I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: F.A.Q. (Frequently Asked Questions) => Topic started by: Bajanne on December 15, 2005, 09:58:15 PM
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Does every dialysis patient at some point stop urinating? What are the pros and cons of this? I hear urine (or lack of it) being mentioned some times. Is not urinating good or bad? Does it have to happen?
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The last time I took a whiz was in 1992 :)
In most patients, urine output rapidly decreases once they start dialysis-- within the first year, most people stop urinating completely.
The pros: Not needing bathroom breaks as much as everyone else, and dehydration risk is greatly decreased.
The cons: You can't excrete fluids and toxins through urine anymore, so whatever you drink stays in you until you get dialysis. Also, some medications can build up to a toxic level in non-urinating dialysis patients. Phosphorus, potassium and magnesium also can build up to dangerous levels. Thirst can never be totally satisfied without exceeding your fluid restriction.
Technically, dialysis is a big communal bathroom where we all pee through machines. (I'm sure that will run through your mind at your next treatment!) :D
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Hummm - never though of dialysis that way, but it is the truth.
I was on a colostomy for about 6 months too. You can pee and poop through medical technology and still live. ;D
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Rerun, I'll bet I know what the neighborhood kids were saying that Halloween in your neighborhood-- "Hey, whatever you do, don't knock on that lady's door! You won't BELIEVE what's in the bags she's handing out!" :D
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Dear fellow renal readers,
What I have notcied in the last 20 years is most people do stop peeing after being on dialysis. This is a big bummer because if you could "Pee" you would not have to watch your fluid gains. Sorry gang for bringing up this horable subject again (fluid gain).........Jamie-G
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I would like some feedback on this subject. I am still peeing, though not as much as I used to.
At what point into dialysis does one stop?
Does the type of dialysis (HD or PD, etc.) make a difference?
If you stop totally and then get a transplant, do you start back (just curious)?
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I would like some feedback on this subject. I am still peeing, though not as much as I used to.
At what point into dialysis does one stop?
Does the type of dialysis (HD or PD, etc.) make a difference?
If you stop totally and then get a transplant, do you start back (just curious)?
Of course you start peeing again once you get a transplant. I mean .. if you think about it logically .. the only reason you stop peeing has NOTHING to do with the type of dialysis but just because kidneys stop working. If the kidneys stop working then there is no way they can produce urine that goes from the kidneys into the bladder and out the body. Once you get a transplant .. this function works and that is honestly how the surgeon will know that the kidney is working.
When I had my kidney transplant back in 1990 the nurses were running all over the children's renal ward of my Toronto Hospital of Sick Kids yelling, "She peed!! She peed!! Right on the table!! The transplant was a success!!"
It is a very exciting time but embarrassing at the same time to the patient as peeing is not normally a thing you want announced if you did it right on the table during surgey .. :-[
Actually, no question is a dumb one .. so here is mine: When you get a transplant and start peeing again (keep in mind that I didn't have my 2nd kidney removed until I got my transplant so I never stopped peeing before my transplant. This time around is the only time I stopped peeing and it was after 2 years of PD .. I stopped slowly .. for awhile there it was just peeing once a week .. and then .. never..) do you tend to "leak"? I ask this because I know without having the ability to pee you are not using those muscles to hold "it" in anymore. Do the muscles get weak? Does the patient tend to "leak" accidently? Does the bladder shrink at all from non-use? Does the patient pee more often if so??
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Six months into hemo, still peeing at about quarter of normal. Maybe a bit less.
I'll take it while I can get it. The ability to increase my fluid intake to compensate is a wonderful little side effect.
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I've been on HD for about 5 months. I have about 5% function and I have not noticed a decrease in peeing yet. Hopefully things will keep "flowing" until my transplant in Dec.! ;D
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Hi,
I was lucky I never stopped peeing all the time on dialysis and wasn't on a fluid restriction at all. I was on PD for 14 months which I was told preserves you residual function better than hemo as it is constant so takes the pressure off your kidneys. I actually have more problems now with fluid retention post transplant than before ::) mainly due to the drugs.
Mike
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My experience with this regard was actually quite good (so far).
Prior to starting I was bugged ALL NIGHT for about 6 or so months by being bugged by my blatter to get up almost on the clock every 2 hours to go. This lead to horrible nights with next to no sleep (and you don't even want to imagine how it sucked if I had anyone over or i was at someone else's place....
Anyway as soon as I started dialysis (hemo) the volume decreased a heap as others have noted, but I got my sleep back!!! Now I can sleep 7-8 hours a night comfortably.. if there are any positives to dialysis (apart from living, of course) this, for me, has been the single biggest change that is good!!
I am thankful that I am still able to pass urine because it means that bit extra I can drink. Last time I measured it (how sad!) it was about 400ml in a day, but really I think that might be on the higher side of the average. I have pushed it a bit to make my daily fluid limit about 1 litre/day and it seems to work reasonably well as I usually can fit in under 2kg gain between regular sessions. The nurses seem to think between 2-3 is ok too.. I guess it all relates to how much you can handle being taken off, and I only seem to have had problems with cramp/crashes etc when it gets over 3.5 to take off.. so I now know pretty much my limits there.
I hope I don't urinate less... but reading this it seems like it will be more likely than not.
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I've been told I can gain 3-5% of my body weight. That is a huge difference 1.4kg - 2.37kg hhhhmmmm I'll take the 5% gain.
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When i was on hemo for 7 months in 1999, I didnt pee at all. When I had my transplant, I pee'd right when they hooked up my kidney before they even got a chane to close me up... :lol; I pee'd normally again and it was great, I couldn't even hardly drink all the fluid I was supposed to as it filled me up :lol; Then in 2004 when my transplant failed I slowly started peeing less, and now i'm on PD I pee usually every morning and sometimes one more time in the afternoon... however, its a few drops each time.. not even enough to do a urine collection for my monthly doctor visits.... :lol; Good thing is dont have to mis nothing due to going potty.. bad thing, not being abl to drink how much I want... :lol;
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I have not yet stopped totally, but it is much reduced.
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I know this subject has been discussed alot, but I cannot find the answer I am looking for.
Which is it? Is the urination declining because the dialysis is successfuly removing excess fluid?
Or is the kidney failure causing less fluid to be processed and it gets backed up in the body?
I know they are related, so I am not sure I am even asking the right question.
I know people can continue to urinate while on dialysis. But I am confused about why it stops.
The kidneys were already failed when dialysis began, so if it was a matter of them not passing
the fluid through, why would you still be able to produce urine?
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In my case, different kidney functions have been failing at different rates. My ability to produce natural epogen stopped over a decade ago. My kidneys ability to clear toxins has been in a gradual decline for even longer than that, and have now reached the point where I need to start dialysis. Up until a year ago, phosphates and potassium levels weren't a problem either. My kidneys ability to clear fluid from my body hasn't changed yet. So I'm not retaining fluid even though I still drink just as much water as I ever did. I'm hoping I can hold onto that last bit of function quite a bit longer - it will mean minimal or no fluid restrictions as long as it continues.
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Like you, jbeany, I continued to make a fair amount of urine, but my kidney's ability to filter out the toxins became the issue of why I needed to start dialysis. I wonder if it depends on the cause of one's kidney failure?
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I don't know, Jill. Mine was juv. diabetes. But all the docs told me that my failure to make epo when my function for the rest was still above 25% was very unusual. They also said my kidney pain wasn't supposed to happen at all, and they had never heard of any kidney failure patient having something like it. However, when I posted on here about it, several members had similar symptoms, even if they weren't nearly as severe. So who says the docs know much of anything at all?! :P
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I know this subject has been discussed alot, but I cannot find the answer I am looking for.
Which is it? Is the urination declining because the dialysis is successfuly removing excess fluid?
Or is the kidney failure causing less fluid to be processed and it gets backed up in the body?
I know they are related, so I am not sure I am even asking the right question.
I know people can continue to urinate while on dialysis. But I am confused about why it stops.
The kidneys were already failed when dialysis began, so if it was a matter of them not passing
the fluid through, why would you still be able to produce urine?
Hi Carol,
This is something that I can't seem to get a straight answer to from any my renal docs. They say that with PD for instance, residual function continues and that PD does not accelerate the rate of natural diminishing output. Then in the next breath they tell you that after you begin dialysis urine output will gradually cease as if dialysis is a factor which completely contradicts the first statement. The truth is that I don't think they really know. To sum it all up, the unanswered questions are these; does the dialysis process get to the fluid first before any natural function has had the chance, and if so, why doesn't it stop natural output from day 1, or, do the kidney's override dialysis for a time and then it swaps and dialysis overides kidney function and what are the factors governing when this starts to happen? And, finally a hypothetical question, If you gave dialysis to a person with normal functioning kidneys, would his/her kidneys stop functioning eventually?
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Sadly my urine output has gone right down. About a month or so after I started dialysis I measured urine over a 24 hour period and put out about 400ml of it. Just now I completed an "IntraDialysis" urine test (basically all of the urine between two sessions, discarding the first) and in around 36 hours I think I only produced around 200ml - 300ml at the most.
Some days I feel like I put out more than that, but lately it has seemed less.. I guess dialysis has kicked in.
I guess I need to rejig my daily allowence of fluide... down :(
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In a little chat with my dietitian and a nurse in the centre the other day, they suggested that I record my urine output. In a twenty-four hour period (from 6 a.m.) my output was just about 250 ml.
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In a little chat with my dietitian and a nurse in the centre the other day, they suggested that I record my urine output. In a twenty-four hour period (from 6 a.m.) my output was just about 250 ml.
Can i borrow some of that?? lol, ew, i am lucky if i get that in a weeks time :-\
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At last check I was at 1200, but I have a feeling I may need to check again soon...
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hey, my doc told me my urine flow would decrease after starting dialysis
during my first months I had to get off the machine and go pee pee
then suddenly, I noticed I did not urinate as much
I noticed it also the teacher's restroom
some teacher's "peed a river"
I miss it
I still do some urine and I thank God each time
sounds crazy; I know
I call urine liquid gold :shy; twirl
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When Jenna was in-center and they'd give everyone those big red jugs to fill in a 24 hour period, she was the only one who had much volume. You think they'd have a smaller container for dialysis patients.
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I haven't measured it, but 2½ years into dialysis, I'm still peeing, maybe just about 250ml per day.
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Nearly 4 years on dialysis and i still 'go' mostly at night tho' >:(
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Although I have decreased greatly I still have to go to the boys room,but not like I use too.
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I still drink my special diuretic and it keeps me going strong.
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I still drink my special diuretic and it keeps me going strong.
what is your special diuretic drink and can anyone drink it
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I drink bottled spring water. To each bottle I add a good squirt of lemon juice and about a teaspoon of frozen cranberry juice concentrate. It works for me.
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mmmm.. Flip, that sounds good!!! I will have to try that concoction!
I piddle. I don't pee. If you like, you can use the word dribble. That's all i do, even when I have a cuppa coffee.
Kinda nice in one way. Makes for better long trips.
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It makes me pee like crazy. I don't mind because I don't gain between treatments.
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I will definitely be trying that one.
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I'm nosy / curious. If you don't pee very much, do you do it daily, just in smaller amounts, or do you pee in closer to normal amounts further apart? If you just pee every day or two, then is it ok for it to just be sitting in your bladder for so long?
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when I was on dialysis in 1999, I pee'd a few drops every morning. When I say a few drops, I literally mean a few drops.
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I have learned that one thing you can do to preserve whatever renal function you do have is to avoid dehydration. For new patients (especially those who may not be on dialysis permanently), it is extremely important to avoid dehydration. You are at a greater risk for dehydration on hemo. I have been told that CAPD is a little more "preserving" of whatever kidney function you have, because it is a much more gentle process-meaning less risk of dehydration.
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In most patients, urine output rapidly decreases once they start dialysis-- within the first year, most people stop urinating completely.
The pros: Not needing bathroom breaks as much as everyone else, and dehydration risk is greatly decreased.
Except for those with no kidneys. You may forget to drink and then run the risk of dehydration. Not fun.
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I stop producing urine about a year after I started dialysis. Road trips were the best, while everyone had to stop and pee, I just stayed in the car and napped. Also I have a bit of "Verminophobia" (fear of germs) so I hate using public restrooms.
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They've tried three times in the last 6 months to measure my output, but I don't do enough to measure.
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I was on dialysis from September 2007 to June 4, 2008. When I first started, I had to pee right before I got on, had to stop about 1/2 way through to go potty, then pee again right after. My output declined rapidly. Within the first two weeks I didn't have to stop in the middle anymore. Then about a month later I didn't really have to pee after (but I did just to try to get my scale to read a little lower :2thumbsup; ).
I also noticed that my bladder seemed like it shrank. I would have to go potty, but only pee a little bitty bit.
Now that I have my transplant, I am averaging between 3000 - 3500 ml output! I am 3 weeks and 4 days post tx and am still peeing between 500 - 1200 a day more than I take in. My TC asked me if I was still taking lasix (I took lasix for 5 days because I had SOOOO much fluids on me after tx). He is surprised that I am still peeing so much more than I take in.
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I was on dialysis for almost 6.5 years before i stopped urinating, but about 7-8 months after i got a transplant
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My sons love taking me on trips......no potty breaks for me......only up side that I can think of today... :yahoo;
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this was so thrilling
I was at Walmart with my youngest daughter and we were about to checkout
I had to pee-pee so badly that I could not wait
I left the line and quickly walked to the restroom
it was such a thrill to feel that again
my daughter and I were so happy for me
we were laughing and the other people in the line looked at us like we were crazy
who cares
I enjoyed every second of peeing
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When Cujo and I go for a walk, he has to stop and pee on every tree. I get so jealous I can't stand it.
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Cujo is showing off :yahoo;
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cujo rocks..... :bow;
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The first time Marvin started dialysis (1995), he still urinated for about two years -- though the volume decreased, decreased, decreased to nothingness. After his transplant, he urinated every hour or so (bladder had shrunk) for the first six months. Then, it was about every two-three hours. The second time he went on dialysis (2003), he stopped urinating completely after being on D for only a month! I've always wondered why the difference from the first round of dialysis to the second.
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I just plain think it's different for everybody. I take in about 1.5 L a day of liquids and get out around 1 L every night. I only pee in the morning and usually once in the afternoon but it's a total of under 300 ml all together. (Averages of course) I've been in renal failure for years but only Stage 5 and dialysis since May 2008.
Apples and Oranges, right. Why is your K this when we eat the same but mine is this.... :bandance; (I just love that banana dude, lol)
Renee
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You definitely do not want me driving on a long trip. Oh ya, I haven't even tried driving since I lost my right foot. So now I just wait in the car as they all run in. Ohh but I do hear, Hey Mark. you want something to drink. Good grief...Boxman
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:bump;
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Thnk God i have not stopped peeing.I noticed though that when i wasnt taking care of myself{mostly not following the diet} my phosphorous and pottassium was high i could not pee as well but now ive been following the diet and take fosrenol for my phosphorous and take in natural medicine to cleanse my system out i noticed and increase in urine flow like a lot more than before.
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I know this subject has been discussed alot, but I cannot find the answer I am looking for.
Which is it? Is the urination declining because the dialysis is successfully removing excess fluid?
Or is the kidney failure causing less fluid to be processed and it gets backed up in the body?
I asked a neph what is it about dialysis that has made me quite urinating. She replied that dialysis is not the culprit, rather it is the natural progression of the ESRD that put me on dialysis. Right now I go only once a day usually in the morning, but I still go through periods where I do produce quite a bit.
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Does Every Dialysis Patient, at Some Point, Stop Urinating?
From AAKP
At some point, most dialysis patients will stop urinating, but the rate of decline in urination is different for each patient and is dependent upon the type of kidney disease as well as the type of dialysis modality employed. Generally, patients receiving hemodialysis (HD) lose their ability to urinate faster than patients receiving peritoneal dialysis (PD). This decline in urinary output has various implications on patient management and survival.
Patients who continue to urinate while on dialysis (HD or PD) are said to have “residual renal function” (RRF), and this factor is an important consideration in their management. Dietary restrictions on sodium and fluid intake can be liberalized to some degree. Depending on the degree of RRF, less dialysis therapy may be indicated. Nevertheless, close monitoring is needed because kidney function tends to decline over time. Recognition and acceptance of this fact greatly facilitates individualization of dialysis therapy. Studies also suggest dialysis patients, who have RRF, have a greater likelihood of survival than patients who do not. In PD patients, RRF declines steadily by 1.2-2.8 percent per month, irrespective of the underlying kidney disorder that initially led to dialysis2. This survival advantage falls in tandem with declining urinary output.
Similar survival benefits have been shown for HD patients. A Netherlands trial (NECOSAD-2) showed a 56 percent reduction in death in HD patients who had RRF3,4. Similar results were shown in a study conducted at Brown University5. HD patients lose RRF at a faster rate than PD patients; about 5.8-7.0 percent per month, irrespective of the underlying kidney disorder2.
Although PD patients lose RRF at a slower rate than HD patients, the likelihood of survival on either dialysis modality over a five-year period is comparable. Therefore, it would not be advantageous to change from HD to PD despite the differences in RRF.
For those on dialysis, significant RRF permits patients’ a degree of denial about the severity of their kidney disease. As long as a patient has some RRF, it permits the notion that kidney function may recover. As such, a patient may deny that dietary restrictions and dialysis prescriptions are fully applicable to their situation. The consequences of this denial can result potentially in significant morbidity. Conversely, the loss of RRF forces a patient to fully confront the stark reality that he/she is dependent on dialysis and must be fully engaged in appropriate lifestyle and dietary modifications.
Recommendations for stopping the decline in RRF are limited. It is not clear why RRF decreases once patients start dialysis, nor why there is a difference in RRF between HD and PD patients. However, it is safe to assume in most instances there is inexorable progression of the underlying disease process itself. Some general guidelines to slow the decline in RRF include:
1) Vigorous blood pressure control, 2) The use of angiotensin-converting enzyme inhibitors (ramipril, enalapril, lisinopril) and angiotensinreceptor blockers (losartan, valsartan, candesartan), and 3) Avoidance of kidney-toxic agents (non-steroidal anti-inflammatory agents, aminoglycoside antibiotics, iodinated contrast agents used for Cat Scans)2. Because each patient is different, it is important you speak with your physician regarding the applicability of these recommendations to your situation.
More research needs to be done to learn the importance of RRF in patient survival.
Generally, patients who begin dialysis will notice a steady decline in urination (and RRF) at varying rates. Survival is improved if RRF is preserved for patients receiving PD or HD, but RRF alone does not make one form of dialysis better than the other. With additional research, we will know if it is important to direct our therapies toward preserving RRF at all.
References:
1. Bargman JM and Golper TA. The Importance of residual renal function for patients on dialysis. Nephrology Dialysis Transplantation, 2005. Volume 20: pp. 671-673.
2. Jansen MAM, et.al. Predictors of the rate of decline of residual renal function in incident dialysis patients. Kidney International, 2002. Volume 62: pp. 1046-1053.
3. Termorshuizen F, et.al. Relative Contribution of Residual Renal Function and Different Measures of Adequacy to Survival in Hemodialysis Patients: An analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. Journal of the American Society of Nephrology, 2004. Volume 15: pp. 1061-1070.
4. Termorshuizen F, et. Al. The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. American Journal of Kidney Diseases, 2003. Volume 41: pp. 1293-1302.
5. Shemin D, et.al. Residual Renal Function and Mortality Risk in Hemodialysis Patients. American Journal of Kidney Diseases, 2001. Volume 38: pp. 85-90.
James Bailey, MD, is a professor of medicine in the division of nephrology at Emory University and head of the renal fellowship program.
Tejas Desai, MD, is a Nephrology Fellow in the Emory University Division of Nephrology. His academic interests focus on Internetbased medical education for physicians in-training and dialysis patients.
This article originally appeared in the November 2008 issue of aakpRENALIFE.
http://www.aakp.org/aakp-library/Stop-Urinating/
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Hello,i still urinate even more.but what i found is that if you eat what you are not supossed to your urine decreases and you get sick thats why THE DIET IS IMPORTANT.some medications dry up the kidneys,I take natural medicine which makes me pee more feel good and also take fosrenol to keep my phosphorous low.i'm sketched out about some medications i took sensipar and couldnt use the bathroom for one whole day i FREAKED OUT after that i dont trust medications that much but NATURAL MEDICINE IS A WHOLE DIFFERENT STORY>
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After 7 months on dialysis I still uranate 700 ml plus a day. A nurse told me that was very good for a dialysis patient.
Troy
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:bump;
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I stopped peeing altogether about a month into dialysis; it was very upsetting because I had expected to maintain at least a little residual function. Then when I got home and started doing nocturnal it gradually started to come back. Now I'm back to peeing 4 or 5 times a day, just like normal. Sometimes in the morning I have to do a little dance while we get me off the machine, I have to go so badly. Obviously I don't have any fluid restrictions at all. I hope it keeps going like this!
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@nycrtst85 What natural medication are you using?
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I've been on dialysis 7.5 years and have gone from an output of 2600 ccs to less than 100 ccs, but I still pee a little bit every day.
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I've been on dialysis this time for not quite 7 years, and I stopped peeing all together about 3 years ago. In the year leading up to the complete stop, I'd pee maybe once or twice a week. I remember going to the hospital for clinic and they wanted me to do a 24 hour urine test. The nurse handed me the jug, and I laughed. I remember the small celebrations I had when I did pee. My best friend always thought it was funny when I'd announcer to her, "hey! I peed today!"
I didn't stop peeing before my first transplant. I think I probably slowed, but I didn't really notice. I think that between the ages of 12 and 14, you have better things to notice than how much you pee. *L* I remember, in the days after the transplant, for some reason the nurses had me sitting up on a commode without the pot. I was still wearing johnny shirts, because I still had iv's and drains and things of that nature. I was watching tv, and one of the nurses came in. She asked me if I knew why the floor was wet. I didn't, but when we looked, the johnny shirt that I was wearing over my back was wet too. I had peed without even realizing it. I had to learn how to hold it again. I'm not really looking forward to doing that again, because it's going to be harder, because I don't pee at all anymore
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.
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I've been on dialysis almost 6 years now and still pee, though much reduced. Most folks (both drs. & fellow patients) are very surprised. I estimate I pee under 300ml/day and am grateful for even that bit.
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I found this thread doing some research. I just noticed yesterday that I did not have to go pee really bad after dialysis. Then this morning, not so much either...got me worried so I researched. I have FSGS/Nephrotic Syndrome so I am not sure this is good? They have started cleaning me at 450 now so it is a better cleaning than before...
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I found this thread doing some research. I just noticed yesterday that I did not have to go pee really bad after dialysis. Then this morning, not so much either...got me worried so I researched. I have FSGS/Nephrotic Syndrome so I am not sure this is good? They have started cleaning me at 450 now so it is a better cleaning than before...
You should feel better since there cleaning your blood more to get rid of all those nasty toxins!
I haven't peed in 7 yrs, haha ... I joke with my hubby when we go places, that at least he doesn't have to wait for me :2thumbsup; Plus I love going places knowing I don't have to use those dirty bathrooms.. I just hope my bladder will know how to work the day I finally do get my kidney!
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I found this thread doing some research. I just noticed yesterday that I did not have to go pee really bad after dialysis. Then this morning, not so much either...got me worried so I researched. I have FSGS/Nephrotic Syndrome so I am not sure this is good? They have started cleaning me at 450 now so it is a better cleaning than before...
Mamagemini,
Running you at a higher blood flow of 450 does not necessarily benefit you any more than a lower blood flow. Remember, Dialysis is only cleaning what is currently in your bloodstream. Some toxins as well as phoshorus and other middle - larger molecules take time to go from your tissues into your bloodstream. Therefore you are not necessarily getting a better treatment. Plus with the day off and the weekend you are buildup up more toxins so actually there is a net gain over time of the buildup of phosporus and other Beta2m which can cause bone iissues.
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Jenna still urinates, she's been on manual PD for over a year now.
I think she has a tiny bit of function left from her nearly 8 year old transplanted kidney (rejected :()
She's still on anti-rejection meds so that may have helped hang on to the last 5%.