How is fluid restriction typically determined for a CKD patient?

• A. Based on body weight
• B. Based on daily urine output; in anuric patients, a rough limit of about 500–750 mL/day plus insensible losses.
• C. Fixed 1500 mL/day
• D. No fluid restriction

Answer: (B)

Fluid restriction in CKD is guided by the amount of urine the patient still produces each day, plus an allowance for insensible fluid losses from skin and lungs. The idea is to match intake to what the kidneys can handle. A common practical rule is to set the limit equal to daily urine output, plus about 500–750 mL for insensible losses. In anuric patients, with no urine output, the rough limit becomes about 500–750 mL per day plus insensible losses, giving a total that reflects non-urine water loss. This approach explains why a fixed volume or a plan based on body weight isn’t appropriate for CKD, since it needs to adapt to how much the patient actually urinates and how much fluid is lost insensibly.