PD: How dangerous are the red (4.25%) bags?

[kickingandscreaming]

I've been running into some swelling issues and I think my RRF is tanking.  So how often can I safely use red bags?  Is there a rule  of thumb?

[Tío Riñon]

Why would you turn to red bags instead of using the green and yellow bags to deal with this situation?  In my experience, I've only used red bags when I need to remove a large quantity of fluid in a short amount of time.  Even so, I always have limited their use because it is my understanding that red bags can lead to faster deterioration of the peritoneum.  If at all possible, I would opt for changing my combination of bags (green and yellow) and/or increasing the length of time on the cycler.

Have you consulted with your nurse or nephrologist?

[kickingandscreaming]

My nurse suggested using a red/green combo on the cycler (once or twice) and using a single red manual bag.  My legs were very swollen yesterday a nd the day before.  I use mostly greens and green/yellow on the cycler most of the time.  But most of the time my fluids are better controlled.  Longer cycles are out for  me as i am a high transporter and  in long dwells I take on fluid.

[Tío Riñon]

I definitely encourage you to follow the instructions of your nurse and get that excess fluid off.  Once that matter is resolved, you should revisit your prescription with her.  Perhaps you need more greens and fewer yellows OR maybe only greens.  As for the dwell time, that can be adjusted to match your transporter characteristics.

Try to use as few reds as possible throughout your treatments, if you are able.  You don't want to wear down your membrane any faster than necessary.

Let us know how things go!

[kickingandscreaming]

The fluid is slowly coming off.  I have incorporated an additional manual (green) exchange mid day until this resolves.  My usual rx is every other day: 2 greens or a yellow/green.  That may need to be adjusted.  I meet with my nephro this Friday, so all will be discussed.

[sahern]

When I first started I was using mostly yellows the I had to move to a mixture of greens and yellow.  For a while now I have been using only greens.  For whatever reason if I go back to yellow even for a day I have a small amount of fluid build up on one of my ankles.  It takes a couple of days with just greens to get all of the extra fluid off.  When I started dialysis I was told to make the choice of the color of bags based on my blood pressure and/or weight.  I did not need to contact anyone unless there was a problem.  There was only one time that reds were used on me and that was when I was in the hospital for bypass surgery.  It caused no end of problems with low BP.  I was able to get them to go back to my normal routine and my BP went back to normal.  I will not use reds for any reason.  After my surgery I was using yellows for a week and started retaining fluid.  It took about four days to remove all of the extra fluid. 

[Charlie B53]

.......... My usual rx is every other day: 2 greens or a yellow/green.  That may need to be adjusted.  I meet with my nephro this Friday, so all will be discussed.

I may have misunderstood this.  Do you mean you only do PD every OTHER day?

On PD a bit over 3 1/2 years prior to losing my cath because of a nasty persistent infection, I did exchanges DAILY.  Never missed, or I would immediately begin to gain water weight.

Dwell times need to be adjusted to match your transporter rates.  Shorter dwell times and more exchanges often work better to remove excess water and are easily adjusted using a Cycler.  All Greens until you are very well controlled then switching to half Yellows to see if you can maintain that control is a solid plan.

Somewhere along the way we switched my prescription and increased the number of exchanges, switching from 5 liter bags to 6 liters bags.  It was an easy change in my Cycler program and made a noticeable improvement in my labs.

I was still able to drink all the ice water/ iced tea that I wanted in the warmer Summer months without gaining more excess water.  My residual kidney function wasn't a major help as I still didn't produce even a liter of urine daily.  The PD was easily able to take off all the fluid.

Keep letting us know how it's working for you.  Wishing you well.

Take Care,

Charlie B53

[kickingandscreaming]

I do PD every day.  I alternate the bag strength every other day.  But I think that is changing such that I need a greater proportion of green to yellow to keep the fluids under control.

[Charlie B53]

I did much the same, most days using one each green and Yellow, but there were those times I found myself a bit 'puffier' have had gained a couploe of pounds.  Then I would use both Greens those nights to take that excess water off.

Some Summers I would be outside in the heat far more sweating as I did things around the yard and garden.  I must have sweated off far more than I thought as my evening weight was down a bit.  Those days I would use both Yellows to prevent losing too much water.  I had to learn that the hard way.  Getting to 'light' I found myself getting dizzy every time I bent over to pick up a stick, branches that die off and the winds break them out of all my trees.  I found myself actually on the ground three times.  Had to laugh at myself every time.  Such a simple little thing, pick up a stick, get dizzy, fall down and wake up within a second not even remembering how I got all the way down without knowing it.   Son still today doesn't like me to pick up anything.

I've learned to 'pinch' the back of my hand and see how long it takes for that fold of skin to fall down flat again.  If more than a second and a half I go make myself a big cup of chicken broth.  The combination of the salt and water are absorbed and held in the circulating system better than just drinking plain fluids.  Pedeolyte should work fine as well.