Red Bag PD

[Whamo]

Does anyone use red bags very often?  I used one last night, and I liked it.  My nurse said they make some people cramp.

[Rerun]

Does it pull more fluid or what?

[Grumpy-1]

YES the red bags will pull off about twice the fluid as a green bag.  It goes in this order Yellow bag about 100 - 200 ml  green bag about 200-400 ml and red bag about 400-800ml.   Now the amount pulled is more dependant on the person and the amount of fluid to begin with but those numbers are just indicators.  Grumpy

[Joe]

I use a red occasionally. Typically when I think I'm not getting the fluid off I need. My Neph told me periodic usage wasn't a big deal, but not to use them often as they are much harder on the peritoneal lining than the others. And once that's gone, we're over to hemo.

[tito]

I have been cautioned against using red bags too often - apparently they wear out the peritoneum more rapidly. I can count on one hand the number of red bags I've used in my three and a half years of PD.

[amanda100wilson]

they do wear out the peritoneum.  kudos to you, Tito that you have used so few, but the peritoneum  does stop working so well over time and once residual function is lost, reliance for fluid removal falls completely to dialysis and the need for red bags increases.  I was on Pd for about nine years and over time my useage of red bags increased.  it is not a failure to use red bags, it's just the way it is.  however, their useage should be kep to a minimum.  my useage over time went
from yellowyellow
to yellow/green and yellow/ yellow on alternate days,
to yellow/green
to green/green
to green/red and green/green on alternate days
to green/red
to predominantly red
there were obviously variations within this,but this is how it changed over the nine years.

[Willis]

I use Red/Green 3 or 4 times per month if my BP goes up too much or if I seem to be retaining a lot of fluid. Normally I use Green/Green. I don't use Yellows because I just absorb most of the fluid from Yellows and have poor UF numbers. I made the mistake of using Red/Red only once and my UF was over 3000 with morning BP something like 80/50. That's another danger of using Reds: taking off too much fluid and/or low BP.

 

[Whamo]

That's good advice.  Thanks gang.

[Lillupie]

they do wear out the peritoneum.  kudos to you, Tito that you have used so few, but the peritoneum  does stop working so well over time and once residual function is lost, reliance for fluid removal falls completely to dialysis and the need for red bags increases.  I was on Pd for about nine years and over time my useage of red bags increased.  it is not a failure to use red bags, it's just the way it is.  however, their useage should be kep to a minimum.  my useage over time went
from yellowyellow
to yellow/green and yellow/ yellow on alternate days,
to yellow/green
to green/green
to green/red and green/green on alternate days
to green/red
to predominantly red
there were obviously variations within this,but this is how it changed over the nine years.

Did you ever use the purple ones?
 How long after you used the red ones was it time for hemo?
Lisa

[blondie1746]

Lillie, I used reds and purples when I was having fluid retention and absorption.  I am a rapid transporter, so I when I was doing manual PD, I used purple for overnight.  Once I got on the cycler, I used reds overnight and last fill was a purple for an all-day dwell.  Right after my stem cell transplant I was able to use yellows for a while, but eventually moved up to green.  I have used an occassional red for fluids, but haven't in the past 2-3 months.  Still can't use yellow, I get low drain alarms, etc.  So, I'm a green gal!  Glad I can stay away from the reds for now, to preserve my membrane.  And I am getting good clearance, so I am dry during the day now.  No more purples, at least for now.

[Ricksters]

I use green/green on the cycler, with a purple (extraneal) for the long daytime dwell.  I am a rapid transporter, and this has finally stopped the problem is was hacing with absorbing too much fuid during the day.  I have only had to use a red bag twice in the months that I have been using the purple bags.

Ricki

[MaryD]

The purple bags are completely different to the yellow, green or red bags.  The yellow, green and red bags are basically glucose-based fluids.  The purple bags are dextrose based.  The dextrose molecules are bigger than the glucose molecules and therefore don't cross the peritoneum as easily as the glucose molecules and are therefore more suitable for longer dwells as all the 'stuff' doesn't get reabsorbed as fast.

(Probably described using the wrong words, but that is basically how the difference was explained to me)

[Willis]

The purple bags are completely different to the yellow, green or red bags.  The yellow, green and red bags are basically glucose-based fluids.  The purple bags are dextrose based.  The dextrose molecules are bigger than the glucose molecules and therefore don't cross the peritoneum as easily as the glucose molecules and are therefore more suitable for longer dwells as all the 'stuff' doesn't get reabsorbed as fast.

(Probably described using the wrong words, but that is basically how the difference was explained to me)

I think at least for Baxter these are called "Extraneal." I do a day fill and when I mentioned using Extraneal for that my neph looked like she'd been slapped. I'm guessing that Extraneal costs a lot more than the "regular" stuff and with the new Medicare bundle payment system that the extra cost would come out of the doctor's own pocket. 

 

[MaryD]

I actually asked about the difference in cost between the extraneal and the others.  In Australia, the extraneal costs just under twice as much as the others, but seeing you use them for twice as long they should work out as approximately the same.

[Ricksters]

Yes, the extraneal (purple bags) are for the long daytime dwells.  I had no problem with my neph & Baxter approval...all I can say it is a blessing for me as it stopped the weight gain I was having from the regualr bags during the day!  And it was exlained to me that the molecules in the maltrose are too large to be absorbed like the othr fluids.

Ricki

[amanda100wilson]

Lillupie, I used Extraneal (the purple ones)  during the long day dwell.  I the transition across the different bags was over an eight year period.  the reds started to need to be used once I lost my residual function over a four year period until I switched to HD.  by the end of my time on PD I felt like I was dying a slow death (even though my Kt/v was fine!

[Whamo]

Does anyone ever use red/yellow bags?  It seems like most of the second bag doesn't get used anyways during my three dwells.  I use the Baxter Homechoice Pro.  My flow chart shows I take off a little over 2300 with a red/green combination and 1200 with green/green.  I've never used a yellow bag, and I have, like, five of them, and they've been sitting there for a couple of months.  My PD nurse confirms the red bags are harder on your system, but she's only seen one person wear them out during her entire career.  And that guy was on PD for 15 years before it happened.

[jeannea]

I've tried red/yellow but I thought green/green worked better than that. If I really needed red I used red/green.

[Joe]

I typically use green/yellow on my cycler. Total UF with that combination is in the 1500 - 1800 range. Occasionally I use a 2L red for my manual fill in the afternoon to kick start my system. I do this when I've noticed that I'm not draining as well as usual. When I do that, I typically get a UF somewhere in the 22-2500 range.

[Ricksters]

Haven't had to use a red bag since I started using the etraneal for my long daytime dwell.  When I did, it was a red bag on the cycler, green for the 2nd bag.  My PD nurse and neph always stressed to use the red bag first.  I have never used a yellow bag, as my body loves to hold onto all its fluid so I always have fluid to remove in addition to toxins.


Ricki

[Lexxtech18]

When I was on PD, I used reds at least twice a week. But my body was bad with re-absorbing the fluid I would hold through the day, so I usually had no choice but to use reds. My PD nurse said it's not good for your body to use them too often, though.

[amanda100wilson]

I used to vary which bag was on the cycles depending on how much fluid I wanted to take off when using reds and green together.  If I wanted to take off more I would put red on first, if less, the green.  After the first fill, there is a dilution effect on strength if using green to refill a red back, or the converse if a red is filling a green starter bag.

[M3Riddler]

Does anyone use red bags very often?  I used one last night, and I liked it.  My nurse said they make some people cramp.

Whamo,

You want to try to limit the red bags ( 4.25%) as the more you use, the more it can wear out your peritoneal cavity over time.  I wish I would have known this when I was on Pd over 8 years ago.  I was on PD for approx 13 years.  The reds have a higher dextrose solution and it is harder on the peritoneal cavity than the lower concentration of dialysate..

[MaryD]

Don't the yellow, green and red bags have a glucose solution?  Extraneal has the dextrose solution which is supposed to be used for long dwells as it doesn't damage the peritoneum??

[Joe]

All of my 1.5, 2.5 and 4.25 bags are Dextrose solutions. And I did just go in and look to double check.