Tell me about Number One

[Bajanne]

Does every dialysis patient at some point stop urinating?  What are the pros and cons of this?  I hear urine (or lack of it) being mentioned some times.  Is not urinating good or bad?  Does it have to happen?

[LifeOnHold]

The last time I took a whiz was in 1992   

In most patients, urine output rapidly decreases once they start dialysis-- within the first year, most people stop urinating completely.

The pros:  Not needing bathroom breaks as much as everyone else, and dehydration risk is greatly decreased.

The cons:  You can't excrete fluids and toxins through urine anymore, so whatever you drink stays in you until you get dialysis.  Also, some medications can build up to a toxic level in non-urinating dialysis patients.  Phosphorus, potassium and magnesium also can build up to dangerous levels.  Thirst can never be totally satisfied without exceeding your fluid restriction.


Technically, dialysis is a big communal bathroom where we all pee through machines. (I'm sure that will run through your mind at your next treatment!)   

[Rerun]

Hummm - never though of dialysis that way, but it is the truth. 

I was on a colostomy for about 6 months too.  You can pee and poop through medical technology and still live. 

[LifeOnHold]

Rerun, I'll bet I know what the neighborhood kids were saying that Halloween in your neighborhood-- "Hey, whatever you do, don't knock on that lady's door!  You won't BELIEVE what's in the bags she's handing out!"       

[Jamie]

Dear fellow renal readers,


  What I have notcied in the last 20 years is most people do stop peeing after being on dialysis. This is a big bummer because if you could "Pee" you would not have to watch your fluid gains. Sorry gang for bringing up this horable subject again (fluid gain).........Jamie-G

[Bajanne]

I would like some feedback on this subject.  I am still peeing, though not as much as I used to. 
At what point into dialysis does one stop?
Does the type of dialysis (HD or PD, etc.) make a difference?
If you stop totally and then get a transplant, do you start back (just curious)?

[angieskidney]

I would like some feedback on this subject.  I am still peeing, though not as much as I used to. 
At what point into dialysis does one stop?
Does the type of dialysis (HD or PD, etc.) make a difference?
If you stop totally and then get a transplant, do you start back (just curious)?

Of course you start peeing again once you get a transplant. I mean .. if you think about it logically .. the only reason you stop peeing has NOTHING to do with the type of dialysis but just because kidneys stop working. If the kidneys stop working then there is no way they can produce urine that goes from the kidneys into the bladder and out the body.  Once you get a transplant .. this function works and that is honestly how the surgeon will know that the kidney is working.

When I had my kidney transplant back in 1990 the nurses were running all over the children's renal ward of my Toronto Hospital of Sick Kids yelling, "She peed!! She peed!! Right on the table!! The transplant was a success!!"

It is a very exciting time but embarrassing at the same time to the patient as peeing is not normally a thing you want announced if you did it right on the table during surgey .. 



Actually, no question is a dumb one .. so here is mine: When you get a transplant and start peeing again (keep in mind that I didn't have my 2nd kidney removed until I got my transplant so I never stopped peeing before my transplant. This time around is the only time I stopped peeing and it was after 2 years of PD .. I stopped slowly .. for awhile there it was just peeing once a week .. and then .. never..) do you tend to "leak"? I ask this because I know without having the ability to pee you are not using those muscles to hold "it" in anymore. Do the muscles get weak? Does the patient tend to "leak" accidently? Does the bladder shrink at all from non-use? Does the patient pee more often if so??

[Oc]

Six months into hemo, still peeing at about quarter of normal.  Maybe a bit less.

I'll take it while I can get it.  The ability to increase my fluid intake to compensate is a wonderful little side effect.

[Jill D.]

I've been on HD for about 5 months. I have about 5% function and I have not noticed a decrease in peeing yet. Hopefully things will keep "flowing" until my transplant in Dec.! 

[Mike]

Hi,

I was lucky I never stopped peeing all the time on dialysis and wasn't on a fluid restriction at all. I was on PD for 14 months which I was told preserves you residual function better than hemo as it is constant so takes the pressure off your kidneys. I actually have more problems now with fluid retention post transplant than before  mainly due to the drugs.

Mike

[RichardMEL]

My experience with this regard was actually quite good (so far).

Prior to starting I was bugged ALL NIGHT for about 6 or so months by being bugged by my blatter to get up almost on the clock every 2 hours to go. This lead to horrible nights with next to no sleep (and you don't even want to imagine how it sucked if I had anyone over or i was at someone else's place....

Anyway as soon as I started dialysis (hemo) the volume decreased a heap as others have noted, but I got my sleep back!!! Now I can sleep 7-8 hours a night comfortably.. if there are any positives to dialysis (apart from living, of course) this, for me, has been the single biggest change that is good!!

I am thankful that I am still able to pass urine because it means that bit extra I can drink. Last time I measured it (how sad!) it was about 400ml in a day, but really I think that might be on the higher side of the average. I have pushed it a bit to make my daily fluid limit about 1 litre/day and it seems to work reasonably well as I usually can fit in under 2kg gain between regular sessions. The nurses seem to think between 2-3 is ok too.. I guess it all relates to how much you can handle being taken off, and I only seem to have had problems with cramp/crashes etc when it gets over 3.5 to take off.. so I now know pretty much my limits there.

I hope I don't urinate less...  but reading this it seems like it will be more likely than not.

[Rerun]

I've been told I can gain 3-5% of my body weight.  That is a huge difference 1.4kg - 2.37kg hhhhmmmm I'll take the 5% gain.

[angela515]

When i was on hemo for 7 months in 1999, I didnt pee at all. When I  had my transplant, I pee'd right when they hooked up my kidney before they even got a chane to close me up...    I pee'd normally again and it was great, I couldn't even hardly drink all the fluid I was supposed to as it filled me up    Then in 2004 when my transplant failed I slowly started peeing less, and now i'm on PD I pee usually every morning and sometimes one more time in the afternoon... however, its a few drops each time.. not even enough to do a urine collection for my monthly doctor visits....  Good thing is dont have to mis nothing due to going potty.. bad thing, not being abl to drink how much I want... 

[Bajanne]

I have not yet stopped totally, but it is much reduced.

[okarol]

I know this subject has been discussed alot, but I cannot find the answer I am looking for.
Which is it? Is the urination declining because the dialysis is successfuly removing excess fluid?
Or is the kidney failure causing less fluid to be processed and it gets backed up in the body?
I know they are related, so I am not sure I am even asking the right question.
I know people can continue to urinate while on dialysis. But I am confused about why it stops.
The kidneys were already failed when dialysis began, so if it was a matter of them not passing
the fluid through, why would you still be able to produce urine?

[jbeany]

In my case, different kidney functions have been failing at different rates. My ability to produce natural epogen stopped over a decade ago.  My kidneys ability to clear toxins has been in a gradual decline for even longer than that, and have now reached the point where I need to start dialysis.  Up until a year ago, phosphates and potassium levels weren't a problem either.  My kidneys ability to clear fluid from my body hasn't changed yet.  So I'm not retaining fluid even though I still drink just as much water as I ever did.  I'm hoping I can hold onto that last bit of function quite a bit longer - it will mean minimal or no fluid restrictions as long as it continues.

[Jill D.]

Like you, jbeany, I continued to make a fair amount of urine, but my kidney's ability to filter out the toxins became the issue of why I needed to start dialysis. I wonder if it depends on the cause of one's kidney failure?

[jbeany]

I don't know, Jill.  Mine was juv. diabetes.  But all the docs told me that my failure to make epo when my function for the rest was still above 25% was very unusual.  They also said my kidney pain wasn't supposed to happen at all, and they had never heard of any kidney failure patient having something like it.  However, when I posted on here about it, several members had similar symptoms, even if they weren't nearly as severe.  So who says the docs know much of anything at all?! 

[Ken Shelmerdine]

I know this subject has been discussed alot, but I cannot find the answer I am looking for.
Which is it? Is the urination declining because the dialysis is successfuly removing excess fluid?
Or is the kidney failure causing less fluid to be processed and it gets backed up in the body?
I know they are related, so I am not sure I am even asking the right question.
I know people can continue to urinate while on dialysis. But I am confused about why it stops.
The kidneys were already failed when dialysis began, so if it was a matter of them not passing
the fluid through, why would you still be able to produce urine?

Hi Carol,
         This is something that I can't seem to get a straight answer to from any my renal docs. They say that with PD for instance, residual function continues and that PD does not accelerate the rate of natural diminishing output. Then in the next breath they tell you that after you begin dialysis  urine output will gradually cease as if dialysis is a factor which completely contradicts the first statement. The truth is that I don't think they really know. To sum it all up, the unanswered questions are these; does the dialysis process get to the fluid first before any natural function has had the chance, and if so, why doesn't it stop natural output from day 1, or, do the kidney's override dialysis for a time and then it swaps and dialysis overides kidney function and what are the factors governing when this starts to happen? And, finally a hypothetical question, If you gave dialysis to a person with normal functioning kidneys, would his/her kidneys stop functioning eventually?

[RichardMEL]

Sadly my urine output has gone right down. About a month or so after I started dialysis I measured urine over a 24 hour period and put out about 400ml of it. Just now I completed an "IntraDialysis" urine test (basically all of the urine between two sessions, discarding the first) and in around 36 hours I think I only produced around 200ml - 300ml at the most.

Some days I feel like I put out more than that, but lately it has seemed less.. I guess dialysis has kicked in.

I guess I need to rejig my daily allowence of fluide... down

[Bajanne]

In a little chat with my dietitian and a nurse in the centre the other day, they suggested that I record my urine output. In a twenty-four hour period (from 6 a.m.) my output was just about 250 ml.

[goofynina]

In a little chat with my dietitian and a nurse in the centre the other day, they suggested that I record my urine output. In a twenty-four hour period (from 6 a.m.) my output was just about 250 ml.

Can i borrow some of that?? lol, ew,   i am lucky if i get that in a weeks time 

[Fox_nc]

At last check I was at 1200, but I have a feeling I may need to check again soon...

[twirl]

hey, my doc told me my urine flow would decrease after starting dialysis
during my first months I had to get off the machine and go pee pee
then suddenly, I noticed I did not urinate as much
I noticed it also the teacher's restroom
some teacher's "peed a river"
I miss it
I still do some urine and I thank God each time
sounds crazy; I know
I call urine     liquid gold   twirl

[okarol]

When Jenna was in-center and they'd give everyone those big red jugs to fill in a 24 hour period, she was the only one who had much volume. You think they'd have a smaller container for dialysis patients.