When my kidney transplant failed recently after 22 yrs, I lost a lot of muscle mass within a few days. I am on now on dialysis. If I try to gain my muscle mass back by eating high protein diet and exercising, how can I tell if the weight gain is due to fluid or due to muscle mass gain?

This is a complex question and involves many variables.  In general, your nephrologist or nephrology nurse must evaluate your blood pressure, your weight gain between dialysis sessions, the amount of swelling that you have, and examine your heart and lungs. Each of these pieces of information, along with your history of nutritional intake, must be continuously evaluated in order to determine what is your appropriate “dry weight”.  You can assist them by carefully monitoring your fluid intake, monitoring your blood pressure at home and carefully weighing before and after dialysis.  You should have an ongoing conversation with your nurse and nephrologist about your dry weight and your attempts to gain muscle mass without gaining fluid weight.


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