advice card. This way you prevent dehydration from leading to hospitalizations due to medication-related complications.

Advice from the pharmacy

We recommend that you always be alert to the signs of dehydration. Make sure you drink enough, especially during hot days or illness. Keep the following tips in mind:

Drink at least 2 to 2.5 liters of water daily if you are taking SGLT2 inhibitors.
If you vomit more than 3 times, have water-thin diarrhea or a prolonged fever, contact your doctor or specialist.

According to information from Thuisarts.nl, Apotheek.nl, Rijksoverheid.nl and KNMP.nl, it is very important to know what to do in case of dehydration. Prevention and timely action can prevent serious complications.