Creatine Increasing On Dialysis?

[Veilus]

Its been about three years  and i apologized for not posting, i have been doing well on pd. So my creatine is going up and was wondering why? does this mean dialysis is not working 100% as it used to?
The doctor mentioned i may need to do hemodialysis in the future so i had a couple of questions?

Would it be wised to get a fistula now? so if i did get a transplant in the near future it could come in handy? i really don't want one in the chest again for temporary access after the operation.

Am i allowed to do weight lifting before a fistula or is it a bad idea?

The reason i ask is that i have 3 months before i see my specialist and ill probably forget by then lol.

Thanks for your input.

[noahvale]

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[RichardMEL]

Re the creatanine going up - this all really depends on when you are taking your blood. Usually (at least for hemo) patients have their blood taken PRIOR to dialysis - this gives you an idea of the "worst" case your body is inbefore being cleaned and it's usually done in the "mniddle" of the dialysis week, so you're not doing it after a weekend. So, if you (on pd) are similar, the creat going up is no real cause for concern I should think because all it means is that there are more toxins going around - this could be caused by increased diet, or exercise (specially exercise - and you mentioned weight lifting). since creat is a product of muscle wastage(or something like that) exercise definitely affects it.

Anyway once starting D creatanine isn't so important - but if it is what is important is that how clean you are after dialysis - ie the clearance, or Kt/V.

As for weight lifting BEFORE fistula - that's fine - it's after that will be the issue as you really should not lift weights of any real kind (and that includes shopping etc!) with your fistula arm. Some lifting before hand may actually help to strengthen the veins a bit (but don't quote me - I'm not a doctor!).

Has the neph pegged an issue with your creatanine as being something to be concerned about or is this your worry?

[Henry P Snicklesnorter]

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[Veilus]

Thanks for all the replies, the doctor showed me a graph and it showed my level increasing over the 6-12 months. I have been doing the same dialysis treatment. When i first started it was lower than what it is now.

I shall talk to my doctor more when i see him next

[RichardMEL]

Thanks Henry. I fully admit I've never done PD and don't really know as much as I should about it so I should not put up an opinion when I don't really know lol.

[Veilus]

Another question, if i got a fistula now, how long do they last for? Can you always get another one? Do you still have to exercise them when you had a transplant? im 21 now so i hope it lasts a good while.

[PatDowns]

Another question, if i got a fistula now, how long do they last for? Can you always get another one? Do you still have to exercise them when you had a transplant? im 21 now so i hope it lasts a good while.

Short answer....fistulas can last many years and if they become problematic, revisions and other interventions will be tried before creating another one.   At your age and with no other disease affecting your vascular system like diabetes, a fistula can last quite a while.

No, you do not continue exercising the fistula after a transplant, especially if all is going well and dialysis is no longer a consideration. 

Yet, there are many factors that go into ensuring a long lasting fistula.  First  is the skill and commitment of the vascular surgeon in establishing the best possible fistula given your vein anatomy.  How well you build it up from post surgery to usage plays a role.  However, the most important components will be the protocol on how to stick it (buttonhole vs ladder techniques) and on who the cannulator will be. 

Seems most experts, selfcare dialysis trainers and staff, (and patients) now believe buttonhole technique for cannulation is the ideal way to go.  There are numerous threads on IHD about this topic so please search around for more info.

Generally speaking, fistulas last longer with fewer complication when patients stick themeselves as opposed to relying on staff members.  No one will know your arm better than you.  Again, more threads on this topic elsewhere on IHD.

Post transplant - In many cases the fistulas clot off on their own over time because hemoglobin levels go back to within normal range.  Also, those with large fistulas that have developed over the years, might experience complications and will need to have the fistulas surgically closed off.