Itching

[jcanavera]

Patty just changed her therapy in the last two weeks.  Apparently her kidney function has gotten worse and her PD nurse informed us that we would need to change the therapy to add more fluid.  I protested saying that some final drains in the am were approaching 3,200 ml which is pretty uncomfortable for her.  They wanted to add 400 ml to her nightly fill and 300 ml more for her extraneal.  After protesting they said they would go back and rework the numbers.  Our new therapy now requires 3 6L bags (we were 2 6L bags and 1 2L).  We went from 80% tidal fill to 50% and from 8 to 18 cycles, all in the same 9 hour timeframe we used in the old program.  Needless to say our dwell cycles average about 14 minutes and we are pushing out a lot more fluid through her.  The good side is her UF has gone up and we no longer have to use the stronger fluids.  We are now using 2, 6L greens and 1, 6L yellow.  Prior we were 2 greens and 1, 2L red.  Starting tonight we are switching to 1, 6L green and 2, 6LY since we need to start to compensate for lower weight and blood pressure.

The side effect is that she seems to be itching and we are wondering if we are just dealing with the dryer weather of winter or whether pulling anywhere from 1 lb to a half a lb a day for the last 10 days might cause the itching.

Jack

[Rerun]

I know that high phosphorous can cause itching.  What do the labs show on phosphorous?

[jcanavera]

We get her labs drawn on Wednesday.  We usually hear back by Friday.  This will be her first labs after 2 weeks on her new therapy.  Thanks for the heads up!

Jack

[jcanavera]

FYI, her test came back and her phosphorus was high.  Too much cheese in her diet.  She cut back and her levels dropped.  Itching went away.

Jack

[codyedwardwilliams]

A common cause of itching is a high level of phosphorus in the body. Because dialysis doesn't effectively remove phosphorus, a renal diet that limits foods high in phosphorous is prescribed.