This question was answered on Tue 10, Jan 2012 11:45pm by Dr.Kokil Mathur

Permanent dehydration - water not being absorbed?

    
Asked by blulettice (Female; 28; Glomerulonephritis; Relevant drugs:Nil ) on Tue 10, Jan 2012 11:03pm
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I'm wondering if the water I drink is being absorbed by my body...I never really get thirsty even if I don't drink all day so I force myself to drink about 6 glasses of water a day. I have to go to the toilet after every glass though so it seems to go right through me. My skin is always dry and peels intermittently on a couple of my fingers, my lips peel, my eyes are often dry and itchy/burning. I was told by an opthalmologist that the puffiness around my eyes is due to fluid retention. I don't moisturise every day but I don't think my body should be so dry?? I have been diagnosed with early glomerulonephritis but not sure if this is related.. I was told to decrease sodium and not drink too much water so as not to put too much pressure on my kidneys. So I can't drink much more water than I already do. My thyroid is fine and I don't have diabetes. My iron levels (iron and transferrin, not saturation) have been quite strange lately..low for 3 months, then fine for a year, then high for a few months, now fine again. I also have a slightly high level of creatinine in my urine but the ratio with albumin is fine. Any ideas what could be wrong?
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Answer by Dr.Kokil Mathur  on Tue 10, Jan 2012 11:45pm:

Hi! Puffiness around eyes and increased urination (passing urine after every glass of water) are symptoms of glomerulonephritis. However, if you have generalized dryness then this can be due to dehydration. Get the specific gravity of urine checked, and if it is low, then possibility of diabetes insipidus, which is an adrenal gland problem, should be looked into. Apart from his high blood glucose or diabetes too could be a cause. You can limit the water you drink and increase fruits and vegetable intake to replenish fluids with minerals and vitamins. This may improve the dryness. Also use a good moisturizing soap. Simple daily routines like bathing, applying soaps and scrubbing yourself dry can decrease the moisture in the skin. You will have to choose a moisturizer suitable for your skin and apply it 2-3 times in a day. Also AC and heating depletes the skin of moisture, so if you stay for long hours in AC or heaters you should use a humidifier too. Use warm water and a mild soap for bathing. Petroleum jelly used at night along with glycerine can help keep the skin supple and moist. When choosing a moisturizer, look for oil-based creams and ointments. Fresh juice of tomato, cucumber and orange can be applied. If these tips do not help, chances are that the dryness is due to underlying skin conditions like dermatitis, psoriasis etc. Vitamin A deficiency, hypothyroidism, Sjogren's syndrome, and diabetes too can cause dry skin. Hence these should be ruled out. It may sound strange to you but extreme dryness can be a sign of hormonal imbalance as seen in polycystic ovary and early menopause due to ovarian failure. Hormone replacement therapy often takes care of this dryness. Please consult your gynecologist if other causes are ruled out. It is difficult to diagnose any condition on net. Please discuss these possibilities with your treating doctor who can run tests to rule these out. Please feel free to ask anything else you may want to know. Take care!

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Comments:

Comment by Dr Rowena S, MD on Wed 11, Jan 2012 06:00am:
Hi, Welcome to the forum!How are you? Dr Kokil has discussed the differentials and possible management for dry skin very well. Indeed, edema in the eyes and excessive urination can be observed with glomerulonephritis. This particular kidney disease may be temporary and reversible, or it may get worse. Glomerulonephritis can also present with anemia, high blood pressure and even signs of reduced kidney function. That is why it is important that you have regular follow-up with your attending physician or be referred to a nephrologist for monitoring and to manage your symptoms. With regards to dry skin,when the skin loses moisture, it may crack and peel, or become irritated and inflamed. If it persists despite the recommendations of Dr Kokil, further diagnostic tests and evaluation by a dermatologist may help. Lifestyle changes, including: maintaining a healthy weight; restricting salt intake to prevent or minimize fluid retention, swelling and hypertension ; and cutting back on protein and potassium consumption to slow the buildup of wastes in the blood are very important. Take care and best regards.

Comment by Christina on Thu 12, Jan 2012 07:40pm:
Hi, thanks to you both. Dr Rowena, you say that my condition can be reversed? I have been told by my nephrologist just to monitor it and not do anything besides reduce fluid and sodium intake, which I have been doing for months now. What can I do to reverse it?? I have just purchased an oil based organic moisturiser so I will see how that goes. My Dr hasn't been of much help with this as my results are never consistent enough to send me to a specialist of any kind. Things just come and go, eg. the iron being down and then up and now fine, erythrocytes in urine being there on one test and gone the next. The fatigue and puffy sore eyes are my main concerns so if I can reverse the kidney disease and get my health back I'd be very happy!

Comment by Dr Rowena S, MD on Fri 13, Jan 2012 07:28pm:
Hi! Thanks for the update. Glomerulonephritis is a group of kidney diseases in which the glomeruli of the kidney become damaged and inflamed. The chance of being a reversible condition depends if it is an acute or chronic type of glomerulonephritis. At this point, it is best that you discuss what type with your attending physician. In acute glomerulonephritis symptoms come on suddenly and may be temporary or reversible. This type usually occurs when there is previous infection (such as strep throat, chickenpox or malaria) and the antibodies that are created to get rid of the body’s infection begin to attack the glomeruli. With chronic glomerulonephritis, the symptoms develop slowly over time and the cause can be the product of a genetic disorder or an autoimmune diseases. The treatment of glomerulonephritis depends on the specific type present. You can get another doctor's opinion or a referral to a specialist for proper evaluation. Aside from urine and blood tests, imaging tests like kidney X-ray, ultrasound or CT scan may be done. A kidney biopsy can also confirm the diagnosis if there is still doubt. Hope this helps. Take care and warm regards.

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