Toxin-removal & fluid regulation.

[kristina]

Those dialysis-patients who are “only” having the toxins removed,

do they still have to weigh themselves every day and

carefully regulate their fluid-intake?

Thanks. Kristina.

[billybags]

kristina, I don't really understand what you mean. I thought hemo does the whole lot. I know at my husbands unit they have machines that take off pacific things. I think Richardmel would be you best bet for info on this.

[monrein]

If you are still peeing a lot then you don't yet have to watch your fluids so much (although you should be careful about WHAT you drink since phosphorus and potassium can come from drinks.  I personally avoid colas and limit coffee because these can have a real impact on our bones, actually whether we're healthy or not.  Milk and dairy is high in phosphorus.)

I think it is wise to keep track of your weight nonetheless because with time your output will most likely decrease and you might notice it on the scale as well of course in your ankles and fingers sometimes.  Even if you're still peeing it's always a good idea to see if you might be gaining actual weight as well so they don't start thinking you are now retaining fluid.

Good luck.  This is quite a tightrope we must walk and it never seems to stay exactly in the same place either.

[Rerun]

You have to remember that they fill the lines with saline at the beginning and at the end that go into you, so they usually pull some fluid....  500 cc's or so.

[Maker]

I have wondered this too...the nurses get upset with me because I come in under my dry weight (which my Dr. refuses to adjust) and they say they still have to take off the minimum.  Then at the end they send me to the scales, then back into the chair to pump me full of enough fluid to reach my dry weight.  So I'm assuming there is no way to dialyze without removing any fluid, and have "only toxins" removed.   

And no Kristina, I don't regulate my fluid intake.  Last month when i started dialysis my Dr. told me to, but now that they took the excess fluid off I had in the beginning I can't even get up to dry weight.  Not sure if that makes any sense, but this has all been a source of much confusion for me as well 

[RightSide]

I still urinate, so I don't have to drastically restrict my fluid intake.

But there's no question that I could drink more fluid than my kidneys could excrete.  (I've seen my ankles swelling up.)

Right now, I just use common sense about not drinking more fluid than I really need.  And I drastically cut my sodium intake, which helps my kidneys excrete fluid too.

And yes, I weigh in and weigh out, each session.  It's a good check to see if my kidneys still are filtering any fluid. So far, they are.

[RichardMEL]

Of course you can do dialysis with zero fluid being taken off.

It is common, yes, to remove the "rinseback" as a minimum - that is common and most do it automatically(as in calculate the 400 or 500ml for that) because the lines are flushed at the end and that involves a few hundred ml's of saline that goes in.. so they account for that that way.

I think it's absolutely insane that the nurses pump you (Maker) full of saline to make UP to your dry weight. If you were cramping or crashing - absolutely - but if you come off under and are fine... good grief! That should tell even the dumbest of techs that at the very least your dry weight can be brought down to where you came off just fine (specially if your BP is good). I don't get why they pump fluid IN, or why the doc won't lower your DW.. that just doesn't make any sense to me.

[kristina]

Thank you so much for your kind replies.

I am not yet on dialysis & I have been really wondering about this question.

My kidneys have been "hanging on" at ~10%,
and I have no symptoms yet.

From what I can gather, it seems a little like "touch and go",
every dialysis-patient seems different as well
(perhaps due to the different reasons for their kidney failure?)
and different medical people seem to deal with it differently.

Thanks for your thoughts and replies, Kristina.

[whiskeyfrank]

Im gathering dry weight tends to be a little confusing, ive had 3 different weights as im always under. BUT im full of fluid so they keep lowering it, i personally have figured out that after a while you get to know how much fluid you need to take off yourself. I judge it by my ankles and hands and breathlessness.

The technicians i work with are great and help me in the decision of how much to take off.

[Ken Shelmerdine]

Kristina read Galvo's thread 'Still Peeing Mightily'

[kristina]

I do, but the fluid-intake and/or toxin-removal
seems to be such a very crucial point
and I wanted to make sure
I really understand.