Take control of your water balance

May 4 2016

Water is the only drink for a wise man, Henry David Thoreau said... and we agree!

Water supports kidney and bladder functions, helps prevent constipation, and makes it easier to maintain your weight as water reduces cravings for other more calorie-dense drinks. Water also helps those with tetraplegia to manage low blood pressure issues.

So let’s dive into the essentials!


Fluids in = fluids out

It’s quite simple maths—fluids in should equal fluids out. It’s recommended to drink 1.5-2.0 liters a day to keep the water balance and to rinse the bladder. The volume is individual and depends on your kidney capacity, food intake and fluid loss on warm days or when you are exercising.

Some food contains a lot of water which counts in this equation, but also consider restricting drinks with a dehydrating effect such as coffee, tea or alcohol, as they will actually increase the outcome.

Keep in mind that your thirst sensation runs quite a bit slower than your body’s need for water. By the time you realize that you’re feeling thirsty, your body will already be suffering from drought. Most experts suggest that you drink before you get thirsty.

Some people with spinal cord injury, or other conditions that impact their ability to pee, avoid drinking to avoid urinating. This is not a good idea since low water intake can lead to a lot of health complications:


With a low fluid intake the urine gets more concentrated. You can tell from the color and smell if this is the case. If you use a urinary catheter, it is good to know that highly concentrated urine may affect the friction during insertion and withdrawal.

Water molecules are bound to the catheter surface (purple line) making it smooth. When the urine concentration is high, the water will leave the catheter to even out the concentration, and the catheter becomes less slippery.


To keep catheterization as smooth as possible, it’s important to drink enough water and to choose a catheter with a high osmolality. The water molecules will remain in place, ensuring that the catheter’s low friction surface is maintained throughout the whole catheterization procedure.



Normally you empty the bladder 4-6 times per day, and that should also be the frequency of Clean Intermittent Catheterization (CIC).

During the night the body produces a hormone that slows down the urine production so you don’t have to go to the toilet that often. For most people with spinal cord injury this hormonal regulation is damaged and it is even more important to empty the bladder just before bed-time to avoid accidents.

Many people also try to schedule their daily water intake, and drink less water during the last hours before bedtime. Some use medicines (anti-diuretics), and yet some use compression clothes.

Keep track of your water balance  

To be able to keep track of your fluid intake and output, you can download the LoFric® Mic Chart app. This app allows you to record the fluid you drink and the urine you pass over two or three days (48/72 hours). This can provide valuable information about your bladder situation. When completed, bring or email the chart to the appointment with your doctor or nurse.

Download the Mic Chart App


Topics: Clean Intermittent Catheterization (CIC), Health