New Member with a Question

[WillieWundt]

Greetings,
 
I look forward to joining in with this group. I have had polycystic kidney disease which first was diagnosed in my early 30s. Finally when I reached the age of 70 it had worsened to the point where I needed to go on dialysis. Fortunately I was a candidate for home hemodialysis with NextStage. With the dedicated partnership of my spouse I began training for home hemo in March of this year and by May we were sufficiently proficient to have everything set up at our home. Since then I have acquired a Stage 2 dialysis machine and I dialyze 4 days a week for about 4 hours each day.

Things were going well with only minimal difficulties until about 2 weeks ago.

I'd like to find out if anyone has had a similar experience to the one I am about to describe. Except for the dialysis, I have been relatively healthy. Some high blood pressure (which seems to go away with the dialysis), and I also take a statin drug and sleep with a CPAP for 20 years.

About two weeks ago I began to get an irregular heartbeat during dialysis. It lasted while I was on dialysis and sometimes my blood pressure dropped to 100/50 and my heart rate went down to 48BPM. I was very anxious about this and quite frightened although I had no other symptoms such as light headedness, sweating or the feelings of palpitations. It was like my heart was a car engine that was trying to start on a cold morning. When I ended dialysis, after about six hours my heart rate returned to normal.

My nephrologist advised me to stop taking atenolol (which was the only medications I was taking foe HBP). The irregular heart beats continued, but my BP and HR were maintained at a fairly normal level. I now seem to be getting an irregular heart beat almost all the time during the day and at night but with no other symptoms. I went to see a cardiologist and I have full day heart monitor and an echocardiogram scheduled shortly.

I don't know whether the irregular heart rate is due to the dialysate, or my age or some other heart condition (which I have never had).     

Has anyone had any similar experience and what was the outcome?

I really do look forward to being a part of this discussion. It has been tremendously useful for me to read many posts and the help and advice that comes from real people who have been through the dialysis political ringer has been both informative and inspirational.

Thank you for letting me part of the discussion

[Vt Big Rig]

First welcome to the forum.

I personally have not experienced your symptoms.

Also on Next Stage and started just a month after you. Age similar. I am 63.

But you will get responses if anyone has.

[Rerun]

Welcome!

Yes I have and I ignored it hoping my heart would just stop and I wouldn't have to endure dialysis anymore.....

But, then I went to a cardiologist and I have a "Premature heartbeat" which I never had before starting dialysis and he put me on Metoprolol and it quit happening.   Then my bp started getting too low so we backed off on the Metoprolol a little and things are fine.

I hate that flutter in my chest!  My advice is to go to a Cardiologist because a Nephrologist... bless them... are NOT heart specialists!

[cassandra]

Welcome to the site WillieWundt

   


And I have those horrible flutters too. I think it's worse when I'm a bit over my dry weight, and thanx for the cardio tip Rerun.

Take care, Cas

[cattlekid]

I cannot say that I had similar experience when I was on NxStage but I will also say that I was only 40 when I started dialysis. 

One question:  what are your fluid gains between treatments?  Do you find the heart rate changes correlate to fluid gains/losses during treatment? 

[WillieWundt]

Thank you all for your comments. I appreciate you suggestions and your well wishes. I have gone to a cardiologist and just had a day long halter monitor and an echo cardiogram, so I should have some results next week.

[kristina]

Hello Willie Wundt ("wundt" with "dt" is a very old word from the dark ages (the modern word is "wund") and translates "injured"; did you mean it like this? Or is "Wundt" your name?) ... and I have just seen your question by chance...
... To tell you the truth, in my opinion the betablocker "Atenolol" has lots to answer for : Many years ago I was prescribed "Atenolol" for my uncontrolled high blood pressure. But taking "Atenolol" made me suffer a severe stroke at a very young age because "Atenolol" did not control my high blood pressure, but gave me instead cold extremities i.e  ice-cold feet and ice-cold fingers etc and "Atenolol" also made my blood pressure get completely out of control and made my pulse fluctuate erraticaly at the same time ... and because of all theses symptoms I felt extremely miserably, became housebound and shortly after I suffered a severe stroke at a very young age ... and, as you can imagine, it took me many, many years of strict rehabilitation to get back my speech (the stroke made me mix up all my languages), my walking abilities, my thinking abilities etc...
... The stroke also traumatized me for many years and it is only now after all these years that I feel rehabilitated... and it was lots of work to finally get there...
... If you have any problems with "Atenolol" please work together with your doctor straight away to find another BP-medication as soon as possible...
I wish you good luck and all the best from Kristina. 
P.S. As you can imagine, I have avoided beta-blockers ever since ...

[McKay]

Hello Willie Wundt!  I don't know if this will help but here goes.  My husband never had to go on dialysis but had a living donor kidney transplant 7 months ago.  All has gone beautifully with this new kidney!  He has had excessive PVC's for many years, but he was cleared by the cardiologist for the transplant and did fine.  That said, a few months ago his heart rate was down in the low 30's at night, and barely 50's during the day.  His b/p was no longer high once he had the transplant, and he was no longer on b/p meds.  With this new lower b/p AND the very low pulse, he was terribly low on energy, and very discouraged.  His 24 hr. monitoring showed he was having 45,000 PVC's a day.  They tried metoprolol, but it caused him to have edema in his lower extremities.  Even though it did reduce the number of PVC's by half, it was not working well enough and was causing other problems.  The cardiologist referred him to an ElectroPhysiologist - a cardiac 'electrician'.  They determined PVC Ablation was the best treatment.  This is where they insert a catheter through the groin, similar to a cardiac catheterization to determine blockage in the coronary arteries.  They are able to visualize the area where the PVC's originate, and they either freeze or burn the pathway of erratic beats.  We were told it would be an outpatient procedure, has an 80% success rate, and very low risk.  The transplant nephrologist approved it.  We had to wait a month for the procedure appointment, and were pretty nervous about it.  But I am happy to report it was a HUGE success - they located the problem area right away, and his irregular beats were immediately corrected - incredible!!  After a few days of rest and a gradual increase in activity, he is a bundle of energy and finally able to fully enjoy this amazing kidney transplant! 

Mind you, I am NOT suggesting this is what you need,  but wanted to share our story.  I do not know about dialysis causing your problems.  The cardiologist told us if the metoprolol had reduced the PVC's to 5,000 a day, he would have been happy.  But considering it didn't, and my husband was experiencing edema while on it,  and all these PVC's could eventually cause cardiomyopathy,  he recommended seeing the specialist about ablation.  We are SO happy we did!   

How did your 24 hr monitoring, and echo go?  Did you get the answers you need?  I wish you the best and hope our story helps!  McKay

[Vt Big Rig]

Hello Willie and welcome.

I am 63 , started dialysis in April 2015.  Also on NxStage. I was on several BP meds before I started and now only take something if BP is over 140 which is very rarely.

But the cardiologist has me on carvidorol (sp) and I as experiencing dropping pulse during dialysis. We cut the dose on half and then in half again and it seemed to do the trick. Now I run in mid to low 50s while on the machine.

Good Luck

[Angiepkd]

Hi Willie!  I also have PKD and have had a funny heart rhythm for many years.  I found it was more pronounced while I was doing home hemo.  I was told that having PKD causes some people to have an "off" heart beat.  Unfortunately, I also have some episodes of extremely high heart rate, one of which happened in the hospital.  I was referred to a cardiac specialist who recommended an ablation.  I haven't done it yet, because I feel like I have been through so much this past year.  I am going to schedule in the fall.  If you google polycystic kidney disease, you can find info on the heart problem.  I had many issues with low blood pressure while on nextage.  My meds were constantly being switched.  I used to get so low that I would get dizzy and throw up.  Not fun while on the machine and scared my poor husband to death.  I had to start eating pickles while dialyzing to keep from passing out.  Those occurrences were pretty rare, thankfully! Best of luck!