Muscle exhaustion- Pre-Dialysis

[Tkski]

Has anyone experienced it, pre-dialysis only?

I think that is the best way to describe it. If I exert myself in any way, IE: walking at a fast pace, climbing a few flight of stairs. It is combined with heavy, heavy breathing. It resembles someone who has emphysema, no I have never smoked, am not overweight and no other health conditions come into play. I am NOT anemic, red blood cells levels are in healthy range. The majority of my levels are in check. Naturally my creatitine level, Glucose and Urea Nitrogen levels are high.

Other than the tiredness, muscle issue, these are the only symptoms that I am experiencing. I feel blessed when I read what some of you others are going through. My GFR is at 11%.

[cassandra]

I would think that it's your urea that makes you feel really cr..p, but could also be your potassium, I'm afraid it's time for D ?

Love, Cas

[Sibella]

I'm there too (short of breath) and also just discovered my eGFR has dropped to 11. Otherwise I've been asymptomatic. Just had my visit with the vascular surgeon and hope I can get the fistula in place in time. Good luck to you!

[hatedialysis2]

The loss of muscle mass complicates clinical syndromes and erodes patient quality of life. In patients with CKD, muscle wasting is common and studies of animal models of CKD and other catabolic conditions indicate that impaired insulin/IGF-I intracellular signaling stimulates protein degradation in muscle. These defects activate caspase-3 and the UPS to stimulate muscle protein catabolism. If these defects can be overcome by exercise or other methods, accelerated protein loss could be blocked. There is evidence that muscle biopsies could prove useful in identifying patients with accelerated muscle protein catabolism, and therefore potentially to evaluate the success of interventions such as correction of metabolic acidosis. However, it is clear that new strategies are needed to combat muscle protein losses.

http://ajcn.nutrition.org/content/91/4/1128S.full

I found that taking a good quality amino acid supplement and a good vitamin/mineral supplement helped alot.  If you have to watch your potassium and phosphorus, just make sure the supplements do not have those added.    I would also check into the protein quality intake.  If you are eating meats, make sure its grass fed, cage free, no antibiotics, no hormones.  No fried or charcoal grill meats.   Take a digestive enzyme with it to make sure the protein is digested.    Probiotics and probiotic rich foods are also strongly recommended to ensure absorption of nutrients from the foods you eat.   

Hope this helps.   Best of wishes.

[Tkski]

HD2, what brands of supplements do you recommend? My in range levels are what is so puzzling. Neph tells me that although the kidneys are failing, they're still working sufficiently to get rid of the toxins and keep #'s in check. Trust me, I am not complaining. Sodium is great, potassium the same. I have cut out a large majority of potassium loaded foods.

Cass, I'm  it doesn't happen any time soon.

Off to get my every two week blood work done.....positive thoughts...no creatitine increase

[hatedialysis2]

HD2, what brands of supplements do you recommend? My in range levels are what is so puzzling. Neph tells me that although the kidneys are failing, they're still working sufficiently to get rid of the toxins and keep #'s in check. Trust me, I am not complaining. Sodium is great, potassium the same. I have cut out a large majority of potassium loaded foods.

Off to get my every two week blood work done..;

What stage CKD are you at?   What are your BUN, ctratinine levels, and Uric acid?  Do you have to watch your phosphorus intake?

The first place to start is always with fine tuning your diet.   As for brands for amino acids  do you want vegetarian, vegan , gluten free sources or do you prefer animal sources?    Capsules or protein powder?   Summertime offers amazing selections of fruits, berries that you can add to a good quality protein powder for a delicious shake or ice cream. It gives you protein, antioxidants ( God help us we need tones of those)' minerals, nutrients, phytonutrients, antinflammatories all in one drink that is easily digestable  and goes right to the cells producing very little waste and not consuming much body energy to digest.  I know that was a run on sentence.    Also, replacing some or all of you animal protein intake may help to keep dialysis further away or perhaps avoided altogether.  Depending on the cause of your CKD .

I am not an expert, I just read a lot and have been battling CKD for many years.  I am merely sharing my own experience but everyone is different and unique.

Good luck with your tests today.

[Charlie B53]

Are you swelling?   Gaining water weight?    If so it may be possible that fluid is accumulating within the lungs causing, or contributing to shortness of breath.

How is your resting heart rate?  Is it higher than it was a year ago?  A month ago?   Fluid can also accumulate within the sak surrounding the heart, impeding it's ability to fully expand and fully fill so it ends up pumping less with each beat.  Often speeding up in attempt to move adequate blood to provide the body with oxygen.   This may be a lead into congestive heart failure.

Either or both of this symptoms are serious and need the attention of your neph and cardio Dr's immediately.

Dr's first reaction is commonly to prescribe water pills in attempt to remove as much excess water as possible.  When that is not adequate then Dialysis may soon be recommended.

Watch your legs for swelling,  See your Dr's, now.

[Tkski]

Charlie, absolutely no swelling. I see my Neph every 6 weeks now with blood work done every 2 weeks. ALL series of testing was completed with my transplant screening. Fistula surgery 8 weeks ago. I am on a diaretic, TRUST ME, it works. Pressures are actually good, surprisingly and my heart rate has always been below 70.

This "muscle exhaustion" as I call it, does not happen with all activity. For instance, I have to go through a regime in order to get my veins half ways exposed in order to have blood work done, ie: 3-4 sets of dumbell curls, a few sets of push-ups. I don't experience the same thing, with it.

On a different note, although not significant, but to me it is, my creatitines went down .5.    ANY lowering of that # is a plus at this stage of the disease.

[raramorgan]

I have the same problem with some days being really bad and then I will go for several days and have no problems with muscle weakness. I am not as far along in CKD as you are. Stage 3b. I think my tiredness and muscle weakness is because my HR runs really low like in the 50's sometimes it drops into the 40's. Most of the time during day when I am busy or working it will go to the 60's. If I have a busy day and then at night I am very tired it will drop into the 30;s and this freaks my Dr. out he wants at least 60. I just can't seem to get it there. Good Luck to you I hope your labs keep getting better.

[MuddyGurl]

Dr. WE Mitch is one of the few MDS studying diet and CKD.  here is the full text of one of his  studies..you can find many more on the topic of VLProtein and supplemented Amino Acids.  I take a  supplement that is a balanced set of 8 essential aminos..and raised my GFR from 26 to 42 over 6 months.

Beneficial responses to modified diets in treating patients with chronic kidney disease.
Mitch WE.
 
BACKGROUND:
In rats, protein-restricted diets prolong survival from experimental chronic kidney disease (CKD). Diets for CKD patients that are restricted in protein and modified to limit the intake of phosphates and sodium not only reduce the accumulation of unexcreted metabolic products but also protect against hypertension and proteinuria. Their ability to slow progression of CKD is controversial, and this fact, plus concern about the nutritional adequacy of restricted diets, has limited this treatment strategy for CKD patients.
METHODS:
Expected responses of CKD patients to dietary manipulation are examined. The influence of this strategy on complications of CKD, including results from the MDRD Study, is analyzed.

RESULTS:
Dietary compliance with low-protein diets can be monitored from 24-hour urea excretion. Long-term therapy with diets containing 0.6 g protein/kg/day or less protein supplemented with essential amino acids or their ketoanalogues maintain body weight and normal values of serum proteins while reducing the accumulation of acid, phosphates, urea. Low-protein diets suppress proteinuria even when angiotensin-converting enzyme inhibitors are used. Patients in the MDRD Study who complied with the diet had a significant slowing of the rate of loss of glomerular filtration rate (GFR).

CONCLUSION:
Successful dietary manipulation can ameliorate many complications of CKD. Low-protein diets are nutritionally safe, they reduce the accumulation of metabolic products, and they can suppress progressive loss of kidney function. Dietary manipulation should be an integral part of the therapy for patients with progressive CKD.


Dr Mitch knows/communicates with the scientists  that make the Aminos I take--see www.calwoodnutritionals.com  they more costly than OTC brands, but you can read more at their site or look at the Facebook page. They now offer a  Dialysis-aid drink powder to boost energy post D treatment for those patients.

[Charlie B53]

........... No fried or charcoal grill meats. ...................

This hasn't been a problem since I switched to a GAS grill many many years ago!   lol


On a serious note.

I've have problems with muscle weakness for a long time.  Mostly in my legs.  Caused by poor circulation attributed to Periferal Arterial Disease. (PAD).   This has been substantial improved with stent placement in both inguinals however there is no way to enlarge the many sub-arterials that feed the large muscles in the upper buttocks that move the legs.  Within a very short distance they tire, the lactic acid builds, burns, my steps shorten until I simply stop and have to wait until the reduced flow finally flushes them out and I can move again.