Dr Rusna Consultant Nephrologist Hospital Kuala Lumpur

1. DRY WEIGHT Dr Rosnawati Yahya Consultant Nephrologist Hospital Kuala Lumpur

5. BODY WATER INTRACELLULAR FLUID INTRA VASCULAR FLUID INTERSTITIAL FLUID EXTRACELLULAR FLUID

6. BODY WATER INTRACELLULAR FLUID 2/3 TBW 28 L INTRAVASCULAR FLUID 3.5 L 70kg man TOTAL BODY WATER:42 L INTERSTITIAL FLUID 10.5 L

12. WHAT IS DRY WEIGHT?

15. Evaluation of fluid status (extracellular volume)

22. Pathophysiology of dry weight

24. Pathophysiology of dry weight At the initiation of each HD session: the patient is saline overloaded, or "wet." He needs to lose the weight gained during the interdialytic period to return to the last postdialysis weight. Wt : 62 kg Wt 58 kg

26. Pathophysiology of dry weight DRY WEIGHT : 58kg 2 3 2.5 2 4 2.5 3 2 IDWG (kg) 2.2-2.5 3.2-3.5 2.7-3.0 2.2-2.5 4.2-4.5 2.7-3.0 3.2- 3.5 2.2-2.5 UF target (litres) 58 58 58 58 58 58 58 58 Post wt (kg) 60 61 60.5 60 62 60.5 61 60 Pre wt (kg) wed mon fri wed mon fri wed mon

27. Pathophysiology of dry weight The water and salt subtraction from the plasma volume creates a disequilibrium situation between the plasma and interstitial spaces. Water & salt removal from plasma/ intravascular space

28. Pathophysiology of dry weight Refilling from interstitial (and intracellular) spaces has started but is not yet completed (it takes about 4 hours).

34. Assessment of Dry Weight

49. DRY WEIGHT “MY WAY”

53. Management of Dry Weight

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