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Author Topic: What are symptoms of low ktv  (Read 1907 times)
Aaisha.Dar
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« on: December 09, 2018, 02:25:10 PM »

For hemo patients ktv/v (how well dialysis is working) should be higher than 1.2. I saw my results and its 1.9. While that isnt below the range its a number I have never gotten before. What are symtpms of low ktvs? What does this mean?
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cassandra
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« Reply #1 on: December 09, 2018, 10:24:25 PM »

Well your Kt/v is really good. Basically it is an indication of your clearance (as in how well your blood is being cleared of toxins) K stands for potassium, t stands for time, v for volume. So it's a formula where you multiply potassium (say 5) times the time you are on the machine (say 3 hrs) equals 15 devided through the amount of volume taken of (say 1 liter). So 15 divided by 1 is 15. Obviously I haven't got a clue. I'l look it up


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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
cassandra
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« Reply #2 on: December 09, 2018, 10:30:49 PM »

Aha it's the clearance of Urea not potassium


   :angel;
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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
UkrainianTracksuit
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« Reply #3 on: December 10, 2018, 06:48:27 AM »

Hi Aisha,

I agree with cass. A kt/v of 1.2 means that "adequate" dialysis or clearance is being done. And yes, as you say, any number above that is desired, so 1.9 is good! As a result, you wouldn't have those symptoms of inadequate dialysis (feeling sluggish, out of breath, excess fluid...).  :)
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Mr Ken
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« Reply #4 on: December 10, 2018, 07:46:45 AM »

Doing PD my number is 1.18 low from the 1.7 they want to see....... So they changed the prescription by increasing the volume, number of exchanges to five and obviously dwell time. Not happy about it because I  am not going to be tethered to the machine day in and day out. I promptly sent an email to the Nephrologist stating this is the last damn change of increase that will happen. I refuse any increase changes going forward. A lot of this is a numbers game. They want a Kt/V number of 1.7 to make them look good at the expense of the patient.  Sorry I know how the game is played.......If 1.2 is acceptable for HEMO why does it need to be 1.7 for PD............ Also you cannot have the regular solution dwell for more than 4 hours because the UF will start to reabsorb back into the body...  Damned if you do damned if you don't... Driveway is calling for the PD machine..... Thousand pieces - YEP!!!
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Simon Dog
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« Reply #5 on: December 10, 2018, 07:59:28 AM »

There are many different Kt/V measurements even for HD, and the HD vs PD Kt/V share only a general concept and name.

Wikipedia has some interesting info at https://en.wikipedia.org/wiki/Kt/V
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Mr Ken
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« Reply #6 on: December 10, 2018, 09:11:53 AM »

There are many different Kt/V measurements even for HD, and the HD vs PD Kt/V share only a general concept and name.

Wikipedia has some interesting info at https://en.wikipedia.org/wiki/Kt/V
interesting  but but but but I cannot be tethered to the machine day in and day out. so my equation is (Kt/V) / Butt. 2800ml for 5 exchanges that is it.... Don't even mention any increase with this.... Not being difficult just being realistic... I am doing what I am supposed to be doing but this is it. EOD with them..... End Of Discussion. Just like my clinic visit  and blood draws.. They change the times and days.... No no no no Times and days are going to be set the same for each month.... Come January there will be some changes going on...... Patient is taking control over this crap......

 
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Simon Dog
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« Reply #7 on: December 10, 2018, 09:56:02 AM »

One of the symptoms of low Kt/V is opening the car door at stoplights and puking on the road.  BTDT.
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Mr Ken
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« Reply #8 on: December 10, 2018, 10:13:23 AM »

One of the symptoms of low Kt/V is opening the car door at stoplights and puking on the road.  BTDT.

I will take my chances and carry a barf bag!
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KatieV
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« Reply #9 on: December 10, 2018, 10:42:35 AM »

They want a Kt/V number of 1.7 to make them look good at the expense of the patient.  Sorry I know how the game is played.......If 1.2 is acceptable for HEMO why does it need to be 1.7 for PD............

My NxStage clinic wants my kt/v to be at or above 2.1.  This past spring, it fell just under (2.0 something) and they had me redo it as they will look bad to the regulators.  I should have refused - the reason it was low was NxStage kept sending me bad cyclers!

I'm really frustrated because the hospital my clinic is associated with has closed several lab locations.  I have been dropping my monthly labs off (that I draw, spin, and label) on my way into work.  That location is now closed and I will now have to drive into the main hospital.  I will have to leave at 6:15 tomorrow to drop off labs and get to work on time!  Mind you, I get to bed about 1 am after dialysis!

EDIT: and the only reason I knew about the closed location and didn't show up with my labs, was that my sister, a phlebotomist at the hospital, let me know!
« Last Edit: December 10, 2018, 10:45:21 AM by KatieV » Logged

~~~~~~~~~~~~
March 2007 - Brother diagnosed with ESRD, started dialysis 3 days later
April 2007 - Myself and sister also diagnosed with Senior-Loken Syndrome (Juvenile Nephronophthisis and Retintis Pigmentosa)

Since then, I've tried PD three times unsuccessfully, done In-Center hemo, NxStage short daily, Nocturnal NxStage, and had two transplants.  Currently doing NxStage short daily while waiting for a third transplant.

Married Sept. 2011 to my wonderful husband, James, who jumped into NxStage training only 51 days after our wedding!
~~~~~~~~~~~~
Mr Ken
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« Reply #10 on: December 10, 2018, 04:14:46 PM »

They want a Kt/V number of 1.7 to make them look good at the expense of the patient.  Sorry I know how the game is played.......If 1.2 is acceptable for HEMO why does it need to be 1.7 for PD............

My NxStage clinic wants my kt/v to be at or above 2.1.  This past spring, it fell just under (2.0 something) and they had me redo it as they will look bad to the regulators.

BINGO BINGO BINGO!!!!!!!


 I should have refused - the reason it was low was NxStage kept sending me bad cyclers!

I would have.....


I'm really frustrated because the hospital my clinic is associated with has closed several lab locations.  I have been dropping my monthly labs off (that I draw, spin, and label) on my way into work.  That location is now closed and I will now have to drive into the main hospital.  I will have to leave at 6:15 tomorrow to drop off labs and get to work on time!  Mind you, I get to bed about 1 am after dialysis!

Crazy crazy crazy....

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Aaisha.Dar
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« Reply #11 on: December 10, 2018, 07:57:40 PM »

Most of you guys well actually all of you guys say my number is actually good so ill go with that!
For pd patients, the number is higher because you are getting dialysis EVERYDAY and for longer hours so the adequately should be at higher number.
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Mr Ken
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« Reply #12 on: December 11, 2018, 04:35:05 AM »


For pd patients, the number is higher because you are getting dialysis EVERYDAY and for longer hours so the adequately should be at higher number.

Except in my case.........
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Simon Dog
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« Reply #13 on: December 11, 2018, 07:01:42 AM »

Quote
For pd patients, the number is higher because you are getting dialysis EVERYDAY and for longer hours so the adequately should be at higher number.
Ah, no.   It is because they are different measurement of clearance with the same name.
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Aaisha.Dar
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« Reply #14 on: December 11, 2018, 11:14:50 AM »


For pd patients, the number is higher because you are getting dialysis EVERYDAY and for longer hours so the adequately should be at higher number.

Except in my case.........

Whats your case?
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Mr Ken
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« Reply #15 on: December 11, 2018, 04:44:02 PM »


For pd patients, the number is higher because you are getting dialysis EVERYDAY and for longer hours so the adequately should be at higher number.

Except in my case.........

Whats your case?

My Kt/V is low....... Far from where they want it though I am doing the PD treatments every night.... They just added more solution and will be adding another exchange...... THATS IT NO MORE!!!!! After this I will no longer accept any increase in treatments. There is a reasonable boundary and we are at it....


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Simon Dog
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« Reply #16 on: December 11, 2018, 06:07:16 PM »

It is sometimes impossible to get a sufficient Kt/V with PD, in which case one graduates to (or flunks out to, depends on your perspective) HD. BTDT.
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Aaisha.Dar
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« Reply #17 on: December 12, 2018, 04:02:39 AM »


For pd patients, the number is higher because you are getting dialysis EVERYDAY and for longer hours so the adequately should be at higher number.

Except in my case.........

Whats your case?

My Kt/V is low....... Far from where they want it though I am doing the PD treatments every night.... They just added more solution and will be adding another exchange...... THATS IT NO MORE!!!!! After this I will no longer accept any increase in treatments. There is a reasonable boundary and we are at it....

How many hours are you doing and how many cycles?
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Mr Ken
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« Reply #18 on: December 12, 2018, 07:47:29 AM »

It is sometimes impossible to get a sufficient Kt/V with PD, in which case one graduates to (or flunks out to, depends on your perspective) HD. BTDT.

Yea right..... In your wildest dreams....... Too bad with the Kt/V it is what it is.... I already gave notice that there will not be any more changes / increases to the treatment regimen. Not even up for discussion. Mean time the patient has to suffer. I will not be going to HD but I am also not going to be attached to a PD machine for 12 hours....... I keep the people on their toes.... One of their better patients........ I think so anyway....  :laugh: :laugh: :laugh:


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Mr Ken
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« Reply #19 on: December 12, 2018, 08:02:39 AM »


How many hours are you doing and how many cycles?

Currently 2800ml per four exchanges. Time is around 9 hours treatment time. They want to add one more exchange up to five exchanges per session.....  I know they get their pants all up tight with the Kt/V number but there has to be a reasonable boundary line.... You cannot be on the PD machine all day and you cannot have that crap dwelling for hours and hours off the PD machine. It will re absorb back into the body .... so the solution is accept the Kt/V for what it is.... No more increase changes. Patient is refusing. I think with the added exchange the Kt/V number might hit around 1.5....
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Aaisha.Dar
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« Reply #20 on: December 12, 2018, 10:27:07 AM »

I was on 9 dwells and 10 hours. Dwelling time is actually very important. The fluid needs to sit in your stomach to help remove toxins. You will probably feel even better and you wont feel tired. Do you do pd at night when you sleep?
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Mr Ken
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« Reply #21 on: December 12, 2018, 05:15:26 PM »

I was on 9 dwells and 10 hours. Dwelling time is actually very important. The fluid needs to sit in your stomach to help remove toxins. You will probably feel even better and you wont feel tired. Do you do pd at night when you sleep?
Yes I do it at night while sleeping. Actually I feel fine. The Kt/V number is not where they want to see it at. There has to be a balance. Don't focus so much on an arbitrary number. Focus on a good balance for the patient. Takes two to have a good dance with the tempo.... 10 hours is at the upper limit for me...... I cannot be tethered to the machines for hours on end every night... I am not going to do it.  I understand the process but I also understand that there are other things that need to get done not just about all dialysis. Next week is going to be so interesting for the clinic visit... They got to take the Tylenol...
 
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Aaisha.Dar
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« Reply #22 on: December 12, 2018, 06:09:57 PM »

I understand your point, it was tough for me doing 10 hours every night and frustrating when I was late to school. I hope you and your doctors can find a balance.
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Paul
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That's another fine TARDIS you got me into Stanley

« Reply #23 on: December 20, 2018, 05:29:38 PM »

Some time back I had a row with a clinic manager who refused to tell me what were the side effects of a bad kt/v reading. The reason she refused to tell me was that it was the clinic's fault my kt/v was poor. Eventually I brow beat her into an answer and she told me that a poor kt/v leads to an earlier death. I believed her because she did not want to tell me this (for fear of legal action). It is somewhat confirmed by that Wikipedia link which says "Kt/V has been widely adopted because it was correlated with survival."

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Whoever said "God does not make mistakes" has obviously never seen the complete bog up he made of my kidneys!
Mr Ken
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« Reply #24 on: December 20, 2018, 06:22:05 PM »

Some time back I had a row with a clinic manager who refused to tell me what were the side effects of a bad kt/v reading. The reason she refused to tell me was that it was the clinic's fault my kt/v was poor. Eventually I brow beat her into an answer and she told me that a poor kt/v leads to an earlier death. I believed her because she did not want to tell me this (for fear of legal action). It is somewhat confirmed by that Wikipedia link which says "Kt/V has been widely adopted because it was correlated with survival."

I look at it as a reasonable amount of time doing the treatment. I am sure the Kt/V number was low before dialysis so the number only goes up from there...........
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