Where Does All That Water Weight Go?
The question keeps getting asked: Water pills (diuretics) do not take care of my water weight problem. Why is this when aquapheresis works great?
The figure represents the water distribution of a 70 kilogram male (150 pounds) with no extra fluid. You are mostly water. If you have swelling in the legs (edema), the EXTRA fluid is located in the interstitial space. Of interest, patients with 30 pounds of edema have all that extra water weight located in the interstitial space.
According to the figure, only a tiny amount of fluid is located on the arterial side (0.7 liters or about 2 cans of Pepsi), the place where diuretics (water pills) have an effect. Too much stress placed on that system from water pills can lead to sudden kidney failure.
Since the venous compartment contains much more fluid (3.9 liters), the process of aquapheresis can pull fluid from the venous side without really affecting the arterial side — sparing the kidneys. During aquapheresis, we take off pounds of fluid over the 3 day process because the interstitial fluid (9.4 liters or more in a patient with pitting edema in the lower extremities) replaces the removed fluid from the venous side.
We have actually seen some patient’s kidney function improve during the procedure!