Pd solution being absorbed by the body

[Atooraya]

Question for experienced PD users.
I'm on the Bax cycler 5500 liters + 1000 last fill. My last fill occurs typically at 5 AM.
When I do the initial drain later in the evening typically around 9 PM, Only 600 comes out.
Is my body absorbing the difference?
Does this lead to weight gain?
I'm thinking of reprogramming the machine to do 500 last fill - less to absorb.
I'd appreciate any feedback on this.

[peleroja]

Are you doing a midday exchange?  Are you on Extraneal as the last fill?  This could make a difference.  Dianeal usually has a 6 hour dwell period before the body begins to reabsorb it.  Extraneal has a 12-15 hour dwell.  Might make a difference.

[Atooraya]

Dear Peleroja
No, I don't do a mid-day exchange. The Pd fluid basically sits in my belly for 12-16 hours.
Thanks so much for the feedback regarding Extraneal. It's helpful. I'll discuss with my Nephrologist when I see him next week.
Regards,
Fred
 

[george40]

Hi, did you solve this? Yes, peleroja is correct. My suspicion is that the dwell time of 12- 16 hours is too long. After 6 hours the body starts to reabsorb. Sometimes I have no choice but to have a long dwell time like yours, and the same thing happens.

[KICKSTART]

You need to do more exchanges , on average once every 4 hours. If you are a high transporter you will start to absorb anything after 2 hours (i used too) so i did 4 hourly exchanges with Extraneal overnight.

[Atooraya]

Hi All

Thanks for all the feedback.
I discussed my absorbing of the fluid with my Neph. He suggested trying Green solution (2.5%) for the last fill. Previously I was doing yellow (1.5%) for last fill.
Switching to Green seems to have helped. I'm not absorbing it as much after long dwell times.
However, what the Neph said is that he doesn't like me to use a lot of green because in relation to yellow, it will decrease the life of my peritoneal membrane.

[WishIKnew]

Using a higher level solution decreases the life of the peritoneal membrane?  I've never been told that.  I've used a red and a green every night for three and a half years.     Am I shortening my time for PD by using these solutions?

[sherry7668]

Hi all,
 My husband is on pd at home , has been for 6 years going on 7. We hardly ever use 4.5 solutions only if he has extra fluid gain. Using the 2.5 and 4.5 all the time does destroy your pd catheter .That is what we have been told. We use 2.5 and 1.5  , one night we use 2 bags of 2.5 and one bag of 1.5, the next night we switch. My husband comes off the machine in the am and dwells for 6 hours only , then he has to do a pause @ 2:00 in the middle of the day.
good luck!!!

[Atooraya]

WishIKnew, if you have the opportunity, can u run that by your Neph and shre the feedback?

[Bill Peckham]

I attended the Annual Dialysis Conference in Phoenix and heard the Keynote Address: Stephen Vas Memorial Lectureship: Etiologies, Pathophysiology, Diagnosis, Prevention and Treatment of Ultrafiltration Failure in PD  by Simon Davies, MD who is the Professor of Nephrology and Dialysis Medicine, Institute of Science and Technology in Medicine, Keele University, Stoke-On-Trent, United Kingdom.

It was way above my head but I now understand how you can have good solute clearance even as the peritoneum's Ultra Filtration ability deteriorates. Unfortunately it was way over my head and I didn't take notes. However the Handouts from the meeting are on line so you can browse many of the speaker's PowerPoiunts. Unfortunately Dr. Davies Keynote isn't posted but I did see this PPT listed: PD Solutions and Effects on the Peritoneal MembraneTerri Bonadio, RN (PDF link)

There are some other interesting titles - you guys can probably make more of the slides than I can.

[Henry P Snicklesnorter]

.

[Atooraya]

Thanks Bill P. I reviewed a few of the articles. Good feedback.