Blood sugar and blood pressure readings for diaysis patients

[jo]

Hi,

I am wondering what the normal blood sugar and blood pressure readings are supposed to be for someone on dialysis? My mom's blood sugar always averages around 300 after she eats. If we give more insulin(humalog) before she starts having food, then her blood sugar drops very quickly, which becomes a problem especially during nights. Her blood pressures stay around 170's. Sometimes even after dialysis, it would show 170. Is that because she still has fluid in her body? But, she starts getting cramps and her BP drops during dialysis. One of the nurses think she doesn't have fluid anymore and that is why she gets cramps and low BP's. I am confused. Can anyone throw some thoughts and suggestions in here? Thanks.

[cassandra]

I can't help with the sugar levels, but 170 BP is quite high, and if your mum is having cramps, it's probably not fluid. Maybe the BP meds need increasing? Or changing?

Love and luck, Cas

[kristina]

Hello jo,
I also can't help with the sugar levels, but I agree with Sugar that a BP of 170 is high
and perhaps the current BP-medication does not agree with your mother's body-system ?
... I have experienced terrible cramps in my leg as well, when during dialysis too much fluid was taken off 
and I have taken great care ever since, to have less fluid taken off and I made as sure as I can,
that this painful experience does not repeat itself ...
Good luck from Kristina.

[LisaBart]

Maybe it's best to discuss with the nephrologist or make an appointment with her doctor and ask for an explanation and say that you don't understand.
It can be really confusing...we are not nurses and haven't studied like they have, and they should be guiding and explaining.

[jo]

I can't help with the sugar levels, but 170 BP is quite high, and if your mum is having cramps, it's probably not fluid. Maybe the BP meds need increasing? Or changing?

Love and luck, Cas

My mom doesn't feels good with normal blood pressures of 120/70. She feels better only if her systolic pressure is around 140. Is that a problem? Right now, she takes 2 BP medications Amlodipine and Lisinopril. Is there any problem with taking multiple BP medicaitons? How much should the BP's be on non dialysis and dialysis days?

[jo]

Hello jo,
I also can't help with the sugar levels, but I agree with Sugar that a BP of 170 is high
and perhaps the current BP-medication does not agree with your mother's body-system ?
... I have experienced terrible cramps in my leg as well, when during dialysis too much fluid was taken off 
and I have taken great care ever since, to have less fluid taken off and I made as sure as I can,
that this painful experience does not repeat itself ...
Good luck from Kristina.

Yes, you are right. I think part of the cramping (which happens during every session) is caused by pulling too much. They try to take off about 4L in 4 hours which is high. How can we explain to them to take less? When we tell them, they don't listen to us and keep saying that they can't do anything against the doctor's orders. The doctor visits my mom once a month for less than 5 minutes or so, and all he keeps saying is she has got too much fluid which needs to be removed. Pulling too much makes her sick and not being able to achieve the goal of 4L/session as they plan. With all the cramping and BP's going highs and lows constantly, all they will manage to take is only about 2-2.5L/session. Instead, her weight keeps increasing day by day. I am very stressed about this. If anyone has any thoughts on how to approach this and make them understand, let me know.

[kristina]

Hello jo,
I am terribly sorry for the distress you and your mother are going through and the only idea I could come up with
is asking the nephrologist to have your mother's weight-gain medically investigated further...
... Are the doctors really sure that her weight gain is due to water-retention and nothing else?
I am asking this because of her continuous cramps ... and I remember that I suffered terrible leg-cramps,
when too much liquid was taken off in the very beginning after my having started with dialysis.
Because of these early experiences, I now have maximum 2.2 litres taken off and if I would have 2.3 litres or 2.4 litres taken off,
I would have terrible leg-cramps and because of this I avoid having taken off too much liquid ever since and it works.
Could it be that your mother has continuously taken off too much liquid and this results in her suffering from continuous cramps?
I wish you and your mother good luck and hopefully this can be medically sorted out soon and please let us know how things develop.
Best wishes from Kristina.

[Charlie B53]

Is your Mother still using the salt shaker?

Canned or boxed foods have too much salt added, which causes the body to retain even more water and when the kidneys fail to remove that salt, the body weight keeps growing.  Attempting to remove that water, without removing the salt, causes a salt/water imbalance resulting in cramps.  Sometimes even worse.  Find any excess salt in her diet and remove it.  Often just identifying the salt sources and removing them will result in both lowering BP and allow excess water weight to be taken off without cramping.

140/70 can be an acceptable BP for those like me .  My numbers used to be a LOT higher, but with the two BP meds I noiw take the Dr's are satisfied with 140's.

There are many BP meds, her Dr considers a lot of things in determining which may be best for her.

[LisaBart]

Jo I think you should take your concerns to your Mum's regular GP and have the GP discuss it with nephrologist?
If they are not listening you must make them listen. 4L over 4 hrs sounds a lot, ask them if she can do 4L over 5 hrs?

[jo]

Is your Mother still using the salt shaker?

Canned or boxed foods have too much salt added, which causes the body to retain even more water and when the kidneys fail to remove that salt, the body weight keeps growing.  Attempting to remove that water, without removing the salt, causes a salt/water imbalance resulting in cramps.  Sometimes even worse.  Find any excess salt in her diet and remove it.  Often just identifying the salt sources and removing them will result in both lowering BP and allow excess water weight to be taken off without cramping.

140/70 can be an acceptable BP for those like me .  My numbers used to be a LOT higher, but with the two BP meds I noiw take the Dr's are satisfied with 140's.

There are many BP meds, her Dr considers a lot of things in determining which may be best for her.

No we cook food at home. Ocassionally she adds a little bit of salt to her food. Doesn't dialysis remove the little bit of salt she adds once in a while?

[jo]

Jo I think you should take your concerns to your Mum's regular GP and have the GP discuss it with nephrologist?
If they are not listening you must make them listen. 4L over 4 hrs sounds a lot, ask them if she can do 4L over 5 hrs?

They changed her dry weight now after a lot of struggle we had in convincing the supervisor there. Let's see how this goes. Now they are trying to take about 3-3.2L in 4 hours.

[jo]

Hello jo,
I am terribly sorry for the distress you and your mother are going through and the only idea I could come up with
is asking the nephrologist to have your mother's weight-gain medically investigated further...
... Are the doctors really sure that her weight gain is due to water-retention and nothing else?
I am asking this because of her continuous cramps ... and I remember that I suffered terrible leg-cramps,
when too much liquid was taken off in the very beginning after my having started with dialysis.
Because of these early experiences, I now have maximum 2.2 litres taken off and if I would have 2.3 litres or 2.4 litres taken off,
I would have terrible leg-cramps and because of this I avoid having taken off too much liquid ever since and it works.
Could it be that your mother has continuously taken off too much liquid and this results in her suffering from continuous cramps?
I wish you and your mother good luck and hopefully this can be medically sorted out soon and please let us know how things develop.
Best wishes from Kristina.

Yes you are right. I also think its because of taking too much fluid continuously. But the neph doesn't understand that. I am thinking about taking her to a different clinic and to a better nephrologist.

[Charlie B53]

Get the salt shaker OUT of the house.  Two shakes a MONTH is all that is necessary.  You will find more than that in most ANY prepackaged foods, breads, noodles of any kind, etc.  We do NOT need any additional salt.  Most people are addicted to the taste of the salt, that will soon wear off and she will be able to enjoy the true taste of foods.

Fast acting insulin begins to act IMMEDIATELY.  IF it is taken before any meal she should be already seated at the table with her meal before her.  I would rather see her take her shot immediately AFTER eating so to prevent any possible sugar crash.

About the only time I take insulin before eating or drinking is that rare occasion that I will have a glass of juice, which causes a very quick sugar rise.  And even then, most of the time I take the shot as soon as I set the empty glass down.

They call it fast acting insulin because it works very fast.