Emory started in-center nocturnal last night

[rsudock]

Greg is spot on with his advice. Nocturnal means a lot more than dialysing at night so that you have your days free. In my view 3 x 8 hour sessions weekly still equal 24 hours of dialysis and whilst you might have free days and weekends on, you are still open to the problems Greg is outlining.
Nocturnal means at the least, 4 sessions weekly of 8 hours...that's the whole point...not only convenience but the better outcomes that only come with more hours and less gaps between sessions.

Please read up on the Tassin experience.

Zach should I google "Tassin experience"?

xo,
R

[Zach]

http://www.wple.net/nefrologia/nef_numery-2006/a-nefro-4-2006/141-146-charra.pdf

Long 3 x 8 hr dialysis: the Tassin experience
A long hemodialysis (HD), typically 3 x 8 hours/week, has been used without
significant modification in Tassin since over 35 years with satisfactory morbidity
and mortality outcome. It can be performed during the day or overnight. The
longer patients' survival than usually achieved by the more conventional shorter
dialysis sessions is mainly due to a lower cardiovascular mortality. This in
turn is mainly due to the control of blood pressure including drug-free hypertension
control and low incidence of intradialytic hypotension. This blood pressure
control is probably the result of the tight extracellular volume normalization
(dry weight achievement), although one cannot exclude the effect of other
factors such as serum phosphorus control, well achieved using long dialysis.
The high dose of small and, even more, of middle molecules, is another essential
virtue of long dialysis, leading to good nutrition, correction of anemia, control
of serum phosphate and potassium with low doses of medications and providing
a very cost-effective treatment. In 2006 one must aim at an optimal rather
than just adequate dialysis. Optimal dialysis needs to correct as perfectly as
possible each and every abnormality due to renal failure. It can be achieved
using longer (or more frequent) sessions. Overnight dialysis is the most logical
way of implementing long HD with the lowest possible hindrance on patient's
life. (NEPHROL. DIAL. POL. 2006, 10, 141-146)

more on the pdf site.

[noahvale]

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[rsudock]

I stopped peeing within a few months of going back on dialysis due to rejection.  As a general rule, though, the type of kidney disease is usually the determining factor in diminishing urine output once starting dialysis.  However, patients on manual peritoneal dialysis usually continue peeing for a longer time.  Probably has to do with the body doing the cleansing "naturally" through the peritoneum as opposed to having a machine (either hemo or PD cycler) doing the work.  If anything, more hemodialysis would work against increasing urine output (kidneys get "lazy" and let the machine do the work) so that shouldn't be a consideration for you going to nocturnal.

Noahvale,
 Your journey into nocturnal dialysis is very exciting to read!! I too have been doing incenter dialysis in thinking about switching to nocturnal if my living donor doesn't work out. Not to get personal but has your urine output changed since switching to nocternal? Since I have been on incenter D my urine output has been virtually none. I am hoping that if I switch to nocternal that it may increase...have you notice anything similar?

thanks

xo,
R

thanks for the quick response! I am just getting tired of the constant urge to pee all the time. If that would stop I think I may not mind dialysis so much. Maybe I need to have the non working transplanted kidney taken out?

xo,
R

[PatDowns]

thanks for the quick response! I am just getting tired of the constant urge to pee all the time. If that would stop I think I may not mind dialysis so much. Maybe I need to have the non working transplanted kidney taken out?

xo,
R

Notice you have PKD.  Were your native kidneys removed before your first transplant?  Was cyst formation the reason for function loss of your transplant? 

[noahvale]

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[rsudock]

thanks for the quick response! I am just getting tired of the constant urge to pee all the time. If that would stop I think I may not mind dialysis so much. Maybe I need to have the non working transplanted kidney taken out?

xo,
R

Notice you have PKD.  Were your native kidneys removed before your first transplant?  Was cyst formation the reason for function loss of your transplant? 

I still have my native kidneys. I assume that the cyst were what caused the kidneys to stop, but I have never been told point blank that.

[PatDowns]

I still have my native kidneys. I assume that the cyst were what caused the kidneys to stop, but I have never been told point blank that.

Noticed on a different board that your transplant date has been set.  Congratulations! 

I asked the question about the cysts to see if you were going to have a nephrectomy so they don't  leech onto the new kidney.  Is it the type of PKD you have or preference of your transplant center to leave the first transplant in?  Always thought cysts in PKD made the kidneys so huge and painful as well.

[noahvale]

**

[rsudock]

I still have my native kidneys. I assume that the cyst were what caused the kidneys to stop, but I have never been told point blank that.

Noticed on a different board that your transplant date has been set.  Congratulations! 

I asked the question about the cysts to see if you were going to have a nephrectomy so they don't  leech onto the new kidney.  Is it the type of PKD you have or preference of your transplant center to leave the first transplant in?  Always  thought cysts in PKD made the kidneys so huge and painful as well.

thanks for the well wishes Pat!

I am not going to have a nephrectomy b/c my native kidneys are not huge ....yet. I don't have the dominant PKD so that maybe why mine aren't huge. (someone correct me if I am wrong. I have tried to look up the data but no luck)  The transplant center wants to keep the first transplant in if it is not causing any problems. Guess it is a simpler surgery to put the kidney in a new place. Also it is easier for the patient as well. Less time under anesthesia.

I didn't know the cysts could leech onto the new kidney....weird!? Learn something new everyday.

xo,
R


ps-Noah so glad the program is going so well and you are happy! Sorry to hijack your post!

[noahvale]

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[noahvale]

**

[rsudock]

I still have my native kidneys. I assume that the cyst were what caused the kidneys to stop, but I have never been told point blank that.

Noticed on a different board that your transplant date has been set.  Congratulations! 

I asked the question about the cysts to see if you were going to have a nephrectomy so they don't  leech onto the new kidney.  Is it the type of PKD you have or preference of your transplant center to leave the first transplant in?  Always  thought cysts in PKD made the kidneys so huge and painful as well.

thanks for the well wishes Pat!

I am not going to have a nephrectomy b/c my native kidneys are not huge ....yet. I don't have the dominant PKD so that maybe why mine aren't huge. (someone correct me if I am wrong. I have tried to look up the data but no luck)  The transplant center wants to keep the first transplant in if it is not causing any problems. Guess it is a simpler surgery to put the kidney in a new place. Also it is easier for the patient as well. Less time under anesthesia.

I didn't know the cysts could leech onto the new kidney....weird!? Learn something new everyday.

xo,
R


ps-Noah so glad the program is going so well and you are happy! Sorry to hijack your post!

talked to the doc....autosomal recessive PKD the kidneys do not get huge (good news) but, the liver tends to have more problems. (bad news)

the cysts on the kidneys don't typical leech onto new kidneys b/c the cysts grow b/c their is a genetic abnormality within the kidney. When you transplant a new kidney that kidney is good to go b/c the genetic mutation would not exist in the new kidney.

Just wanted to clear up the info!

xo,
R