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Author Topic: Getting extra nutrition during D.  (Read 4149 times)
casper2636
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« on: October 06, 2010, 05:38:55 PM »

Because I wasn't getting enough protein, potassium, phosphorous, and sugar in my diet, my nutritionist put me on and I.V. solution of extra nutrition during D. It has made all the difference in the world! :clap; I wanted to know if anyone else has encountered this kind of treatment? I've gained 10lbs and have increased my albumin to an acceptable level, and all my other numbers have almost come up to par. I would suggest it to anyone having a problem with keeping their levels up!
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greg10
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« Reply #1 on: October 06, 2010, 05:49:40 PM »

What is the prescription and how long did it take you to gain 10 lbs?  Thanks.
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Newbie caretaker, so I may not know what I am talking about :)
Caretaker for my elderly father who has his first and current graft in March, 2010.
Previously in-center hemodialysis in national chain, now doing NxStage home dialysis training.
End of September 2010: after twelve days of training, we were asked to start dialyzing on our own at home, reluctantly, we agreed.
If you are on HD, did you know that Rapid fluid removal (UF = ultrafiltration) during dialysis is associated with cardiovascular morbidity?  http://ihatedialysis.com/forum/index.php?topic=20596
We follow a modified version: UF limit = (weight in kg)  *  10 ml/kg/hr * (130 - age)/100

How do you know you are getting sufficient hemodialysis?  Know your HDP!  Scribner, B. H. and D. G. Oreopoulos (2002). "The Hemodialysis Product (HDP): A Better Index of Dialysis Adequacy than Kt/V." Dialysis & Transplantation 31(1).   http://www.therenalnetwork.org/qi/resources/HDP.pdf
casper2636
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« Reply #2 on: October 06, 2010, 06:11:54 PM »

Greg, It only took a month 1/2 to gain the weight and start feeling better (from 85lb to 95 lbs). The script came from the Dr. directly to the pharmacy since it's I.V. all I had to do was ask and wait for my insure. to approve it. It took in all, about a month. My nutritionist help push it through, so I'd start there and move forward to the Dr. It really has helped me feel so much better, and not so weak and worn out...I try to find out it's name for you on Friday when I go back for D. The only down fall is that it does give you extra liquid that has to be removed during dialysis (390ml).
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Zach
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"Still crazy after all these years."

« Reply #3 on: October 06, 2010, 06:28:43 PM »

That type of IV nutrition is referred to as IDPN (Intradialytic Parenteral Nutrition).

About 15 years ago there was a big scandal relating to fraud and abuse of IDPN in some dialysis centers, so now it is very difficult to have Medicare reimburse for it.  Glad you were able to receive the therapy, casper2636!

Here's more about the therapy:
http://www.nutrepletion.com/patientselection/idpnfaq/

8)
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
casper2636
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« Reply #4 on: October 06, 2010, 07:12:54 PM »

Zack, thanks for the information! Its a shame centers will commit fraud on our insurance. We were just talking about that today at D. Strange charges for services that were not rendered. This hurts the well being of all of us. I always look at my insur. payments to make sure I'm getting what they are charging for!
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Zach
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"Still crazy after all these years."

« Reply #5 on: October 06, 2010, 07:24:03 PM »

Actually the scandal was more about "payola" and overuse of IDPN.
 8)
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
greg10
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« Reply #6 on: October 08, 2010, 07:58:00 PM »

Thank you very much, Zach and Casper.  Useful information to have.

The problem with my father is that although healthy, he is losing weight slowly and he also doesn't eat very much.  He is also diabetic, so close monitoring of this product is needed, as noted from the URL Zach provided:

"Do I need to worry about the amount of sugar in the IDPN solution?

The amount of sugar within the IDPN solution may cause high blood sugar in non-diabetics. For this reason, blood sugars are checked before, during and after each treatment. For those that may experience high blood sugar, regular insulin can be given during IDPN therapy."
Logged

Newbie caretaker, so I may not know what I am talking about :)
Caretaker for my elderly father who has his first and current graft in March, 2010.
Previously in-center hemodialysis in national chain, now doing NxStage home dialysis training.
End of September 2010: after twelve days of training, we were asked to start dialyzing on our own at home, reluctantly, we agreed.
If you are on HD, did you know that Rapid fluid removal (UF = ultrafiltration) during dialysis is associated with cardiovascular morbidity?  http://ihatedialysis.com/forum/index.php?topic=20596
We follow a modified version: UF limit = (weight in kg)  *  10 ml/kg/hr * (130 - age)/100

How do you know you are getting sufficient hemodialysis?  Know your HDP!  Scribner, B. H. and D. G. Oreopoulos (2002). "The Hemodialysis Product (HDP): A Better Index of Dialysis Adequacy than Kt/V." Dialysis & Transplantation 31(1).   http://www.therenalnetwork.org/qi/resources/HDP.pdf
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