weight gain & fluid

[rookiegirl]

Happy New Year All!

Since Thanksgiving my weight has been up and down by at least 5-6lbs.  I've been very concern about my blood pressure especially the bottom number.  It's been running over 90.  I can really tell I'm retaining lots of fluid.  I know the holiday foods is to blame.  I haven't been watching what I eat.  So for the last 5 days, I've been instructed to do an extra exchange from my normal 2 exchange per day.

I was really surprise when I use the 4.25% (4-6hrs) I ultra filtered 1100mls.  That is huge for me because I normally average about 500-700mls with the 4.25%.

The nurse wants me to use one 4.25% per day, but I thought using this is not good for your peritoneal membrane.  So I've been using two 2.5% instead.  I know it doesn't pull as hard as the 4.25% but I don't want to damage my peritoneal because of excessive use.

I'm on day 5 of the 3 exchanges and so far so good.  My weight is back to normal and my blood pressure is better.  I'm afraid to report tomorrow to my nurse because I know they will change my treatment.  I really like the 2 exchanges per day.

So now this brings me to being self-conscious about what I eat.  Everything has SALT in my book.  I get to the point that I just won't eat to avoid the salt or I will eat once a day.  I know this is really bad for me.  It's so hard to choose what to eat that is good for you.

Thanks,
Rookiegirl

[angela515]

I was on PD over a year and a half and used a 4.25% everynight, no problems with my peritoneal membrane, but everyone is different and everyone gets affected by different things differently.

I hope you will eat more than what you are, as you said, it isn't good to only eat one meal on purpose. Read labels... and fresh foods are always better than prepared foods when it comes to salt. However, being on a renal diet, you have to watch more than just salt, so basically it's just finding a balance and reading labels and getting down a routine in your meals and certain foods.

Good luck. 

[goofynina]

I had heard that also, about the 4.25% wearing out your membrane faster, and the neph and the nurse both said that wasnt true, so, i have been using a 4.25% everynight also (and knock on wood, no problems so far)  
I know how hard it is with the food having all the salt and all, but i find it helps if i dont eat as much salt in the evening meals (and not too late either)  i try not to eat anything 2-3 hours prior to hooking up, just so i dont have that full feeling before starting and i think i get better drains as well.  Good luck to you and keep us posted. 

[KT0930]

I'm with ya on the salt. I can control everything else pretty easily, but my husband and I both work full-time and our son is in all kinds of activities, so before dialysis, we used a lot of processed/prepared stuff. (I also LOVE my corn chips and salsa!!). Ok, sorry, back on topic. Like goofynina, I try to keep the majority of my salt intake between breakfast and lunch times. I also don't ADD salt to anything. I mean NOTHING.

I had heard that about the 4.25%, but since I generally only use 1.5%, I never asked. However, if you're not doing what you're supposed to be doing when you're doing PD, they'll put you on hemo because the PD can't do it's job if you won't follow the prescription. Don't withhold the 4.25% just because your peritoneum *might* wear out. They'll play the non-compliance card in a heartbeat.

[KICKSTART]

I've been doing PD for over 3 yrs and never been on 4.25. One thing i did notice you said ...2 exchanges per day ??Is that right ? I thought EVERYONE was on 4 exchanges per day ? This is probably why you are retaining fluid , i would think you are arbsorbing most of it back if you are only doing 2 exchanges ? You would be better with 4 lesser strength exchanges to get that fluid off.

[Ken Shelmerdine]

I've been doing PD for over 3 yrs and never been on 4.25. One thing i did notice you said ...2 exchanges per day ??Is that right ? I thought EVERYONE was on 4 exchanges per day ? This is probably why you are retaining fluid , i would think you are arbsorbing most of it back if you are only doing 2 exchanges ? You would be better with 4 lesser strength exchanges to get that fluid off.

I thought that the stronger the fluid the slower you absorb it so you can have longer dwells with strong fluid. Is this correct?

[angela515]

I've been doing PD for over 3 yrs and never been on 4.25. One thing i did notice you said ...2 exchanges per day ??Is that right ? I thought EVERYONE was on 4 exchanges per day ? This is probably why you are retaining fluid , i would think you are arbsorbing most of it back if you are only doing 2 exchanges ? You would be better with 4 lesser strength exchanges to get that fluid off.

I thought that the stronger the fluid the slower you absorb it so you can have longer dwells with strong fluid. Is this correct?

No, this is not correct. The stronger the fluid the more you pull off, doesn't mean you can dwell longer and absorb any less. To dwell longer and absorb less they have out there another type of fluid to dwell with, I forgot the name but someone will post it as it's in other threads. 

[KT0930]

The fluid you're thinking of is called Icodextrin and is a Baxter product. You can't get it if you're on Fresenius.

[KICKSTART]

The Baxter one is called extraneal  and i am on it ! You use it for overnight dwells because you can leave it in alot longer, but while it is supposed to pull of the fluid it does NOT remove any toxins ! I still cant understand why you are only doing 2 exchanges per day tho'?

[rookiegirl]

The Baxter one is called extraneal  and i am on it ! You use it for overnight dwells because you can leave it in alot longer, but while it is supposed to pull of the fluid it does NOT remove any toxins ! I still cant understand why you are only doing 2 exchanges per day tho'?

Weird I know, but this is what my Dr. prescribed.  When I decided to do CAPD, I started with 4 exchanges/day.  This cause my blood pressure to be too low.  So, he adjusted my Meds and reduced my exchanges to 2.  I use 2.5% at night for 8-10hrs.  When I wake up I use 7.5% Icodextrin which dwells up to 18hrs.

I have been instructed to do a 3rd exchange when needed.  Especially if my weight or blood pressure is up.

For the last 6-7 days, I'm back to my regular 2 exchages/day.  My blood pressure and dry weight is were it should be.  I really think it was the bad eating I did during the Holidays.

[goofynina]

I'm glad they got the prescription you needed down and what works for you best    Thank goodness the holidays are over, now we can all start our resolutions on eating healthy (yah right)

[KT0930]

I'm glad they got the prescription you needed down and what works for you best    Thank goodness the holidays are over, now we can all start our resolutions on eating healthy (yah right)

Eating "healthy" or following the dialysis diet? They're pretty much mutually exclusive, I believe. 

[KICKSTART]

Wow you are lucky .. 2 exchanges a day !!!

[rookiegirl]

Wow you are lucky .. 2 exchanges a day !!!

It's wonderful, I know .  I'm loving every moment of it.  Eventually as the time goes by, they will most likely change my prescription.  Especially once I start to loose my urine output.  Until then, I'm thankful for the 2 exchanges/day.