What Does A Low Sodium Level Mean? I'm confused!

[Cordelia]

My labs this month are fantastic!           My phosphorus, potassium, calcium is GREAT!

PTH levels I don't know yet but the nurse told me since my calcium levels were great, my PTH will be fine to. Freakin' finally!          I'm so  glad the taking of the calcitriol  daiy has worked!  I went from taking calcitriol 3 times weekly to every day and it seemed to do the trick. However, now my sodium levels are low. What the heck does that mean?            

My nurse told me that they may have to take more fluid off. I can't imagine having more fluid removed, I practically have roughly 2 kgs removed every time I'm there. She said something about possibly doing a BBM, she said. What's that mean? I didn't get a chance to ask what all this stuff meant before I left, I was expecting a ride home today and was kinda in a hurry to leave the unit.

If its a case of that I'm retaining fluid, I don't wanna go on any diuretics. They don't agree with me. I hope they just take off a bit more fluid and I'll hope and pray that I don't cramp!       
They take roughly 2 kgs off after a weekend and I only really gain 1-1.5 kgs in between. I dialyze tues, thurs and saturdays.

Basically in a nutshell, I don't 'gain' much fluid between treatments and I'm never, ever over when I come into the unit to be dialyzed. Plus, the nurses always rave how great my clearances are so I truly don't get it!!!!! I'm so confused!       

Can anyone shed light on this? Thanks in advance if anyone can.

[lmunchkin]

Lord, I don't know what the heck they are talking about.  Your sodium is low, and they want to remove more fluid?  What the heck is going on here.  High Sodium would make you drink alot of fluids, but I never heard of low sodium causing fluid overload.  I would question this more, Cord.  Either they misspoke or you misheard.

How have your BP's been?  If theyre real high, then yes, more fluid probably needs to be removed, but if low, then not.  Are you retaining fluid anywhere (legs, face ect....)?  Any edema at all in some places?

Don't know what BBM means unless it is that test for Body mass!  Heck, what do I know!  Ask more about it and get back with us, cause I sure don't know!

God Bless,
lmunchkin

[Cordelia]

I don't understand....I will have to ask more questions.    I didn't think I was retainin any fluid. I am very, very confused. 

           

[Whamo]

My understanding is that the body needs half a gram of sodium a day, minimum.  If you're low, you're low.  If you're low, perhaps it shows you're following a low sodium diet to the extreme. 

[Cordelia]

It's quite possible.    They took off more fluid today. My fistula obviously is clearing even better than my central line, so we'l see if that has anything to do with it too, that's what they advised.

[bsmith51]

Greetings,
When they are talking about sodium levels, they are referring to sodium concentration, e.g., mg/dl, not absolute quantities.  As a result,your sodium levels may be low as a result of your veins having extra fluid.  In other words, the sodium is being diluted by the water and showing as being low.  I think this is what the nurse is thinking when he/she is talking about removing more fluid.  Excess fluid can "hide" and not be seen as in swollen ankles or puffy eyes.  It is possible to have fluid around the lungs or heart without it being evident.
It sounds as if you are making progress in getting fluid off.  Keep challenging yourself by small amounts, stopping when you BEGIN to feel crampy or dizzy.  They should then back off a little on the goal.
Good luck,
Bruce

[lmunchkin]

Now that makes sense Bruce.  Water is mixing with sodium causing a low reading in sodium.

Cordelia, it is wonderful to hear your fistula is flowing much better!  That is a good sign my friend.

lmunchkin

[Cordelia]

Thank you for explaining,  bsmith. Like lmunchkin said, it makes sense now!    I guess perhaps I'm hiding fluid then somewhere in my body. They always check my ankles and I'm rarely swollen there, ever. Scary about the heart and lungs though although I never, ever have any breathing problems between treatments or otherwise so I'm doubtful that it could be on my lungs. 

Thanks about my fistula, lmunchkin.  So far so good. Its running smoothly, almost.........TOO smoothly for the beginning LOL     

[Cordelia]

So the nurse took a vial of my blood this am and shipped it off to the lab.

My sodium levels are pefect.     Because of the extra fluid removal the last couple of treatments, its fine now.   That's all they did, just adjusting taking off a bit more.     

[lmunchkin]

Cordelia, I know when J. was in center, he would get dissy or cramping and his BP would drop so low.  If that happens (either symptom) have them back off of UF.  9 times out of 10, you are at your dry weight, then you can just remove toxins and not so much fluids at that point!

So glad to hear the fluid is being removed and levels are much better.  Good job girl!

God Bless,
lmunchkin

[Cordelia]

LOL I cramped BAD yesterday. Both legs, in the shins. My legs today, 24 hrs later are still sore                  

It's just amazing how when your legs cramp how it can leave your legs feeling so sore and cruddy the next day!