Shortening Dialysis Time For Husband

[2dallascowboys]

Hi,

I introduced myself and hubby on the other board.  I have my first question for all of you
good, experienced people, so here goes:

Les has been on dialysis since March 30.  His time has always been 4 1/2 hrs.
A few weeks ago, unit adjusted him to 4 hrs, 15 mins.  Today he came home and
said they may drop to just 4 hrs.

Was wondering how common it was for time to be reduced.  Don't get me wrong,
I am not complaining, just wondering .   His numbers have been very good, he has
still got a perma cath.  He was fearful of getting fistula, but now should have one
put in in May.

He has completed testing for transplant, but has to have an aneuyrism repaired first.
This will be done on April 25.  I have much confidence in the Dr.  It is small, and wil
be repaired with a stent.

Anyone who has had or heard of time reduction on machine, please respond. I would
so appreciate it

Anne and LEs in NJ

[jedimaster]

The time on the machine depends on many factors, and one of those is how good is your clearance and how you react to the machine settings. Most of the people I know are on the machine for 4 hours, I am a home hemo patient and I do 4 hours each time...at the Clinic they allways did 4 hors runs for everybody. So, to my knowledge you are OK.

Now, tell your husband that the fistula setting is not that bad. I have one and I was overwellmed at the beginning but now is a good working fistula. Tomorrow is its anniversary!...thanks God, no problems with the fistula in one year. It is surgery, though, but not that bad...promise! 

[okarol]

My daughter's runtime on in-center hemo was 3 hours. She had no fluid retention problems and she is small (5'6" 118 lbs) so they
kept the time low. The labs will help them determine how well the dialysis is working. Ask the tech next time he's there.

[jasperkat]

My husband was reduced from 3.5 to 3.25 hours a couple of months ago.  He has never been more than 3.5.  He does not gain a lot and still urinates.  Tell your husband the fistula will be great once it is working.  My husband finally got his catheter out last week - after 15 months.  He is doing pretty good and is feeling much better now that they are using the fistula.  Good luck!

[okarol]

Just found this at the
National Kidney and Urologic Diseases Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/hemodialysis/

Tests to See How Well Your Dialysis Is Working

About once a month, your dialysis care team will test your blood by using one of two formulas—URR or Kt/V—to see whether your treatments are removing enough wastes. Both tests look at one specific waste product, called blood urea nitrogen (BUN), as an indicator for the overall level of waste products in your system. For more information about these measurements, see the NIDDK fact sheet Hemodialysis Dose and Adequacy. http://kidney.niddk.nih.gov/kudiseases/pubs/hemodialysisdose/

[jbeany]

Anne,
It means the dialysis is working well for him, and it's perfectly normal for them to shorten run times after the first few months.  They will shorten the time and then watch his lab results to make sure he is still getting enough dialysis.  I think different clinics must use different standard run times at the beginning, (Mine seems to start everyone at 4 hours, not 4-1/2) but for the most part, they start everyone off with a longer time, and then work down if they can.

[Duane]

Each person's lab results will be different which determines chair time.

When I started  they had me at 3 1/2 hours for my condition and strength of fistula, 1mth ago i was increased 15min to 3 3/4 hrs, most at the center are at 4 or 4 1/2 hrs.

it's a good thing.

[goofynina]

When i was on Hemo i started at 4 hours, in the beginning i was too sick to care for myself so i wasnt overloading myself on fluid and my mom would cook for me renal friendly foods, so 4 hours was good, BUT, when i started feeling better and i was able to walk and get my own food and fluids, oh man, threw my labs for a loop, so the doc had to up my time to 5 hours.   So basically it all depends on how your hubby is feeling and how well he is maintaining his fluid intake and sticking to the renal diet.  If he feels good with the time they give him, then i'd stick to that time.  Good luck and Godspeed. 

[charee]

What I have been told here in Aus that the longer`the better, I have just finished my first week of home hemo training, and have been told they would like everyone 6hours every 2nd day, My trainer doesn't believe in any thing shorter to get  really good dialysis.I started off with 3 and then she slowly increases it every time.

[livecam]

When you are using a catheter longer run times will definetly give you better dialysis.  This is because the blood flow through a catheter is much less than what you can expect with a good fistula.  Hemodialysis is really about the total volume of blood you move through the dialyzer over a given period of time.

In my case run times were adjusted both up and down and sometimes at my request.  There are always reasons for going in both directions.  Sometimes a person just can't do 4-5 hours because of work etc. and the run time needs to be less.  Sometimes without a longer run time the proper adequacy of dialysis can't be obtained.

I was lucky to have developed a good second fistula about 9-10 months after I started dialysis and was able to switch to it.  I had good flow rates and good kt/v at all times while using that fistula.

[angela515]

The whole time I was on dialysis, wether I had a perma cath or graft being used, i always ran 3 hours. Im only 5'0" tho, so... *shrug*