Residual Kidney Function

[Henry P Snicklesnorter]

.

[MooseMom]

In my own research, it seems that the rate of loss of RKF is also contingent upon the disease process and that in those patients whose renal function was destroyed by such an underlying sclerotic process, the dialysis modality is not that influential.  But yes, anything that can be done to preserve residual function should be encouraged.  But I am not sure that chosing PD over hemo for this sole reason is wise.  Although, maybe in some patients that's as good a reason as any to choose PD.

[Dry-Pack-Babe]

I still urinate. Not as much as I used to, but what can I do to make sure that I continue to void?

[Henry P Snicklesnorter]

.

[Henry P Snicklesnorter]

.

[RightSide]

I still urinate. Not as much as I used to, but what can I do to make sure that I continue to void?

You're a guy.  Have your prostate examined by cystoscopy.
Urinary retention from benign prostatic hyperplasia (enlarged prostate) can destroy what's left of your residual kidney function.  If you have that condition, it can be treated with meds or surgery.

And be aware of ALL meds--both over the counter and prescription--that can damage kidney function.  In particular, the contrast media injected into you for CT scans and other imaging can damage kidney function (contrast induced nepropathy).  If you're going to have contrast media, insist on the safest medication possible--and arrange to be dialyzed immediately afterward, to get it out of your system as quickly as possible.

[chook]

I am grateful that I still pass a significant amount of urine each day. I too believe this helps maintain my health and lessens the need for fluid and dietary restrictions.

[vcarmody]

My husband just did his 24 hour urine last week and he turned in 1,200 ML's  his nurse was shocked.  I kept telling them that my husband urinates a lot and they can not look at his KT/V and URR with out factoring that into the mix, they have been saying his clearance is not good and wanted us to add another 5 liters to his prescription (we do Nxstage).  My husband eats and drinks what ever he wants, he never takes his binders and his blood work is always really good, except his sugar.  He has been on dialysis for 1 year 5 months (1 year 3 months on Nxstage)  and I hope we can keep his kidney function they way it has been. 

[jstorm001]

I been on dialysis since 2007 Im 26 i still  urinate like a normal person would but i just pass fluids im lucky i still do they say the toxins stay in my blood my kidneys are End stage to i can fill two of those jugs. i always sometimes have to yell at them at dailysis because they wanna take so much fluids but i cant handle it they must think i lie that i can urinate so much one time i changed my goal myself  lol plus my girlfriend is a tech so i know how to run them! lol max i can only do 3,000  and thats kinda pushing it i can cramp badly if alot is taken.

[MooseMom]

This is a topic I know very little about.  So, may I ask the following?:

What caused your kidney failure?
What kind of D do you do?
For how long have you been dialyzing?
Do you still urinate?
If not, for how long were you on dialysis before you stopped?

I am assuming that someone with FSGS or PKD...diseases that are "processes"...may not have much RKF for any length of time compared to those who are diabetic, but that's just a theory of mine.  Anyone have any thoughts?  I guess I'm just trying to ascertain what the future holds for me in this regard.  Thanks!

[chook]

MM I have PKD and still have good RKF, putting out over a litre a day. I was on CAPD for 6 weeks and then the remaining 9 months APD. Now with my new kidney I think my native kidneys are confusing the output issue. Luckily, just by chance I measured my overnight urine output in the week prior to transplant and it was 900ml. I go much less in the daytime than at night.

[pdpatty]

The reason I put out less urine is fluid restriction. THe center insists we limit our fluids to 32 ounces a day. I try to stick to it,it is hard. I seem to be thirsty all the time.
I also have PKD ,am almost 66 and will never get a transplant.Had a cancer removed from my back last year.

[chook]

Had to say - love the name, Pdpatty!!! But sorry to hear a transplant is not in your future. Stay well.

[Ken Shelmerdine]

I been on dialysis since 2007 Im 26 i still  urinate like a normal person would but i just pass fluids im lucky i still do they say the toxins stay in my blood my kidneys are End stage to i can fill two of those jugs. i always sometimes have to yell at them at dailysis because they wanna take so much fluids but i cant handle it they must think i lie that i can urinate so much one time i changed my goal myself  lol plus my girlfriend is a tech so i know how to run them! lol max i can only do 3,000  and thats kinda pushing it i can cramp badly if alot is taken.

Its simple. If you are convinced you are passing fluid normally then refuse to have any removed. This happened to me when I first went on haemo. They just couldn't believe that I had recently done a 24 hour urine collection of 2.8 litres!  I said go ahead and check with the PD clinic but they obviously didn't because every dialysis day I got the same broken record from each new nurse who put me on. ''Oh oh but we can't just not take any fluid off'' This zombie like attitude to fluid removal seems to persist throughout the NHS. From day one I have self medicated on this and refuse to have any fluid removed not even for washback.

Its a well known fact that fluid removal by dialysis causes urinary function to rapidly decrease much faster than it would have done if it was not artificially removed by dialysis. Dialysis techs and doctors know this yet do not seem to care a jot about how valuable retaining normal  output for as long as possible is so important to us. Oh and another thing, this Dry weight nonsense is irrelevant to us who have full urine output yet even now the nurses at the clinic still comment if I come in over this dry weight. Its as if the assumption prevails that kidney patients weight can't fluctuate in terms of bodyweight like any normally healthy person so any increase over dry weight must be fluid.

My advice is to strictly measure all your fluid intake over one day and also do a 24 hour urine collection and see how the volume compares to what you have drunk and then you decide how much if any to remove on the dialysis machine

I'm glad I stood my ground over this because after 2 years PD and 2 years 6 months on haemo I still output between 2.5 and 3 litres over 24 hours and I feel absolutely fine.
Good Luck

[Ken Shelmerdine]

I been on dialysis since 2007 Im 26 i still  urinate like a normal person would but i just pass fluids im lucky i still do they say the toxins stay in my blood my kidneys are End stage to i can fill two of those jugs. i always sometimes have to yell at them at dailysis because they wanna take so much fluids but i cant handle it they must think i lie that i can urinate so much one time i changed my goal myself  lol plus my girlfriend is a tech so i know how to run them! lol max i can only do 3,000  and thats kinda pushing it i can cramp badly if alot is taken.

Sorry this has happened please read post above

[AguynamedKim]

Fantastic information here.  Thank you all so much for such a great thread.

[Quickfeet]

" Its as if the assumption prevails that kidney patients weight can't fluctuate in terms of bodyweight like any normally healthy person so any increase over dry weight must be fluid."

I just tell them I haven't pooped yet.

I can pee 2.5 L to 3L in a 24 period plus what comes off through my PD. And when the nurses try to claim I'm retaining water I really want to scream bullsh**!

One time they weighed me with my winter coat on and they were all freaking out because my at home weight had been averaging 10 lbs less. I tried to explain why my weight would be different. Besides the coat, I weigh myself in the morning after going to the bathroom and before eating (and in the nude). They wouldn't listen. I had three nurses checking my legs for swelling. They were really going at too, trying to find that elusive water.

[rsudock]

Moosemom my brother and I both have autosomal recessive PKD...the only difference is that he still pees and I do not. He doesn in center nocternal dialysis three times a week and I do just incenter D three times a week. I wonder if there is a person on here who can comment about if there function has change when they switch to in center hemo to nocternal hemo...it made a difference to my bro. I wish I still peed so I could lighten up on watching the fluids....

My brother has been doing nocternal for a year or so and before that incenter for 3 years....

My functioning stopped within a month of doing hemo.

xo,
R