KPJ HEALTHCARE UNIVERSITY

COLLEGE
 LEARNING OUTCOMES

At the end of this session, students will be able

to:
• Define dry weight
• State the importance of assessing dry weight.
• Describe how to assess dry weight.
• State the sign and symptoms to show that dry
weight is achieved.
• Calculate dry weight.
 DRY WEIGHT

DEFINITION
▪ Is the ideal post dialysis weight after the
removal of all or most excess body fluid.
▪ Is the weight after a dialysis session when all
of the extra fluid in the body has been
removed.
▪ Is an ideal weight for ESRF with a general well
being pre and post dialysis.
Currently Definition
The lowest weight a patient can tolerate
without the development of symptoms or
hypertension.
Target weight – after dialysis, all excess fluid is
removed.
Characterized – blood pressure stable, no
swelling/ edema, clear lungs and no cramps.
 DRY WEIGHT

IMPORTANCE OF DRY WEIGHT

• To help in setting total fluid to be removed
during hemodialysis (Goal U/F)
• To assess if patient is compliance to diet and
fluid control.
• To confirm if patient has put on body mass
and not fluid accumulation.
 DRY WEIGHT

ASSESSMENT OF DRY WEIGHT

• Do a chest X-Ray prior to initiating
hemodialysis.
• Give adequate counselling and monitoring on
diet and fluid intake.
• Carry out gentle HD for 2-3 weeks.
• Antihypertensive drugs- reduce by Dr after
reviewed (if necessary)
• Observe for presence of edema.
• Record all sign and symptoms during HD, ex:
hypotension, vomiting cramps.
• Repeat chest X-Ray when weight is achived.
• Review by Dr to confirm dry weight – at least 3
monthly to accommodate increase in body mass
due to good rehabilitation and adequate dialysis.
 DRY WEIGHT

Sign and symptoms of achievable DW

1. Good effort tolerance
2. No SOB
3. Generalised edema not present
4. BP under control with limited medication and
low dose antihypertensive
5. Chest X-Ray – no cardiomegaly
6. Active – well rehabilitated
 DRY WEIGHT

CALCULATION
• Obtain Interdialytic Weight Gain
(present Pre Dialysis Wt – Previous Post Dialysis
Wt)

• Compare wt gain with estimated dry wt

recommended
Between 3 – 5% of dry wt. optimum, differ from
patient to patient depending on general physical
condition and cardiac status
 DRY WEIGHT CALCULATION

Consideration – calculation water to be remove

• Should be not less than interdialytic wt gain
• Include wt of food and fluid that may be
consumed during treatment.
• Amount normal saline return to the patient
• Amount of blood transfusion – if any
• Amount IV fluid – must be added to the goal set
• Additional amount required to be remove if
patient has not achived recommended dry wt
 DRY WEIGHT

COMPLICATION MISCALCULATION
TOO LITTLE ( high dry wt) water remove from
circulatory system – sign of volume OVERLOAD

• CCF
• HPT
• APO
• SOB
• Death
COMPLICATION MISCALCULATION
TOO MUCH ( Low dry wt) water remove from circulatory system –
sign of volume DEPLETION
• Giddy
• Cramps
• Hypotension
• AVF Failure
• Unconsciousness
• Heart attack
• Death
THANK YOU