Congestive Heart Failure and PD

[Chalice]

I searched the forum for congestive heart failure and didn't find any real answers to my question. I'd like to know if there are any members that have or have dealt with a family member with CHF who is on PD? My Mom is in CHF with underlying congenital heart defects and Type 2 Diabetes. Her kidneys have failed due to lack of blood flow from the poor pumping action of the heart. She is near the beginning of starting PD, but has not had the catheter placed yet. First there will be one more blood work-up on July 2nd as well as a Neph visit same day.

I would really appreciate hearing from anyone with heart disease who is on PD. Thanks! 








EDITED:Moved to PD section/Home dialysis section-kitkatz,Moderator

[lodisweetthing]

I searched the forum for congestive heart failure and didn't find any real answers to my question. I'd like to know if there are any members that have or have dealt with a family member with CHF who is on PD? My Mom is in CHF with underlying congenital heart defects and Type 2 Diabetes. Her kidneys have failed due to lack of blood flow from the poor pumping action of the heart. She is near the beginning of starting PD, but has not had the catheter placed yet. First there will be one more blood work-up on July 2nd as well as a Neph visit same day.

I would really appreciate hearing from anyone with heart disease who is on PD. Thanks! 

hello I am here for you.. My husband has chf and cardioneropathy,an insulin diabetic,high blood pressure, and is blind with about every illness to the eyes possible and his stomach and intestines are partly paralized..it is really good for him to do pd ,not as hard on the heart not as diet restricted as well as fluids but you still need to watch for her heart you will learn in training about the different strengths of bags where if she is swelling to pull the water off.. hopefully her cath is done microscopic....no insicion and less healing time..rod,my hubby,has his near his bellybutton..its where its usually put...it takes alittle time to get used to but in no time she wont really know its there..a good choice she can do her treatments in her sleep at night and run all day..baxter is a suplier and they're truck come to the house and lift it for her to her storage spot they even circulate her stock too...baxter is wonderful good luck ..






EDITED:Moved to PD section/Home dialysis section-kitkatz,Moderator

[Hanify]

I don't have chd, but last year when I was sicker I did have very low heart pumping ability.  I can't remember what it was called.  Anyway, I've now been on PD for over  a year and my heart has improved back to normal pump rate.  I don't know if that helps, but PD definitely helped my heart.

[Chalice]

Thanks for your comments! I was hoping there was someone here that could tell me about their experiences.

Lodisweetthing, it sounds like you and your husband have been through alot. It is amazing that with all of his health issues that he can still push on.

Hanify, I believe you are talking about the EF, or ejection fraction. It is the measurement of blood that the heart pumps out to the body, or output. I have read that there have been trials and studies on patients with Congestive Heart Failure where PD is used as a treatment, even if the patient is not in renal failure. It works to pull off the fluid that diuretics can't pull off alone. I'm glad to hear that your output was back to normal after being on PD. That is VERY encouraging!

Thanks...

[Hanify]

Yes - that's it.  My ejection fraction was at 25%, and now is 75-80% which is normal.  I knew it was an odd word that I naturally turned into a much ruder sounding version ha ha.  Still keeping your mum in my prayers.

[MiSSis]

Hi Chalice,

Isn't it nice to be able to come to a place where you can find persons who have experienced many of the things you are dealing with now?   Granted, not all of our circumstances are identical but many times they are similar enough to give us the knowledge to pursue answers with our doctors.

I've been on PD for a little over 5 1/2 years now and I've dealt with Congestive Heart Failure in the past.  My 2nd transplant started failing in Sep '03 following parathyroid surgery.  Unknown to my husband and me, I had been released from the hospital with very low blood counts and hadn't been given any instructions except to return to my family doctor for blood work 1 week later.  I felt pretty crummy following the surgery but I had expected this.  What I didn't expect was that as I started to regain some strength and the ability to eat solid foods, my condition started to deteriorate rapidly.  What we hadn't realized was that my low blood count was placing a tremendous strain on my heart which had already been damaged by coronary artery disease.  After a miserable night of not being able to catch my breath and not being able to lay flat on our bed, my husband took me to the ER where they discovered that I was in congestive heart failure with an ejection fraction of only 15%.  I was placed on a heart pump for 3 days to allow my heart to heal. 

In the process of trying to protect my heart, I guess my body had to make a decision on which organ to protect and my transplant lost the battle.  I ended up not having enough function in my transplant to prevent me from having several bouts of CHF.  Everything had happened so quickly that I had had hopes of my transplant recovering so I fought going back on dialysis permanently.  Over the next 4 weeks or so, I was in and out of the hospital with recurrent bouts of CHF. Finally my doctors told me I had no choice but to go back on dialysis and remain on it. 

Sorry about the very long story but I wanted to give you some background and then to tell you that since I've been back on PD permanently (unless I'm lucky enough to receive a 3rd transplant), I have not had another case of CHF.  As a PD patient you have the ability to change the strength of your dialysate on a daily basis based on your blood pressure and how much extra fluid you might be carrying.  Although hemo would not have been my first choice when it came to dialysis, even my doctors agreed that with a tendency toward developing CHF, PD was the best option for controlling the fluid that can build up each day.  Waiting 3 or 4 days for dialysis would allow too much fluid to be retained and put entirely too much strain on the heart.

If you have any other questions, please feel free to ask.  And I wish you and your mother the best in your upcoming challenges.

 MiSSis

[Chalice]

Thanks a bunch MiSSis! I know it is going to be hard for her to get used to PD. It really is a lifelong commitment. Do-or-die is a hard thing to deal with. My Mom's CHF is caused by structural heart disease. She has only been in the hospital twice for the CHF in the 6+ years that she has had it. She is generally really good with following the strict diet which is low or no salt, low cholesterol/fat and fluid restrictions of 6 1/2 cups per day. With CHF, if you are non-compliant it is almost guaranteed that you will be in the hospital with a Lasix drip. From what I've read about PD, it seems like it will help even more to control the CHF. All we really want is for her to be able to live a normal life up until her heart can no longer beat. The Cardiologist estimates her ejection fraction to be about 10% and clearly, the ejection fraction is worsening, or the kidneys wouldn't be failing. Even with the odds against her, my Mom still isn't just going to lay down and die. It just isn't in her nature. She is the toughest b*tch that I know! 

[lodisweetthing]

yes it is amazing i am trying  to figure how i keep going i have copd and astma,acute bronchitis and sist on ovaries and bone spurs(feet and collar bone )and chronic pain, and so on and still able to manage him...rod showed up with ef what you guys mentioned i couldnt remeber the name .. but not tell after i found it doing vitals..docs missed it..

[MiSSis]

With daily dialysis, your mother might find that she can relax the fluid restriction somewhat.  Of course this should be discussed with her nephrologist but since she will dialyze every night and can adjust the concentration of dextrose solution used based on her weight and blood pressure for that day, she may actually have to drink a little more in order to prevent dehydration.  It's small but it's still a perk of PD!  I've found that I can pretty much drink (with some moderation) and eat what I want.  Unlike patients on hemodialysis, I'm often urged by the dietitian at my unit to eat more protein and potassium because these elements are leached out during the daily dialysis procedure.  The only things I have to watch more carefully are dairy products because of the calcium which is always elevated in my case and also my phosphorus.  However phosphorus can be kept under control as long as you take your binders, not just with meals, but each and every time you're putting food into your mouth. 

I know it'll be tough at first getting used to this new lifestyle but I think you'll be surprised how quickly you become adjusted to the routine and it becomes second nature.  If I can answer any questions or help in any other way, feel free to ask.   

[mjclark]

Hello everyone.  I've been on PD for a year now.  It has been a fast year.  Life is a little different but I feel blessed to be able to do the CAPD.  My pet tests did NOT say I should be able to do it but my nurse says I'm mind over matter!     I feel real good and they watch me very closely at the dialysis clinic.  I am getting ready to have the "work up done" for a transplant but I'm really OK with CAPD so long as it works.  I'm 57 years old and most nights I've fine with being in bed by 10 pm and up at 8 am.  I am a foster parents and fortunately am able to "SET MY SCHEDULE" to suit myself most of the time and I don't do 8 am appts.  I've done forsenious and due to insurance (while my husband was still working) I changed to Baxter which worked out great because of the icodextrin solution they have .  I am also a very slow transporter....Just wanted to say HELLO....

[CCStan]

Hello everyone.  I've been on PD for a year now.  It has been a fast year.  Life is a little different but I feel blessed to be able to do the CAPD.  My pet tests did NOT say I should be able to do it but my nurse says I'm mind over matter!     I feel real good and they watch me very closely at the dialysis clinic.  I am getting ready to have the "work up done" for a transplant but I'm really OK with CAPD so long as it works.  I'm 57 years old and most nights I've fine with being in bed by 10 pm and up at 8 am.  I am a foster parents and fortunately am able to "SET MY SCHEDULE" to suit myself most of the time and I don't do 8 am appts.  I've done forsenious and due to insurance (while my husband was still working) I changed to Baxter which worked out great because of the icodextrin solution they have .  I am also a very slow transporter....Just wanted to say HELLO....

MJ, You say you are on CAPD.  What type of solution are you using ?  Are you using the icodextrin(Extraneal) ?  Extraneal is used for the long dwell and according to info for HIGH transporters?

My husband after 2 bouts of fluid overload and being in hospital for several days each time( within the last month),  finally is in the process of possibily trying Extraneal.   We have been asking to "try" icodextrtrin for months !!!  It has taken (it seems like) an act of congress to get the process going to get icodextrin.     Might have more news if he will be able to get it, tomm.(Monday).

Reason given for stalling on icodextrin have been,"very expensive "low transporter".  Neph actually trying to push him off to a different clinic for home hemo.!!!  His lab work has been coming back very good,the only problem is his problem with fluid overload.  Right now have been able to get some of fluid  off  is with short dwells of 4.25%.