I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: acer on January 09, 2009, 07:10:38 AM
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Hi, I've just introduced myself as a new member and have a question. During the last half/hour of my dialysis I sometimes suffer terrible cramps in my legs and toes, this leads to low blood pressure and occasionally passing out. I'm so anxious about this that I try to keep myself alert at all times, and although I sometimes feel like sleeping during dialysis I'm too afraid to. Is this a general thing and is there anything I can do about it? Acer
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Sounds as though they are taking too much fluid off. Tell them to raise your dry weight. This is something you can do something about. Your dry weight is really a guess until you figure it out. They should not be allowing this to happen.
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Agree that this is almost certainly a problem with too much fluid being taken off. Have the staff not done anything about this in terms of adjusting your dry weight upwards? You should ask about this next session.
One other trick that has worked for me (as long as you're not diabetic) is to have some sweets on hand and eat a few in the last hour.. this tends to up the blood pressure a bit and stave off cramping, but definitely ask to have your dry weight or ideal weight put up as this is a classic symptom of too much fluid being taken off. Given it's near the end of your session probably 0.5kg is all you need to put your dry weight up by.
Hope this helps!
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How much fluid you have on also makes a difference. Regardless of my dry weight, I simply cannot pull off more than 2.5 in a session. My body just seems to refuse to let go of more than that at one sitting. My blood pressure will drop and I'll get cramps. If I have 3 on, I have to set it for 2.5 and take the rest off the next run. If raising your dry weight doesn't help, you might want to keep track of when you are crashing and how much fluid has come off at the time you start. You may see a pattern similar to mine.
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I have blacked out twice while they tried to find my dry weight. When I feel like something is crawling around in my legs, I tell the nurse and they back off taking fluid or even have given more fluid back. This usually stops the cramps. I wont let them take my shoes off, because when they put them back on I cramp bad.
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I think that the assessment of dry weight in haemo dialysis is fundamentally flawed. Every persons weight irrespective of whether that person is healthy or in kidney failure fluctuates from day to day depending on how much or how little that person has eaten in terms of calories, fatty foods etc. When a kidney patients turns up at clinic weighing more than his or her dry weight there is no way of assessing how much extra weight is due to increases in body weight/ mass and how much is due to excess fluid so they have to assume that it is all excess fluid and so set the machine accordingly to take off that amount of UF.
How else can this problem of light headedness and fainting be explained. Surely it is obvious that because of this factor the calculation will often be inaccurately excessive and patients are having fluid drawn off which is part of the bodies natural fluid requirement.