I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Nocturnal => Topic started by: tyefly on July 28, 2009, 08:47:27 PM
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I have been researching anemia managment with CKD and ran into several written docs describing that people who do nocturnal dialysis do not need or have a reduced need for EPO.. which I guess would mean that your anemia is much better because of the nocturnal dialysis..... Is this correct.... Has this happened with any of you ...... I was trying to find more information on the subject.... I thought that our kidneys did not produce enough of the hormone because of CDK and that is why we needed the EPO shot so that we have that added hormone... to help with our Hemoglobin/HCT..... I am puzzled as to why a person would not need the EPO just because of the nocturnal.....
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I still get epo, but not as much now. My hematocrit is in the 12s pretty regularly. I think because you are run slower, the body has time to adjust to the blood being cleaned better than the four hour fast treatments.
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There is compelling evidence that the anemia of renal disease has more than one factor. Lack of EPO is assumed to be the entire cause, but improved iron stores improves anemia as well as improved clearances reduces the affect of anemia of chronic disease. I am fortunate to not need EPO as of yet and hopefully for a while to go since there are many potential adverse side affects of EPO.
In addition, before we had EPO, there was a handful of studies showing that exercise can improve anemia and reduce the need for transfusions in renal patients.
Anemia thus in renal patients has many factors. When you minimize each one including by optimal dialysis, EPO requirements diminish in many people.
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My doctor wants to start me on EPO shots....guess they have a pharmacy program that maintains and oversees all of this..... I dont not take iron or any other supplements... but I have been rather tired for a few months now..... maybe I do need more exercise.... I already walk my Sib Huskies on the beach daily... I will try to increase that time...maybe get the bikes out..... I am concern about my labs at times as I do see a trend in some areas which are now out of the normal ranges.... I have never been like that before either..... Sometimes I just cant believe it..... Its just the acceptance part....and then deal with it and make the best of it..... I am not even on dailysis yet and I still have that to adapt to ....
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After my first year on nocturnal home hemo I stopped taking epo. My hemoglobin is now around 160 (normal range: 120-150). My nephrologist would like to see a lower hemoglobin since high hemoglobin is a risk factor for clotting. In part, the anemia associated with kidney disease is caused by chronic uremia. In my case, once the uremia was resolved so was my anemia.
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The life cycle of red blood cells is part of the issue as well.
Normally, red blood cells can live between 110-120 days.
For those on standard dialysis, the red blood cells may live only 20-40 days.
Optimal hemodialysis, such as nocturnal, removes more toxins from the blood (and tissues) so the result may help increase the life span of red blood cells.
8)
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All interesting stuff, wonder if mine will change.
I have been on nocturnal for more than a year and still take the same dose.
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Hubby has been on dialysis for 13 years and hasn't taken epo since he started hemo 10 years ago. He did need it pre dialysis and when he was on PD. He does take venefor twice a month