This topic is about dealing with acute kidney injury caused by high ileostomy output and severe dehydration. A person with an ileostomy experienced rapid kidney failure due to these issues and is seeking advice on how to prevent future occurrences. Here are some helpful insights and advice:

1. Recognizing and Monitoring Dehydration:
- Regularly perform skin-turgor tests (pinching the skin to see how quickly it returns to normal) and check urine color to monitor hydration levels.
- Keep up with weekly blood tests and respond quickly to any abnormal results.

2. Oral Re-hydration Strategies:
- Use oral re-hydration solutions (ORS) like St. Mark’s solution as recommended by healthcare providers.
- If commercial ORS flavors are not to your liking, you can mix your own using recipes from the World Health Organization or St. Mark’s, which include water, glucose, sodium chloride, potassium chloride, and sodium bicarbonate.
- Avoid or limit plain water, cola, coffee, and other caffeinated drinks that can increase output.

3. Intravenous Support:
- Some individuals with high-output ileostomies may need daily IV infusions, such as 1 liter of Lactated Ringer’s solution, when oral re-hydration is insufficient.
- Quick hospital readmission for aggressive IV fluid replacement can help reverse kidney decline.

4. Reducing Stoma Output:
- Consult with a gastroenterologist about medications like loperamide or codeine, which can slow down transit time.
- Adjust your diet to reduce high-sugar or hyper-osmolar drinks and increase foods with soluble fiber, like oats and bananas, to thicken the output.

5. Protecting Against Kidney Stones:
- Drink fluids containing citric acid, such as lemonade, to help prevent kidney stones.
- Limit iced tea, as it can contribute to stone formation, especially when dehydrated.

6. Awareness of Risk Factors:
- Manage or rule out diabetes and hypertension, which are major non-dehydration causes of kidney failure.
- Be aware that kidney decline can happen very quickly; inform family or caregivers about early warning signs like cognitive changes or lethargy.

7. Reference Material:
- A patient leaflet on dehydration and inflammatory bowel disease is available at buckshealthcare.nhs.uk, providing additional ORS recipes and hydration guidance.