temperature after dialysis

[justwilly]

first post, here I go ... so I've been on dialysis for nearly four years, but now after the last five session I come up with a temperature within a few hours of getting off 101 to 102+ I guess that's 38 to 39 also ... then the next day (my off day), I fine ... no temperature, I realize that many other people have had this experience this, BUT ... I can't get a straight answer as to what would cause this all of a sudden ... what is going on with my body ... I've tried to do a search on the internet for answers, and I'm coming up with nothing (I'm 81 ... my good searching days are probably way behind me) ... so if anybody out there can give me a story or their expericences ... an answer ... something to guide me to an answer ... my wife and I have talked to the doctor ... nothing ... they did some blood work ... checked into the aged vials and the glass thingy ... my center says they are fine ... they've flushed out everything that can be flushed ... so ... any help out there would be apprecitated ... willy

[Bruno]

That happens to me as well. I vary between getting heated so that I need to throw the sheets off and breaking out in a severe sweat. I always get the sweats after loosing a fair amount of fluid. My doctor is currently running a test to make sure I haven't got a hidden infection but the nurses say she won't find one because what I have is not uncommon with HD.
After some thought I've come to the confusion that failing kidney function and/or dialysis interferes can interfere with the body's temperature regulator. It's another of those things we have to learn to live with, I believe.
Good luck, pal.
 

[Hazmat35]

When I get home after wards, I'm so HOT.  I don't run a fever per say, but INTERNALLY, I feel HOT.

[justwilly]

thanks for the reply, and Burno I'm the original TOGF (typical old grumpy fart), anyways ... I headed to the doctor and my son is going to go with me ... he does better asking some hard questions of the doctor without making his feel like he doesnt' know whats going on with my HD, because not only for me but for everyone there needs to be some list of "these are the reasons you're running  temperature" ... like "HD can alter you internal temperture gizmo" ... but I'm going to keep posting now that I found this site if there are any answers I come up with ... thanks for replying ... willy

[Bruno]

Willy
My nurses here are brilliant. The one looking after me has 28 years experience, almost totally with CRF patients. She tells me that nobody is sure what causes the temperature fluctuations, but there are plenty of theories. From what I've seen on the 'net I think she's right.
You might be a grumpy old fart but my grandchildren tell me I'm a pleasant old fart. So there.
Good luck, pal.

[jbeany]

Kidneys do a lot to help regulate body temperature, so if your function has gone down a bit more, your internal temp controls may be a bit off.  Have you taken your temp during the same time frame on off-D days?  It may be something your body clock does to you during that time regardless of the D machine.  (Body temps fluctuate with your wake/sleep schedule.)  Check that first - it's easiest to eliminate.

If your bp is running low, you can get a sweaty sort of hot flash.  That never made logical sense to me - why would the body make you sweat when your fluid levels are already low?  But it happens, and that might be raising your temp, even if you don't have any other signs of crashing.  You don't have to be hooked to the machine for a crash, either - it can happen after you are off, as the fluid levels in your body shift.

You could be having a reaction to  - well, any number of things.  A mild allergic reaction will raise your temp as well.  Have they changed the dose of anything at all with your pills, your IV meds, the machine filter, etc.?  For that matter, are you being exposed to anything non-D related that's different the last couple of days?  A different brand of spice in your food?  Different brand of multi-vitamins?

If you're not getting a straight answer from your doc or nurses, it's because none of them are willing to say the three magic words - "I don't know."  There could be a large number of causes, so it's going to be very difficult to narrow it down.  All you can do is try to think of everything that might possibly be different during the last few runs.

[Restorer]

Everyone else has given you some good ideas. As far as kidneys controlling your body temperature, that makes sense - my usual body temperature fluctuates between 96.5 and 97.8 these days. I don't think it goes up after dialysis, but I've never checked it myself with the same thermometer right afterward. Later in the night on D days, it's not high.

One thing that I wonder about: when I was on PD, everything was labeled with "non-pyrogenic," that is, not fever-causing. Are some dialyzers not non-pyrogenic? Or, if dialyzers are reused, could something in the detergent or some other factor cause a transient fever?

That hot flash when your BP drops is part of the adrenergic response - adrenaline. It's a multi-purpose reaction; it increases your heart rate, constricts blood vessels, and a few other things, including a hot flash (blood rushing to your skin) and sweating, both meant to quickly cool you down, useful in the fight or flight response. (Yay physiology class!  )

The only other thing I can think of (which I expect they would have already checked) - are they giving you iron when you're on dialysis? I've had reactions to IV infusions of Venofer, and it's possible a mild reaction could increase your temperature, but it's just a guess.

I hope you figure this out. It can't be good to have a fever higher than 101 three times a week. What if you take some Tylenol after you get off?