fluid overload

[brenda seal]

What causes fluid overload ? how can it be avoided in the future ?
 Laurie has been hospitalized for three days due to fluid over load , he had loads of fluid on his limbs and lungs which lead to severe breathing problems . The hospital did not really give a satisfactory explanation other than saying - because he had just started PD and then had to stop because of peritonitis , his body is confused - Well that makes two of us !

[MaryD]

I think my body would be confused if I had gone through what his has been through.

Is he being careful with his salt intake?

Right now my left ankle is looking like a balloon with little stubby toes sticking out of it.  We are having stinking hot weather here at the moment, and looking back, every time the temperature goes over 30 degrees and stays there for a few days my ankles disappear.  I'm going to ring the clinic on Monday and check.  The weirdest thing is whenever my ankles disappear, my weight drops.

I hope Laurie gets home very soon, and has the time needed to get settled on PD.

[boswife]

yep, fluid, and salt are usually the culprets.  Also when albumin is low that can cause easier seepage.  Dont know what the diatery stuff is on PD though.  For us on HH, it's protien protien protien!!! bla bla bla!!  lol  I 'think' that it's a bigger concern on PD as far as fluid overload as it's harder to get off?

[brenda seal]

Laurie is home , they got the fluid off by putting him on a cycler with red bags - 10 hours on and 4 hours off - they did this for 3 days and gave him lasix IV . Yes Mary it is strange but he has dropped over 6 kg in less than a week ! He is now down to 73 kg ( his working weight was 110 kg ) . He has nil appetite and has no salt other than what can't be avoided , we are also careful to stick to his fluid restriction - very hard in an Australian humid summer . I think he must still have some fluid on his lungs as breathing difficulties are still an issue especially when lying down . He sees kidney doctor tomorrow again .
 However bad things get , there is always someone worse off - the man in the bed opposite had a kidney removed a few years ago because of cancer and was in hospital this time as the cancer had come back in his remaining kidney and he had to have that removed also . It all was happening very quickly and neither he nor his wife knew anything about dialysis - all I could do was tell them about this site . He did not come back to the ward after the surgery as I am assuming he went to ICU . I can only hope things went well .
  It just made Laurie and I realise our situation is not the worst ! Imagine no kidney function at all !

[MaryD]

I'm glad to hear Laurie is home.

Boswife had a point I hadn't thought much about - albumin levels.  Mine is just outside the minimum desirable level.  I've been really pushing protein, but it seems that albumin levels change very slowly.   I'll keep pushing!

I think PD needs even more protein than HD.

Hope Laurie's appetite returns soon

[billybags]

brenda , I hope Laurie is feeling a lot better. Your appetite does seem to go out of the window when on PD, I get sick of throwing food away. Don't worry too much about it, food, little and often. My husbands weight has also dropped a lot in the last year. Fluid over load is awful and it will definitely make him breathless, it is awful to hear them gasping for breath.Hopefully they are sorting him out. Take care.

[tbarrett2533]

(I do CAPD and have for almsot 8 months)

in short really limit your fluid, one on Dialysis (according to my Neph) says that you shold only be drinking 30 ozs a day. 
if you are on PD and you can and want to (I do not suggest using it) but use REDS (4.25 solution) as this pulls the most off at one time.  I do not suggest (unless your doc says its ok) to use them back to back or use them every day, as it can wear out your membrane.

I have only used 4 red bags my entire 8 months on CAPD and will more than likely not use one again as all it did was give me cramps and make it worst for me.

if you cant handle the reds or dont want to use them then use all greens and see if that helps, limit your salt and anything that turns to liquid suck as ice, jello etc. 

good luck

[MaryD]

I'm told that in Australia, red bags are rarely used.  Baxter doesn't issue them to private homes.  The first time I had heard of them being used here was with Laurie while he was in hospital.

I understand that they are very hard on the peritoneum, and that frequent use of them will shorten the time that PD will work successfully.