Dialysate Temperature and Itch/Rash

[Black]

Over the first six weeks Mike gradually developed a horrible rash and itch on his fistula arm.  It was minor in the beginning but eventually got so bad that it was hard to locate the buttonholes.  We tried everything: different bandaids, different tape, different disinfection swabs, different antibacterial soap, extra prime time, new saline for rinsing the needle sets and rinseback, cortisone and diphenhydramine cream.  His whole arm began to itch and finally even his back!  He kept a long handled spoon in his chair to use on his back.

The clinic staff and NxStage were no real help except to suggest that he is allergic to the plastic of the lines and to take Benedryl before and after dialysis, and use a new saline bag for rinseback.  It helped, but not much.

Finally, we figured out that it got worse as we were gradually upping the dialysate temperature!!  We lowered the dialysate temperature to the minimum setting and it improved in 24 hours!  In two weeks it was gone, except for a mild red halo around both buttonholes.  It still itches a little when he's hooked up and shortly after coming off but the rash is gone.  Apparently the chemicals in the plastic are more stable at lower temps.  He has to use a blanket and a hat again, but it's better than the horrible itch and rash!

[jbeany]

Wow - wonder if nxstage uses drastically different plastics in their tubing?

[goofynina]

Thank you Lorelle for posting that, i am sure someone will most likely have that same problem or you have just prevented someone from having that problem    I am glad that Mike is doing better, hope your business is doing well also    Take Care 

[Bill Peckham]

Interesting. You're using the PureFlow? Any difference bags v. SAC?

[Black]

Interesting. You're using the PureFlow? Any difference bags v. SAC?

Not that we could tell, and we used both.