If you are still creating urine

[MomInDialysis]

I have been reading many of the posts that are out here and the discussion blogs.  I read one that stated "if you are still peeing, it will just get worse".  I have no clue what was meant by this statement.  It was in the blog/poll "Is stooping dialysis suicide".  Are your reactions to dialysis affected differently if you are still producing urine.  When I ask the Neph he just tells us the kidneys will stop not to worry.  What does that mean.  If I haven't stated it before, I will now, our neph sucks.  Just wondering what Mom has to look forward to in the near future.

[paul.karen]

Wow what a jerky neph.

From what i have learned most but not all people eventually stop producing urine and this can be speed-ed up once the person starts dialysis.

Many on dialysis still produce alot of urine.  Im one of them.  But i am told it will slowly slow down to a dribble if not all together.  I dont think there is a timeline most everyone is different.   Could be months could be many many years down the road.

[thegrammalady]

i've been on dialysis almost 4 years and i still urinate, just not as much as i used to. it's different for everyone.

[cookie2008]

I have benn doing hemodialysis for about 15 months now and I still produce urine and the nurses at the center told me I might keep producing I hope so.

[peleroja]

I've been on PD for 6 years now, and this is my experience.  When I started PD I still urinated.  Once I went on the cycler last year, I noticed it really tapered off, until I felt I was down to about a tablespoon a day.  Then I had to go on hemo for 6 months and I started peeing again.  Now that I'm back on PD I am  peeing the way I was in the beginning, but they tell me the PD may not be working as well any more.  Perhaps that is why my body produces more urine; it's desperately trying to clear itself of toxins.

[pamster42000]

As I understand it if a person still is having output (urinating) your dialysis time is shorter, maybe 2-3 hours instead of 4.  You probley  only have to go to dialysis once or twice a week. Once the kidneys stop working a person needs more dialysis.
Each person is different depending on their age, health condition etc.

[silverhead]

When Sharon first started hemo she had a high output of urine, but her Neph stated that it was almost completely "water", the kidneys no longer were filtering the toxins and concentrating the urine to the bladder, so she still needed Dialysis to clean the blood, but only had to remove the rinse back volume (about 250 ML) She very slowly lost her urine output over 3 years and conversely had to slowly up her amount removed by the NxStage, last January because of problems with the one remaining kidney she had it removed and now has zero output finally.....

[Rerun]

When you start dialysis and still produce urine it means that your kidneys may not be filtering out toxins but they are still filtering out fluid.  This is good because you don't have to watch your fluid intake as much.  This makes sense as when you don't pee.... anything you drink stays in you unless you sweat.  Then the restrictions are on.  I think that makes being a dialysis patient worse.... when you don't' have any urine output.

                                                           

[Mimi]

When you start dialysis and still produce urine it means that your kidneys may not be filtering out toxins but they are still filtering out fluid.  This is good because you don't have to watch your fluid intake as much.  This makes sense as when you don't pee.... anything you drink stays in you unless you sweat.  Then the restrictions are on.  I think that makes being a dialysis patient worse.... when you don't' have any urine output.

                                                           

Oh, my goodness, I hope I never stop peeing.

[kidneydoc]

Passing urine while on dialysis is good.

Passing urine implies that you have what is called residual renal function.

This residual renal function is capable of clearing quite a bit of urea. In the old days of Urea kinetic modelling equations when dialysis was real science!! they had to measure the urea in your urine the urea in the dialysis fluid that ran through the dialyser and down the drain as well as the blood urea in between dialysis days to tell you what exactly was your clearance. Those equations allow us to now estimate clearance with simpler equations such as URR and KT/v

The point is that dialysis itself will produce enough raw clearance of electrolyte roughly equal to about 9 to 10 ml's of gfr.

SO if two people are dialysed one producing urine with 7 ml/min of gfr and another no urine 0 ml/min gfr the
adequacy or clearance of the first patient is a total of up to 19 ml/min while the next patient gets onyl what dialysis gives them.

The longer you can maintain your residual function the better for you.

Historically peritoneal dialysis has been better for maintaing residual renal functin for longer than hemodialysis.
However PD provides such good control of fluid volumes that frequently there isnt any fluid left over to excrete by the kidneys particularly if you are using rapid cycles with a cycler.

Avoid hypotension on dialysis use biocompatible membranes avoid antibiotics and painkiller such as NSAIDs and your residual function will last longer and you may require less dialysis.

[MomInDialysis]

Can the level of electrolyte being removed be controled, or is it an all or nothing deal

[Stoday]

I would miss not having a residual renal function when it snows.   

[RightSide]

Passing urine while on dialysis is good.

Passing urine implies that you have what is called residual renal function....
Avoid hypotension on dialysis use biocompatible membranes avoid antibiotics and painkiller such as NSAIDs and your residual function will last longer and you may require less dialysis.

I agree.

But there's one more risk:  Contrast dyes, which are used to enhance angiograms, venograms, and CT scans, have about a 1-3% chance of blowing away what remains of our residual renal function (this is called contrast-induced nepropathy).  So if you're getting any such scan, be careful.  Discuss it with both your neph and your radiologist in advance.

There is some evidence that being dialyzed immediately after the scan can reduce the risk, by dialyzing out that dye before it can cause real damage.

[lizabee]

I have started peeing MORE since starting dialysis!  I have a smaller than average, overactive bladder that does not empty itself all the way to begin with...my Neph told me that a lot of PKD patients still produce urine on dialysis..I mentioned that I feel I am going even more often now, and he said that very few people suffer this "side effect"...lucky me!

[Wallyz]

I have been able to pee more on dialysis, which is good.  However, I have stopped telling my neph I am peeing, so they will stop asking me to do 24 urine specimen collections, and trying to cut my dialysis.

[RichardMEL]

strangely enough in the last few weeks I reckon I've maybe increased my output by around 50% maybe a bit more?!! It's weird because nothing much has changed in my diet (although I have cut out those naughty Cokes I've been sneaking because my phosphate went a bit high  ). Kind of funny to start peeing a bit more (it's all relative folks!) after 3 years !

[RightSide]

I would miss not having a residual renal function when it snows.   

I live in New England, and I've still got about 9% of my kidney function left.

But I get no joy from pissing in the snow.

[Ken Shelmerdine]

As I understand it if a person still is having output (urinating) your dialysis time is shorter, maybe 2-3 hours instead of 4.  You probley  only have to go to dialysis once or twice a week. Once the kidneys stop working a person needs more dialysis.
Each person is different depending on their age, health condition etc.

Is this really true? I have full urine output no UF taken off in fact since I started Haemo I'm sure I'm peeing more. If it's possible I'd love to cut down to once or twice a week. Can you give me any links to studies about this?

[RichardMEL]

I doubt it.

Just because I output a bit, it's basically clear - ie: no toxins are being output with that urine. Now yes, it's great that some fluid is leaving my system but the fact that it's clear tells me that the toxins are still running around the blood and I'd need dialysis just as much to remove them. btw my sessions are 5.

The usual measure to determine if a reduction in dialysis is "reasonable" (remember, more dialysis is actually better for you long run) is the URR or Urea Reduction Ratio / "Clearance" - basically a measure of how well dialysis is removing toxins. I got to 82% and was still not allowed a reduction, so.....

Of course everyone's situation is different.