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Author Topic: What determines (BLP) at the end of session w/NxStage?  (Read 8089 times)
lmunchkin
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"There Is No Place Like Home!"

« on: May 19, 2011, 07:53:01 PM »

How is the BLP derived at the end of dialysis. Is there a formula to it or what?  I have asked the nurse at the clinic, but he is "all over the map" when trying to explain it to this dummy.  Can anyone explain it to me in layman's terms please!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!   :waiting;    :stressed;

lmunchkin       :flower;
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11/2004 Hubby diag. ESRD, Diabeties, Vascular Disease & High BP
12/2004 to 6/2009 Home PD
6/2009 Peritonitis , PD Cath removed
7/2009 Hemo Dialysis In-Center
2/2010 BKA rt leg & lt foot (all toes) amputated
6/2010 to present.  NxStage at home
greg10
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« Reply #1 on: May 20, 2011, 04:47:31 AM »

How is the BLP derived at the end of dialysis. Is there a formula to it or what?  I have asked the nurse at the clinic, but he is "all over the map" when trying to explain it to this dummy.  Can anyone explain it to me in layman's terms please!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!   ..
BLP: blood liters processed.
BLP = BFR (blood flow rate/min) * Tx duration (min)
Assuming you have a high blood flow rate of 500 ml/min (don't run at 500 ml/min, it may be too high for most patients) and your treatment is 3 hours (180min) then the
BLP = 500ml/min x 180min = 90 Liters
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Newbie caretaker, so I may not know what I am talking about :)
Caretaker for my elderly father who has his first and current graft in March, 2010.
Previously in-center hemodialysis in national chain, now doing NxStage home dialysis training.
End of September 2010: after twelve days of training, we were asked to start dialyzing on our own at home, reluctantly, we agreed.
If you are on HD, did you know that Rapid fluid removal (UF = ultrafiltration) during dialysis is associated with cardiovascular morbidity?  http://ihatedialysis.com/forum/index.php?topic=20596
We follow a modified version: UF limit = (weight in kg)  *  10 ml/kg/hr * (130 - age)/100

How do you know you are getting sufficient hemodialysis?  Know your HDP!  Scribner, B. H. and D. G. Oreopoulos (2002). "The Hemodialysis Product (HDP): A Better Index of Dialysis Adequacy than Kt/V." Dialysis & Transplantation 31(1).   http://www.therenalnetwork.org/qi/resources/HDP.pdf
lmunchkin
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« Reply #2 on: May 20, 2011, 04:23:26 PM »

That is exactly what I was wanting to know.  I would notice my BLP would be different everytime, I didn't understand why and asked the nurse.  He told me that tells how many liters of blood went through the machine  in the time of treatment.  He was right, but I don't know if he knew how it determined that figure. You know what I'm saying? He may have but just didn't know how to explain it to me. Thanks sooooo much Greg.

Also, I was trying to figure it in hours and not minutes! Makes much more sense in minutes, DAH!!!! I knew someone with IHD would have my answer!  I love reading your posts too, cause I learn alot from the info you post!!

Again thanks, Greg,
lmunchkin     :cheer:
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11/2004 Hubby diag. ESRD, Diabeties, Vascular Disease & High BP
12/2004 to 6/2009 Home PD
6/2009 Peritonitis , PD Cath removed
7/2009 Hemo Dialysis In-Center
2/2010 BKA rt leg & lt foot (all toes) amputated
6/2010 to present.  NxStage at home
Zog
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« Reply #3 on: May 20, 2011, 09:05:53 PM »

I made a nifty spreadsheet to try to figure these numbers out.

If you have a mathmagical person around they may be able to use it (and maybe improve it).

It works most of the time.  There are some values you can enter that will cause it to do crazy things (negative numbers, really low flow rates).  It incorrectly assumes you instantly raise your DFR when you finish UF (yellow 5) and start treatment running at top speed.

https://spreadsheets.google.com/spreadsheet/ccc?key=0AiEa8NMba3u9dFF5WnhjQ3J3OGo1OGxtMDAyemZYVXc&hl=en_US

You have to download it to play with it.  I hope to make an easy to fill out online form someday if I ever figure out how to do that.
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My wife is JDHartzog. In 1994 she lost her kidneys to complications from congenital VUR.
1994 Hydronephrosis, Double Nephrectomy, PD
1994 1st Transplant
1996 PD
1997 2nd Transplant
1999 In Center Hemo
2004 3rd Transplant
2007 Home Hemo with NxStage
2008 Gave birth to our daughter (the first NxStage baby?)
natnnnat
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« Reply #4 on: June 09, 2011, 10:57:40 PM »

Zog, you probably already played with the forms supported by GoogleDocs?
When you look at your spreadsheet, there should be a "forms" tab along the top, near the RHS end, near Tools and Help?

Or you might need to start again by going File > New > Forms...

Not sure though, if you can make a form that will calculate and display a number based on the fields you fill out... maybe? I think not...
But you can use it as a cute "data entry" form, that's for sure.

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Natalya – Sydney, Australia
wife of Gregory, who is the kidney patient: 
1986: kidney failure at 19 years old, cause unknown
PD for a year, in-centre haemo for 4 years
Transplant 1 lasted 21 years (Lucy: 1991 - 2012), failed due to Transplant glomerulopathy
5 weeks Haemo 2012
Transplant 2 (Maggie) installed Feb 13, 2013, returned to work June 17, 2013 average crea was 130, now is 140.
Infections in June / July, hospital 1-4 Aug for infections.

Over the years:  skin cancer; thyroidectomy, pneumonia; CMV; BK; 14 surgeries
Generally glossy and happy.

2009 - 2013 PhD research student : How people make sense of renal failure in online discussion boards
Submitted February 2013 :: Graduated Sep 2013.   http://godbold.name/experiencingdialysis/
Heartfelt thanks to IHD, KK and ADB for your generosity and support.
Simon Dog
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« Reply #5 on: July 18, 2015, 08:53:29 AM »

BLP can vary a bit because of alarms.   When you recover from an alarm, the blood pump slowly revs up to speed, and you also add a small amount of time (a minute or two per alarm) to your treatment.   This can effect the total BLP.

If you want to really understand the math of your machine, learn how to calculate the maximum dialysate pump speed for a given blood flow rate and flow fraction.    If you can do that, you pretty much understand the interaction of fluid flows.
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