I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Loboferos on October 02, 2018, 01:37:55 PM
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I'm a baby for pain.. Can anyone tell me how to tell if a 2.5 on home peritoneal dialysis would cause Charlie horses before they happen? I am holding fluid but I'm petrified of those Charlie horses they are no joke! If I need a 2.5 I will use it but I'm worried it will take to much off...
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I’m on Hemo but you question is a good one. I would ask your Nephrologist or the Nurse at the clinic training you.
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Have been on PD for almost 2 years and never had a Charlie horse- I think hemo patients get them for sure. I started PD because of volume overload heart failure; usually do all 2.5 bags. It's more art than science balancing the % solution choice taking into account sodium in the diet. When I eat very low sodium foods ( no eating out) I can get by with half 1.5 bags. Be afraid of the 4.25's- those are bad for the longevity of your peritoneal membrane.
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You didn't say if you were on cycler or bag exchange, but I'll tell you what I did. I was on the cycler so I used to do a mix of 2.5 and 1.5. The 2.5 bag would be on the heater to start, and as the exchanges went over the night, it would mix, so you'd be taking more off at first and taper off over the night
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Maybe I'm naive, but I have never feared 2.5%. 4.25% is another matter altogether. I never get cramps during PD. Sometimes I get one when I'm not doing PD. It's more important to get the fluid off than to worry about a cramp that probably won't happen. I use one 6-liter 2.5 bag on the heater tray and one 1.5 6-liter bag as the supply bag and a third 3-liter 1.5 bag. Works for me, 3 years out.
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There ARE other causes of cramps besides excess water removal which is very easily done on Hemo with a large fluid take-off.
Cramps on PD can be caused by excess activity, walking far more than your normal day.
The most likely cause of cramps on PD is when your Potassium dips too low.
This can be a problem as for me while on PD 3 1/2 years my potassium used to fall fall too low. So much so my Team was constantly telling me to eat MORE potassium. This still was not enouogh so Dr prescribed potassium pills, supplements. I was taking 60 EU Daily before I balanced out fine again.
Talk with your Dr. Double check your Labs.
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Maybe I'm naive, but I have never feared 2.5%. 4.25% is another matter altogether. I never get cramps during PD. Sometimes I get one when I'm not doing PD. It's more important to get the fluid off than to worry about a cramp that probably won't happen. I use one 6-liter 2.5 bag on the heater tray and one 1.5 6-liter bag as the supply bag and a third 3-liter 1.5 bag. Works for me, 3 years out.
That's pretty much what I did. I only used 4.25 once, and it dried me out so badly I needed to be hospitalized.
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So I did get a cramp from all 2.5s over the course of 2 days (trying to get back to normal weight after a trip out of town and having all take-out food full of salt). It lasted for about 30 seconds and it was not fun. I am on CAPD.
Usually, I do 1/2 1.5 and 1/2 2.5 depending on my weight and BP. If your BP is up and your weight is up, you need the 2.5. I would recommend doing the 2.5 first and then 1.5 for the rest of the day for a couple days until your BP is back to normal or whatever fluid retention symptoms you are having resolve.
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Why dont you mix your solutions? I was on pd for 6 years I would call myseld an expert by this point lol. But that is a main sign of dehydration. How many hours are you doing?
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Unfortunately you won't know until you try. If you have swelling or are short of breath you should use a higher strength solution, a typical 2000ml 2.5% bag will likely only ultrafiltrate around 400-500ml