I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: General Discussion => Topic started by: Mizar on September 18, 2008, 05:47:17 PM

Title: Don't Understand This.
Post by: Mizar on September 18, 2008, 05:47:17 PM

My Husband has been on Dialysis, for Nine Months. He started at Four Hours, with less then 10% Kidney Function. Two Months Ago, he was moved to Three and a Half Hours. Two Days Ago, he came Home and said, " They want me to Gain Weight, I have Lost 15 Pounds in Six Months " Okay. He Eats very little, but this is a Lifelong Pattern of His. Today, He came Home and said, that the Clinic had cut his Time to Three Hours, because His Stats were so good. hmmmm.
If you don't Eat, then Your Potassium, Phosphorus, etc. etc. are never going to get out of line. Right?
I really don't know a lot about this, but it seems to me, that they should see the connection, between the Weight Loss and the Stats.
If I'm wrong about this, Please let me know. I'm trying to learn everything I can.

Title: Re: Don't Understand This.
Post by: Sluff on September 18, 2008, 07:27:35 PM

Great question, I'm not sure how that works but I'm sure someone will know. Glad his stats are good though. How is he feeling?

Title: Re: Don't Understand This.
Post by: Wallyz on September 19, 2008, 05:48:00 AM

His stats were good so they cut dialysis? What the crap is that?  "You're doing great! let's help you feel worse!"


Anyways, check his albumin levels.  They should be available to you on the lab reports.  If they are low, he might not be eating enough.  Does he look like he has lost muscle, or fat? Losing fat is good, losing muscle can be problematic.

Title: Re: Don't Understand This.
Post by: Zach on September 19, 2008, 07:23:30 AM

Quote from: Mizar on September 18, 2008, 05:47:17 PM

If you don't Eat, then Your Potassium, Phosphorus, etc. etc. are never going to get out of line. Right?
I really don't know a lot about this, but it seems to me, that they should see the connection, between the Weight Loss and the Stats.
If I'm wrong about this, Please let me know. I'm trying to learn everything I can.

Your instincts are correct.

In getting "good numbers," some dietitians may ignore the real cause, such as malnutrition.  It's important to have thinking dietitians, when possible.

According to the National Kidney Foundation's (U.S.A.) Clinical Practice Guidelines for Nutrition:
People on hemodialysis should consume daily 1.2 grams of protein per kilograms of body weight and 35 calories per kilograms of body weight.

http://www.kidney.org/professionals/kdoqi/guidelines_updates/nut_a15.html

http://www.kidney.org/professionals/kdoqi/guidelines_updates/nut_a17.html

As Wallyz wrote, a low albumin is one measurement that may point to low protein intake.  Other measurements for malnutrition may include a low predialysis BUN level, serum creatinine, and weight loss (muscle waisting).

http://www.kidney.org/professionals/kdoqi/guidelines_updates/nut_a01.html
 
Perhaps he needs to keep a diary of his daily food consumption for a week and show it to his dietitian.

8)

Title: Re: Don't Understand This.
Post by: flip on September 19, 2008, 11:07:18 AM

Not eating will not improve your numbers. Been there, done that. Your albumin, phosphorus, potassium and calcium can get too low which is as bad or worse than having them too high.

Title: Re: Don't Understand This.
Post by: Mizar on September 20, 2008, 09:56:40 AM

Thanks All. Will be Interesting, to see how He does on Three Hours.