Dialysis Profile – Potassium ?

[kristina]

Hello,
I would like to know if anyone has had experience with the effects of "The Profile" selected on the dialysis machine,
which is designed to enable fluid to be taken off without suffering from cramps and sudden low blood-pressure?
I have noticed that it is usual for the water to be taken off "evenly" in "The Profile" through a 4-hour-dialysis-session,
which is o.k. with me, if I have a small amount of water taken off,
but it gives me cramps three-quarters of a way through, if a larger amount of liquid is taken off...
... But when I had a “Tapered Profile”, where the highest amount of water was taken off at the beginning
and the rest is “tapered evenly” down to nothing at the end ...
... and also, when the Profile began with a smaller amount of liquid taken off to start off with
and built up quickly over an hour and a half to a maximum ... and then “tailed off” slowly until the end...
... Both of these two “Profiles” worked well and avoided blood pressure problems and/or cramps...
... I was told though, there could be potential problems with Potassium-levels when using such Profiles,
if one arrives at dialysis with abnormal Potassium-levels...
... But, I am not quite understanding what this means and the effects it could produce
by using the "Tapered Profiles" I mentioned above?

Thanks from Kristina.

[Charlie B53]

Boy do I have a lot to learn.  Since I am on PD I don't know a thing about Hemo.  Yet I really should be finding out as every indication is that 'someday' PD won't work so well and then I won't have much choice but to switch to Hemo.

From what you mention it makes me think there are adjustments to the machine that allows it to 'cleanse' the blood without removing and water, and other adjustments that allow water to be removed, yet the rate of removal can be tailored both bu volume AND time/speed/rate of removal? 

Is this a correct understanding?

I've read a few posts about paying attention to the purity of water supplly both before and after filtering so as not to introduce desolveed metals into your system.  I can understand how that can create problems.

Is there an on-line primer or operators manual for any of the machines that I can access?  That should have a lot of information I might answer a lot of questions by reading.

[obsidianom]

Hello,
I would like to know if anyone has had experience with the effects of "The Profile" selected on the dialysis machine,
which is designed to enable fluid to be taken off without suffering from cramps and sudden low blood-pressure?
I have noticed that it is usual for the water to be taken off "evenly" in "The Profile" through a 4-hour-dialysis-session,
which is o.k. with me, if I have a small amount of water taken off,
but it gives me cramps three-quarters of a way through, if a larger amount of liquid is taken off...
... But when I had a “Tapered Profile”, where the highest amount of water was taken off at the beginning
and the rest is “tapered evenly” down to nothing at the end ...
... and also, when the Profile began with a smaller amount of liquid taken off to start off with
and built up quickly over an hour and a half to a maximum ... and then “tailed off” slowly until the end...
... Both of these two “Profiles” worked  Wewell and avoided blood pressure problems and/or cramps...
... I was told though, there could be potential problems with Potassium-levels when using such Profiles,
if one arrives at dialysis with abnormal Potassium-levels...
... But, I am not quite understanding what this means and the effects it could produce
by using the "Tapered Profiles" I mentioned above?

Thanks from Kristina.

I am not an expert on profiles. We don't use them with Nxstage. What effects potassium the most is the dialysate bath itself. It can vary form 1 to 2 to 3 meq/liter.
WE use the 2.0 bath. The higher the number the higher the potassium in the bath and the less potassium will be taken off. My wife runs only a little high in potassium so we use a conservative 2 bath. If you run high pre dialysis potassium then a 1 bath is better. If you run normal then a 2 or 3 is better. 

[cassandra]

Hi Kristina, are you using a Fresenius machine in centre? I used to use that, and the tapered UF profile in centre, and was never told, nor did I notice a difference in K+.

Good luck honey, love, Cas

[kristina]

Thank you CharlieB53, obsidianom and Cassandra for sharing your thoughts with me.
CharlieB53, we are in the same boat, I also have to learn a lot as well ...
I have noticed, that different adjustments on the dialysis-machines can be made by the nurses,
in order to avoid as best as possible blood-pressure problems and cramping ...
The practicality involved there is to find out very quickly, which particular adjustment fits the patient best ...
... I was also wondering how other dialysis-patients work with the nurses about their dialysis-adjustment ?...
... Thanks again obsidianom and I shall ask the nurses about the details you have described
and I shall try to find out more about it.
Thank you Cassandra , I don't know the names of the dialysis-machines I am on and every time
I have been on a different dialysis-machine...
... and I was told by the nurses that they are new machines, but I don't know how new they are ...
Thanks again from Kristina.