Blood Presssure Booming

[galvo]

Why, please, does my blood pressure shoot up in the last hour of HD?

[RichardMEL]

Why, please, does my blood pressure shoot up in the last hour of HD?

It *may* be because you're getting close to or a bit under your dry weight (ie: fluid being taken off). Sometimes rather than crashing and cramping my BP has gone up and it's gotten uncomfortable and the suggestion was that sometimes that happens if you've gotten a little too dry.

Maybe ask them about it and see what they say.

(of course it could just be excitement that you'll soon be out of there and back home with kitty!!!)

[galvo]

Thanks, mate. I did ask them and got the interesting response "don't know". Spare me! Please do me a favour and spell out to me in simple terms that an old fella can understand - What is this dry weight nonsense? For example when I turned up for D yesterday, I weighed 93.8 kgs; they said they'd take off 500. After D, and before peeing I was 93.2 kgs. I had a cuppa tea during D, on the basis that if someone puts food or drink in front of me, I shall consume it. I asked what the weight drop meant and recieved an inscrutable oriental stare. Maybe, because I was rushed onto D, I missed the training wheels.

Any help much appreciated. You are right, it could have something to do with getting home to the litilies.

[RichardMEL]

That's interesting to me. You went in 93.8, they took of 0.5 (which is the normal "washback"or "rinseback" amount) - which also factors in your cuppa, yet you came off at 93.2 - 0.6 total down. That suggests you lost more fluid during the session(maybe sweating?).

Now I'm no expert, and there are others far more highly qualified than I to both explain this - and your BP - like Zach, kidneydoc, sluff and others, so I will just give you an opinion - for what little it's worth... 

Are you still passing a lot of urine? I think maybe it was you that posted another thread recently about this? That could indicate they're just giving you dialysis and not taking off any more fluid apart from the washback (0.5l, or 500ml on the machine) - and that's fine I guess but in the long run you will probably need a dry weight established.

Basically the dry weight (sometimes also called the "Ideal Body Weight") is a guestimated target weight for someone where they're not carrying excess fluid in their system. As you'd know from reading IHD, excess fluid running around the body for a ESRD patient can be very serious - specially in larger amounts - as it affects the heart and lungs, pushes up BP (as the heart works harder under the strain) and so on - so the goal of dialysis is to take off as much fluid as possible without getting you too dry, which then causes a real *drop* in BP, a crash (fainting, etc) and/or cramps.

Seems to me "I don't know" isn't a very helpful answer. I might have said back "Do you know of anyone here who might be able to tell me?" or maybe just wait till I spoke with the neph.

You might want to ask them several questions next time:

a) why are they only taking 500ml off per session?
b) Will they establish a dry weight for you? If they have, what is it?
c) If you still have the BP issues late in your session can they explain it? If not I would speak to the neph about it.

In my humble experiene most of the time during HD the BP goes down. Sometimes it will shoot up for me, but as I said that seems to be an indication of too much fluid being taken. If I stop the UF (Ultrafiltration-the taking of fluid) things usually settle down.

Good luck with finding some answers!

[galvo]

Thanks again. I have a D session to-day and questions will be asked! More importantly I have an appointment with the neph next week, and questions will not only be asked, answers will be demanded! This dialysis business gets more and more interesting.

[kellyt]

You get'em galvo!     Let us know how it turns out.  Great advice Richard!  As always...

[MissyKew]

There seems to be a whole lot of don't knows going on.  I seem to get a lot of them too.

[KICKSTART]

There is another theory ! .. I found my bp would go up and up as i was on dialysis ! Now as we all know as you take fluid off it helps bring your bp down ! I dont know what machines you have there or how they use them ? I was on what we call the Loop , which basically pulls most of the fluid off at the begining , then filters out towards the end . Now what happens with me is im a quick 're-filler' so once the fluid was out of my blood , it started to come out of the tissues quickly , so when i had finished dialysis most of the fluid was back in my blood (out of my tissues) Hence the high BP ! Now i go on profile 3 , which pulls fluid off quickly , then pauses (allowing the fluid from my tissues to get into my bloodstream , then it pulls off again , and so on for the four hours. Since i have been on the profile my bp has lowered each session and i must admit , i feel tonnes better , no stinking headache from dialysis either ! 

[Marsh]

Kickstart, I LOVE your new quote!!

[galvo]

To completely confuse the issue, to-day my BP went from 153/91 to 180/90 to 147/94. Go figure.

[RichardMEL]

all those readings are on the high side of normal i think.  Did you get any better answers out of the staff???

KS - profile 3 is a good one - I would use that for quite a bit. I have also used profile 6 from time to time(takes off more at the beginning, then lower and lower as the session goes on). I'm so glad you've found a solution to your BP and headache issues! Does this mean you are even ok when not in the little room?

[KICKSTART]

Nah RM the lights still get my eyes , sadly the little room is a distant memory , im hardly ever in there now. I just sit with sunglasses on and baseball cap pulled down low and plenty of paracetamol !