What is acceptable gain?

[Zach]

Holy shit!!! The most Ive gained is 7kg and it was only because my machine broke down and ER kept sending me home saying your ok. Then when I finally got to do a run incenter, they dialed in my fluid wrong, and only ended up taking off a couple of 100mls.

I dont see how a doctor would authorise an 8 kilo UF? I gain up to 4kgs which is really bad, I couldnt breathe if I gained that much.

We're talking about two very different size people here.
Russ is 229 kg, he's much larger than you.  aMbEr how many kg are you ... 60kg?

[Bajanne]

I was about 5 kilos over my dry weight Monday last week, and the nurse said she could only take off 4 kilos at a session.

[angieskidney]

Ya I guess it depends on the size you are overall on how much you can handle taking off? I can only handle 5kg max taken off (they told me they don't do more than 5.5kg in my unit max) in one sitting. I am 63.5kg and 5'5".

[AlasdairUK]

I was lead to believe that the old fashioned method of 500mls a day went out the window. I'm not sure I have ever meet anybody who actually complied to that anyway.

I'm of the understanding that 3% to 4% of your body weight is acceptable ie. 100 kg person could accumulate 3 - 4 kg of fluid, however if you weigh 60kg you would need to take off less fluid. 

Again we normally feel when we have taken off to much fluid and know our own limits as some people can tolerate a higher UF rate.

[AlasdairUK]

That is different. How does the percentage system actually work? In my unit they just use the old system. I usually gain 4- 4.5kg over the weekend and during the week I usually gain 2-3kg.

Example would be if you had a dry weight of 50 kilos. Your acceptable weight gain by fluid would be 1.5 kilos (3%)during the weeks treatment. Such as M, W, F. Over the weekend F-M it would be 5% or 2.5 kilos.


The effects of fluid on a 50 kilo person and a 100 kilo person are completely different. Whereas taking off 5 kilos on a 50 kilo person is 10% if body mass and taking off 5 kilos on a 100 kilo person is only 5% of body mass.

I just went back and read the thread from the front. I must read to many sports sections from newspapers and jump to the back page first.

I completely agree with this and Zach and maybe someone on the second page, I did not get that far. Just the first and last page for me. Who says I jump to conclusions.

[Russ]

AngiesKidney, I don't understand why centers have rules like that (pulling 5.5 kilos max).  These rules in some cases benefit the clinic and not the patient.  It took them a year but I'm greatful my clinic is finally thinking out of the box as I'm 6'7" and 229 kilos.  My larger mass naturally requires more fluid.  I think most of the rules and guidelines are for more normal sized people.  I"m bigger than the "average bear", as Yogi would say.  This is why I drive a Suburban and not a Corolla. 

I plan on starting NxStage training in December and start DX at home by the end of the year. I'm hoping daily DX, 6x/week will help with my fluid  issues. 

[BigSky]

It took them a year but I'm greatful my clinic is finally thinking out of the box as I'm 6'7" and 229 kilos.  My larger mass naturally requires more fluid.  I think most of the rules and guidelines are for more normal sized people.  I"m bigger than the "average bear", as Yogi would say.  This is why I drive a Suburban and not a Corolla. 

Yep.  The body is made up of a majority of water.  Bigger people tend to carry more muscle regardless of bodyfat.  The more muscle one has the more water the body has in it and therefore with more muscle there is more room for excess water to be stored without encountering the same complications vs. someone who is smaller and carries less muscle.

[angieskidney]

AngiesKidney, I don't understand why centers have rules like that (pulling 5.5 kilos max).  These rules in some cases benefit the clinic and not the patient.  It took them a year but I'm greatful my clinic is finally thinking out of the box as I'm 6'7" and 229 kilos.  My larger mass naturally requires more fluid.  I think most of the rules and guidelines are for more normal sized people.  I"m bigger than the "average bear", as Yogi would say.  This is why I drive a Suburban and not a Corolla. 

I plan on starting NxStage training in December and start DX at home by the end of the year. I'm hoping daily DX, 6x/week will help with my fluid  issues. 

Well take into consideration that my unit is a "Self Care" unit and is NOT near the hospital like the main unit is. The Hospital Dialysis unit takes off more than 5.5kg max.  Anyone remember Jamie the magician from my city? He always came in really heavy so they kept him at the hospital dialysis unit. He would have to have taken off 7kg on a regular basis. Of course that is really hard on your heart!

[Panda_9]

I am more so talking about the effects of fluid gains on the heart, not how much UF you can "handle". I would rather not say, but I am 94kgs at the moment. Was 87 but put on weight when I started nocturnal and got my appetite back. Have raised my dry weight 1kg in the last few weeks due to BP problems, which I dont think are weight related. On average I gain 3.5, sometimes more, sometimes less. I am trying to get it down to 3, then down to 2.5 but I am so freaking thirsty all the time and I have been used HAVING to drink lots when I had the transplant. There is absolutely no way I could stick to the 500ml per day restriction. I dont think its expected here. That is just totally rediculous. You would use it all up taking all the friggen pills, not having any left to "enjoy".

Lately I have been having some chest pain and palpitations, so I am getting a bit worried it is because of my gains. My partner and I are actually considering putting a lock on the fridge so I cant access the drinks in there, and just pour out my allowance for the day.

[angieskidney]

I am more so talking about the effects of fluid gains on the heart, not how much UF you can "handle". I would rather not say, but I am 94kgs at the moment. Was 87 but put on weight when I started nocturnal and got my appetite back. Have raised my dry weight 1kg in the last few weeks due to BP problems, which I dont think are weight related. On average I gain 3.5, sometimes more, sometimes less. I am trying to get it down to 3, then down to 2.5 but I am so freaking thirsty all the time and I have been used HAVING to drink lots when I had the transplant. There is absolutely no way I could stick to the 500ml per day restriction. I dont think its expected here. That is just totally rediculous. You would use it all up taking all the friggen pills, not having any left to "enjoy".

Lately I have been having some chest pain and palpitations, so I am getting a bit worried it is because of my gains. My partner and I are actually considering putting a lock on the fridge so I cant access the drinks in there, and just pour out my allowance for the day.

wow

Wasn't someone saying there is a way they can tell if you have too much fluid on you for your body size? Some kind of attachment for the machine? I don't know. But thought I heard something about something...

I can't even keep myself under my 1000ml limit ... but I know what you mean .. about being used to the transplant drink rule of drinking lots. I did that for 11 years and then now I have to limit myself? Crap ..

If you have fluid in your lungs (trouble breathing .. needing to cough a lot .. congestion) then that is one sign you have too much fluid on you. Another I get is the runs

[sandman]

There is absolutely no way I could stick to the 500ml per day restriction. I dont think its expected here. That is just totally rediculous. You would use it all up taking all the friggen pills, not having any left to "enjoy".

500ml per day is such an unrealistic goal.  The only way I can see that happening is if you slept all day long.    Even one 16oz bottle of water would put you over that goal. 

[Panda_9]

Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.

[angieskidney]

Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.

WOW! 

I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)

[Panda_9]

Yeh it was a lot. My BP went quite low I think.

[Epoman]

Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.

WOW! 

I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)

One Time I was cramping so bad I had them give just over 1400cc's back that is nearly a bag and a half of saline. 

[angieskidney]

Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.

WOW! 

I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)

One Time I was cramping so bad I had them give just over 1400cc's back that is nearly a bag and a half of saline. 

Holy crap! How could they not notice when your BP was dropping that you were too dry? In my unit they take my BP every 30 min. That is how they know if my dry weight it not set right for that day. Of course they don't like to adjust my dry weight goal too often .. maybe once a week .. IF that ..

[Russ]

Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.

WOW! 

I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)

One Time I was cramping so bad I had them give just over 1400cc's back that is nearly a bag and a half of saline. 

Holy crap! How could they not notice when your BP was dropping that you were too dry? In my unit they take my BP every 30 min. That is how they know if my dry weight it not set right for that day. Of course they don't like to adjust my dry weight goal too often .. maybe once a week .. IF that ..

Whenever my BP gets too low, it seems to only be when they do a standing BP after DX.  My ears will ring and I feel woozie.  Then I sit back down and if my BP doesn't come up in a few minutes, they'll give me a cup or 2 of water.  If the water doesn't work, they give me a cup or 2 of broth.   If broth doesn't work, they give me saline, which has only happened 2x in 14 months.

[Panda_9]

Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.

WOW! 

I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)

One Time I was cramping so bad I had them give just over 1400cc's back that is nearly a bag and a half of saline. 

Holy crap! How could they not notice when your BP was dropping that you were too dry? In my unit they take my BP every 30 min. That is how they know if my dry weight it not set right for that day. Of course they don't like to adjust my dry weight goal too often .. maybe once a week .. IF that ..

I was on nocturnal in centre so you dont check BP overnight. I really dont know why I went flat, but then thats just me, everything weird happens to me.

[angieskidney]

I have over 4kg on me right now after the weekend and I have only slept 2hrs cuz I went to bed late and didn't want to sleep. I feel like crap and also feel heavy. I feel like a water balloon. I don't want to move but I must motivate myself. I wanted to wear these comfy pants that match this top I wanted to wear to dialysis but I haven't left to go to the laundrymat yet and dialysis in in an hour... oh well

At least it is only 4kg but I also at 400ml as runback (rinceback) and 300ml tea I bring in on the way there and also add another 200ml for the tea a patients husband brings me an hour and a half later. So that means almost another kilo added .. so it will be a hard day for me today at dialysis.

[Rerun]

Don't drink all the extra.  Just go to dialysis and munch on ice chips.  No need to add to the problem.  JMO

[angieskidney]

Don't drink all the extra.  Just go to dialysis and munch on ice chips.  No need to add to the problem.  JMO

good advice 

I am so bad. I get antsy if I sit for 4 hrs and don't stick anything in my mouth. The ice chips DO work but they go too fast

[Panda_9]

Ice chips are fluid as well though. Its pretty easy to eat 200ml worth of ice. How on earth are you going to get 5L off? Max I can do in 4hrs is 3L and in 5 hours 3.5L and even then I have trouble.

[angieskidney]

Ice chips are fluid as well though. Its pretty easy to eat 200ml worth of ice. How on earth are you going to get 5L off? Max I can do in 4hrs is 3L and in 5 hours 3.5L and even then I have trouble.

Everyone is different .. I can handle between 4.5 - 5 max myself. It depends however if my dry weight goal is perfect or not

[Panda_9]

Holy crap angie, what UF rate is that? Your max that is.

[Russ]

Ice chips are fluid as well though. Its pretty easy to eat 200ml worth of ice. How on earth are you going to get 5L off? Max I can do in 4hrs is 3L and in 5 hours 3.5L and even then I have trouble.

Everyone is different .. I can handle between 4.5 - 5 max myself. It depends however if my dry weight goal is perfect or not

Yep, everyone is different.  After a very busy weekend and being Tuesday, I pulled off 8kg today.  This was a first for me.  I felt fine afterwards.  They monitored my blood pressure closely so that if it started going low they could adjust the fluid pull.  My dialysate was 790 and my blood flow was 500, runtime is 5 hours.  My standing BP after DX was 117/60.

But I certainly don't want to make a habit of gaining and pulling off so much fluid.