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Author Topic: High Blood Pressure @ Dialysis  (Read 5879 times)
monsterman
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« on: December 02, 2009, 04:32:21 AM »

Hi everyone

Well I have been dealing with this for weeks now and I have just been so caught up with Dialysis and feeling so terrible that I have not come here for advice and information. I will try to get right to the point.

I have been on Dialysis since March I had a port in my chest up until June and now have a Fistula in my left arm. Dialysis seemed to be going great while I had the port in my chest but I was also really excited to get the chest port out and have my Fistula surgery. Using the Fistula started out great I have since moved up to the Geen Needles. My blood work, clearances and flow rate are all great. I am getting IDPN as a supplement during my treatments 3 times a week. They also have started giving me an HGH Injection, I have been doing that for almost 4 weeks or so now.

My problem is only during Dialysis my blood pressure goes sky high. I am talking 200/160 sometimes its higher sometimes its lower. My sodium bath is turned off, the only sodium I am getting is during "Rinse Back" there is NO Sodium in the IDPN either. My blood pressure only does this when I am hooked up and at Dialysis. I check my pressure at home and I usually run a little low or norm....


I am pretty sure its either the HFGH injection that I am getting "Saizen" ot maybe its something else such as my Diabetes damaging my heart or I have been doing some reading and have come across the term Renin. I talked ti my doctor and he says that there is a chance that I am making to much Renin now. If that is the case is there any things I can do or a medication that I can take for this to treat the High Renin issue? I am hoping that there are a few of you on here who have maybe had High Renin levels and if so what did they do to treat you??
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Chris
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« Reply #1 on: December 02, 2009, 07:14:54 AM »

When I first started hemo I had high BP when I came off the machine. On the machine my BP was near normal, off the machine after the rinse back my bp went up as high as 170/110. Doc gave me more blood pressure pills, and we removed more fluid the next couple of dialysis treatements and my BP is normal now. BP meds I'm on now Metoprolol 50mg, Norvasc 5mg and Ramapril 5mg.

I do not take IDPN or HGH. Why are you on those? Do you not eat enough? Or not eating the right foods? I lost a lot of weight when I was in the hospital for peritonitis but I gained it back by eating right. I can give you some suggestions to help with that if need be.

I would keep buggin your doc about the BP till they find a solution. That's what they are there for and you shouldn't have to suffer high BP for long because it WILL negatively affect your health in the long term.
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« Reply #2 on: December 02, 2009, 09:43:12 AM »

IDPN is Intradialytic Parenteral Nutrition for dialsyis patients who are malnourished.

HGH is Human Growth Hormone.


Since they have you on IDPN therapy it would seem to me  you have low albumin levels which in turn makes it hard to pull excess fluid off as the fluid tends to leak into the tissues and want to stay there.   

This in turn maybe causing your bp to rise during ultrafiltiration during dialysis.
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monsterman
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« Reply #3 on: December 02, 2009, 09:53:00 AM »

IDPN is Intradialytic Parenteral Nutrition for dialsyis patients who are malnourished.

HGH is Human Growth Hormone.


Since they have you on IDPN therapy it would seem to me  you have low albumin levels which in turn makes it hard to pull excess fluid off as the fluid tends to leak into the tissues and want to stay there.   

This in turn maybe causing your bp to rise during ultrafiltiration during dialysis.


Sorry I should of been more specific, yes you are correct IDPN is Parenteral Nutrition and HGH is Human Growth Hormone.
My Albumin is 3.4 and we do not take off any fluid, I have Gastroparesis and "loose a lot of fluids" so they set me for .5 each treatment and thats it. As I said above my clearances are all good, I dont think it has anything to do with the IDPN or HGH its go to be something going on while on the machine. my bp is fine when I am home or elsewhere its only in Dialysis. I am wondering if if its just got something to do with the blood leaving the body then being put back in.

They check bp everything 15 minutes on me, my bp is high the entire treatment. Once I am rinsed back and off the machine for a good half hour my bp is back to normal. Its really strange and really has me stressed out I almost do not want to go to Dialysis the 3 days I have to anymore just to avoid the bp and the side effects.
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Chris
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« Reply #4 on: December 02, 2009, 01:06:05 PM »

G'day monsterman. I am in the exact same position as you. Why? Why? Why? The D nurses don't have a clue. My G P said not to worry. I am going to try and contact the neph. I'll let you know what I find out, and would appreciate your doing the same.
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Galvo
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« Reply #5 on: December 06, 2009, 10:56:36 PM »

G'day monsterman. I am in the exact same position as you. Why? Why? Why? The D nurses don't have a clue. My G P said not to worry. I am going to try and contact the neph. I'll let you know what I find out, and would appreciate your doing the same.

Hello galvo!

Thanks for the reply and information. Well I did some reading the last couple of nights all over the Internet and also in the library "Oxford Journal" and came across some pretty good information.
I still haven't figured out how they actually get or calculate our dry weights.. Anyhow after the reading that I did the last few days, I went to Dialysis on Friday and had them remove 1.3 Kilo's during my treatment. I normally only have them take off .5!! Yes you read it right .5 not even an entire Kilo. Why you ask?? Well I have Gastroparesis which basically means my nerves in my stomach are damaged from my Type I Diabetes. I cannot digest food correctly anymore. So whatever I eat or drink basically goes in one end and right back out the other.

Reason I am getting IDPN. The Doctors have told me that they could remove my lower Intestines and I would basically never digest food again and would get IV Food etc. But at this point in my life I opted out of that idea.


Anyhow from what I read up on and High Blood Pressure. In my case my body appears to be caught up fluid wise. For many years I walked around so dehydrated that I ran a BP of 100/50 and sometimes even lower then that. Since going on Dialysis I am not quite sure why or what has helped but my Gastroperesis has gotten a lot better and I no longer run to the bathroom as often as I used to. "Hence" not being dehydrated anymore. With that said I had them remove .3 kilos and I was able to almost keep my BP normal throughout the entire treatment. Going to try this approach again Monday morning, I will report back and let you know if my BP was able to stay normal and or if there was anything else that happened..



Chris


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Chris
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« Reply #6 on: December 07, 2009, 02:37:05 PM »

Chris, 'strewth you've been in the wars! Like you, I am letting them take off .5. This is on the basis that I am still urinating 3500+mls per day and the neph has confirmed (as recently as last Thurs) that I am not retaining fluid.
I still have to battle the nurses about this every visit.

A month ago, the neph put me on a new BP medication- Ramipril 2.5mg and halved my Norvasc (amlodipine besylate) from 10 to 5mg. After I complained about my BP last week, he upped the Norvasc back to 10mg. We'll see what, if anything, this does.

Keep in touch.

Paul
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Galvo
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« Reply #7 on: December 08, 2009, 03:43:23 AM »

Chris

To-day I came of at 180/79 sitting and it went down to 156/78 on standing. Still too high but I avoided the 200 mark. Maybe I'm getting there. How are you going?
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Galvo
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« Reply #8 on: December 14, 2009, 03:44:09 PM »

Chris

To-day I came of at 180/79 sitting and it went down to 156/78 on standing. Still too high but I avoided the 200 mark. Maybe I'm getting there. How are you going?

Hey now thats pretty good news!! Well my BP is finally almost back to normal. Guess what it actually ended up being... I had to much fluid on for once in my life, well it wont be the last time but at least I am finally caught up fluid wise!!! With the Gastroperes-is I loose so much during the day but somehow I have finally managed to catch up! So basically what was happening was getting hooked up and getting the 1 bag of IDPN during my treatment was just enough to add the "stress factor" to my heart I guess which was causing the HIGH BP!! We are now taking off 1.2-2.0 kilo's at that seems to be doing the trick!!


Went in today a little "light" so I thought so I only had them start off with 1 kilo.. Well the BP started to rise so we kicked it up to 2.0 and it went back down within a half hour. I am so glad that my BP is back to where it should be the last 2-3 weeks have been hell!! I didn't realize how awful you could actually feel with high blood pressure! Why half the people in this country can live with High BP is beyond me!!
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Chris
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« Reply #9 on: December 15, 2009, 09:35:41 AM »

When I went on the PD cycler last year, my BP dropped so low that they took me off my one and only BP medication.  When I developed peritonitis and had to go on hemo for 6 months, my BP slowly began climbing.  They put me back on my Verapamil, then added Cozaar, then added Clonidine, and I was ok for a while.  When I went back on the PD cycler in May of this year, my BP slowly began to climb in spite of the 3 medications, which were constantly tweaked.  I'm now in the 180s over 90s and 100s.  My BP in the middle of the night was 171/110.  Yikes.  I'm about to email my doc and tell her the latest tweak ain't doing a darned thing.
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