Clotting. End session or new set up to finish session?

[swramsay]

I've had problems with clotting several times. I've had the catheter itself clot and replaced 3 times. Other times, the machine has clotted. When I was at Northwest Kidney in Auburn, WA they simply ended my dialysis session early each time when I had at least 2 hours to go - no choice. There was a week that I didn't have a full run for 7 days and then my catheter clotted requiring emergency replacement the next day. I felt AWFUL. When I moved to Davita, they offered me the choice of stopping or setting up again with a new dialyzer so I could finish. Of course I chose to continue with a new set-up. One of the nurses argued that "it wasn't worth it" but to me, every minute is worth it and whether or not it's worth it is my call, not theirs.

What do others do when they clot?

[Zach]

Perhaps you need more heparin.
Speak to your Nephrologist immediately.

Cutting dialysis with 2 hours to go makes absolutely no sense, if it's the filter that has clotted and not the catheter.
You are right, every minute does count.

[aharris2]

...One of the nurses argued that "it wasn't worth it" but to me, every minute is worth it and whether or not it's worth it is my call, not theirs.

What do others do when they clot?

Good for you! Every minute is indeed worth it. The dialysis staff doesn't like to do it because of the time involved in preparing again. With substantial time left or with multiple occurences it is without question worth it.

Now the question is why is it happening so frequently? This should be addressed.

[boxman55]

If I get cut short for whatever reason my unit offers me to come back the next day to finish my time. It is my choice to do that or not...Boxman

[swramsay]

I don't get any heparin because my platelets are too low. It remains a mystery. Although the heparin antibody tests have been negative, each time they start the heparin, my platelets drop. Something, somewhere is going on related to the dialysis because it all started when I began dialysis in September.  So far, no one has offered any possible reason for it other than ITP. I know it's somehow related to something in the dialysis equation.  I look every day for articles etc.

Instead of heparin, I get saline flushes every 30 minutes and citrate (?) blocks in my catheter after. They tried 15 minute flushes but that wasn't any better. I do worry a bit about this because I will begin training for home hemo shortly. I will need to contend with both clotting and low platelets. The good thing about home hemo I think is that the clotting usually happens after a couple of hours. My home hemo sessions may already be over by then. I just hope my needle sites will stop bleeding.

Thanks for responding. I'm new with lots of questions. I feel awful today like I have a huge, wierd-feeling, toxic lump in my throat. Ugh. I'd say acidic maybe? Definitely toxic. I wish I could hook myself up right now for dialysis. Instead I have to wait until late tomorrow afternoon. Ugh. 

[kitkatz]

If I only have less than an hour to go I will cut the time when I clot the dialyzer, otherwise the change it out for me and we continue on. It adds about a half and hour to my time each time, but I would rather get the blood clean than go around feeling awful.