Balancing life with both an ileostomy and chronic kidney disease (CKD) can be quite challenging. The person in this situation is finding it difficult to follow standard CKD diets, which often include high-fiber foods that are not well-tolerated with an ileostomy. They are looking for practical advice and hope from others who are managing these conditions. Here are some helpful insights and advice shared by others:

1. Hydration balance
- It's important to maintain a high fluid intake, but just drinking water can dilute electrolytes. Consider using oral rehydration solutions, sports drinks, or homemade electrolyte drinks. Juices like watermelon or cucumber can also help.
- The recommended fluid intake varies, with some suggesting around 64 oz (about 2 liters) per day, but it's best to follow the advice of a nephrologist for personalized guidance. Carry a water bottle and sip throughout the day.
- Be cautious of over-hydration, as it can wash out nutrients. Find your personal balance with the help of medical tests and guidance.

2. Work with a nephrologist
- Regular kidney function tests and personalized fluid targets are essential.
- Discuss with your nephrologist when stricter dietary restrictions for phosphorus and potassium should be applied. Some foods might still be allowed before dialysis becomes necessary.

3. Diet strategies for CKD and an ileostomy
- Many people continue to eat a variety of foods but make sure to chew thoroughly and introduce new foods in small amounts.
- Cooking, steaming, or puréeing vegetables can help reduce fiber content. Options like broccoli, cauliflower, and beets, or canned no-salt-added versions, might be easier to handle.
- Some find iceberg lettuce, mashed or well-cooked potatoes, mac & cheese, and finely ground peas to be tolerable.
- It's advisable to limit or avoid corn and animal milk at night to prevent gas and ballooning.
- Using a nutrition-tracking app can help set daily limits for sodium, phosphorus, protein, and potassium, balancing ostomy-friendly textures with renal guidelines.

4. Dehydration risk and kidney injury
- Dehydration after surgery can lead to CKD or kidney stones, so frequent and adequate fluid replacement is crucial.
- Adding lemon juice to water is suggested as a preventive measure against kidney stones.

5. General tips
- Blockages can be caused by scar tissue, not just food choices, so remember to "chew, chew, chew."
- Joining ostomy support groups can provide early alerts to kidney risks that might not be immediately apparent to clinicians.
- If dialysis becomes necessary, dietary rules will become stricter, so enjoy your favorite foods while you can.