HD low bp and sweating. I am confused and worried

[flipperfun]

Hi everyone, I have been a dialysis patient for just over 7 years and have gone through the usual dry weight saga, low bp and crashing.  Not nice.

I have always in the past, felt really cold after I start dialysis and as my bp drops I snuggle under my blanket.  The last 2 times I have dialysed I am finding I am sweating, sticky and hot after about an hour to an hour and a half.  Yes my bp was a bit low for me but no sickness or blackout.  Again today it happend, hot and sticky whilst on dialysis but fine when I come off.

Monday the nurse adjusted my fluid removal, but I was still hot.  My body temperature was normal.  Again today.  This is so very unusual for me, I am always cold.  Has anyone ever had this?  I am scared and unsure what is happening.

I am very small and use 1.7L dialyser, pump speed 300 as I am not able to tolerate it faster.  Usual fluid gain is between 0.8 kgs to just over 1kg at weekends.  On Monday I put it down to the nurse trying to take off 1.1, but today it was only 0.6kg.  Washback is normally 0.4 making total fluid removal of 1.5 (Monday) and 1.0 (today).

Confused, yes I am.  Any guidance would be welcome.  Thank you.

[kristina]

Hello flipperfun,
Could it be that your dry-weight has slowly changed over a period of time without being noticed
and the nurses take off too much liquid right now, whilst during a long period of time you were actually losing weight
and therefore the liquid taken off during dialysis is simply too much?
Best wishes and goog luck from Kristina.

[cassandra]

Hi flipperfun, do you know what the temperature is on your machine, and if it's been changed? Or your HB has increased? I would check all my blood values, just check for changes. It doesn't need to be something scary. With your core temp being normal, it's unlikely to be an infection.

Lots of love, and luck, Cas

[Rerun]

Yes, Cas is correct.  There is a temperature gauge that warms your blood.  I like mine at 36.2.  Ask what yours is set at.  If too low you will freeze and set too high you get hot.

[flipperfun]

Thank you for your very helpful replies.

Kristina, yes there has been a change in my dry weight.  Around 2 months ago I had the flu. Gross!  I lost weight not surprisingly as I was not eating at all well.  Around 4 weeks ago my blood pressure was very high at the start of dialysis. So much so I became really irritated with the nurse when she told me "I have to tell you this because you could have a heart attack or stroke".  My reply was, "It's not my fault".  I was angry about being told off and there being absolutely no understanding that I was grieving and feeling ill with flu.  I do not understand the idea of telling someone that they might have a heart attack or stroke.  How does this help keep blood pressure low?  The nurse then tried to drop my dry weight by 1 kilo.  NO NO NO.  We compromised by .5 of a kilo and it has been this since.  As I am now eating well it is probable that my dry weight needs to go back up.  That will be a battle as they only tend to do that when a patient has passed out or been sick a few times or comes in above their dry weight.  Another conundrum is that the machine I regularly use seems to take off more than it is programmed to.  Yes it does say the correct amount it was programmed with, yet I am often 0.2 under my dry weight!!  On other normal Braun machines I come off at the correct weight.  The nurses refuse to believe there is anything wrong with the HDF machine I use.  I do not use the HDF side of it so why am I constantly assigned to it?   How I hate dialysis!

Cassandra, I did not think about my HB.  Yes I will check my blood values thank you.

Rerun, I often have my temperature gauge warm, because I am so cold, so I will check that tomorrow.

This forum is amazing.  Thank you all for your support and common sense.

[dialysisuser82]

  I run on low BP during dialysis, i.e. 65/35.  My Neph. said it is best to be on low temperature setting, so I am on 36.2 temp. ( I always double check with staff, sometimes they just do not pay

attention.) Of course always tell your Neph. what is going on with you so he can adjust necessarily.
 
  - As for your weight situation, you can try Profiling.  In the past I tried to pull all on first hour and simply dialyzing with no target for the remaining time.

  -Cold feet is normal for kidney patient due to poor blood circulation. If you could afford an electric blanket for your feet that would be great.

   In my case I put my feet inside the sleeve of a thick and warm jacket during treatment.