What is acceptable gain?

[Zach]

You made an important point, BigSky.

Also, with the more modern dialysis machines, there is UF modeling, where the UF automatically changes from higher to lower throughout the treatment to help the body adjust in the transfer between interstitial space and the blood.

And remember, with some high flux filters, setting the UF below 300 ml/hr is not recommended due to backfiltration concerns.

[angieskidney]

A true dry weight (ideal) is a weight where one would be without kidney failure. Meaning that after dialysis if one was to work out they could sweat a liter off without having any affects of low blood volume (low bp).

Really? But they seem to like to get you at a weight just at that point where your BP starts to drop .. that is what I found anyway

[kevno]

Some Kidney machines allow you to be profiled in which means you can take the fluid of more gentle at the end of dialysis. So no cramps or feeling sick. I have most of my fluid taken off in the first two hours. But just now I am trying to keep my fluid intake to a bare minimal because of the pain in my leg while on dialysis.

[Black]

Some Kidney machines allow you to be profiled in which means you can take the fluid of more gentle at the end of dialysis. So no cramps or feeling sick. I have most of my fluid taken off in the first two hours. But just now I am trying to keep my fluid intake to a bare minimal because of the pain in my leg while on dialysis.

How's it doing, Kev?  Is the pain only while on dialysis, or is it chronic, and dialysis just makes it worse?

[Bajanne]

I have been having a very hard time recently.  Earlier this year, I was only gaining 1.5 - 2 kilos between sessions.  All of a sudden, my liquid gain is 4 - 5 kilos.  The problem with this is that I am experiencing cramps, low blood pressure and dizziness.  I am trying hard to restrict my fluids, but it has gotten really difficult for me.  I asked them to up my dry weight, but the last session I still had the problems.  In fact, for the last three sessions they did not even remove all of the liquid.
It is as if I have to start from square one and learn to regulate my fluid intake.

[kitkatz]

Been there, done that, too.  I thinkt he body self regulates and will grab all the fluid it can sometimes.  I find I have to adjust my habits to make up for it.  Sometimes you have to start over and look at what you are doing.  Remember your body goes wonky because of dialysis.

[RichardMEL]

Yesterday my nice nurse ran me through all the profiles on the machine. Very cool really! She said "I like to use profile 6" (the one that stops and starts, and takes the most off earlier so you end up taking hardly any off).. it was interesting to see the chart with the different profiles and what they do. Good idea really!

[Zach]

Yesterday my nice nurse ran me through all the profiles on the machine. Very cool really! She said "I like to use profile 6" (the one that stops and starts, and takes the most off earlier so you end up taking hardly any off).. it was interesting to see the chart with the different profiles and what they do. Good idea really!

Those UF controls are very good.  I use #3.

[angieskidney]

Yesterday my nice nurse ran me through all the profiles on the machine. Very cool really! She said "I like to use profile 6" (the one that stops and starts, and takes the most off earlier so you end up taking hardly any off).. it was interesting to see the chart with the different profiles and what they do. Good idea really!

I wish MY Nurses would go through all the profiles with me. I have just barely seen them but I know they are there. The UF profiles .. I don't have one. It is the same throughout the 3 1/2 hrs I am on. I only have a sodium ramp.

[RichardMEL]

Well my nurse said to me that they in general only use the main profile (as in a consistent UF rate).. some seem resistant to use any other profiles (I have no idea why) but my nice nurse ihas a lot of experience in Dialysis and she knew immediately to use profile #6 for me and it worked pretty well I have to say.

[Zach]

Sodium modeling, as well as Ultrafiltration modeling are usually determined by a Doctor's order, so Nurses (except a Nurse Practitioner) might be reluctant to make those changes.  Unfortunately, some Nephrologists don't want to be bothered with the variations.

[AlasdairUK]

I use the Fresenius 5008 hemodiafiltration dialysis and you do not have sodium modelling as you receive replacement fluid.

On my machine there are three profiling options:

1) starts taking off fluid at the highest rate and drops off on a continuous basis throughout. Used on people who have stable BP.

2) starts taking fluid off at the highest rate, but keeps the rate for each hour and drops down for the next hour. Normally used on people who tend to have there BP drop as keeping the same UF rate for each our allows the BP to stabilize.

3) the stop, start approach to taking off fluid. Used on diabetics who release fluid from tissue to plasma at a slower rate than non diabetics. The stop in UF allows fluid from the tissue to move into the plasma. If you kept taking off fluid then you would cause the blood volume to drop and the BP would crash.

[RichardMEL]

Interesting. I'm not a diabetic though they always ask. My nurse did mention the "fluid moving" thing which was one reason to have it stop for 30 mins (well, what my machine did was start at 2500/hour for 30 mins, then 100 for 30 mins, then 2000 for 30 mins, then back to 100 for 30 mins, and so on)... so it doesn't quite stop, though 100mils/hour for 30 mins is only 50 ml taken off in that time, which is next to nothing.

[angieskidney]

I use the Fresenius 5008 hemodiafiltration dialysis and you do not have sodium modelling as you receive replacement fluid.

On my machine there are three profiling options:

1) starts taking off fluid at the highest rate and drops off on a continuous basis throughout. Used on people who have stable BP.

2) starts taking fluid off at the highest rate, but keeps the rate for each hour and drops down for the next hour. Normally used on people who tend to have there BP drop as keeping the same UF rate for each our allows the BP to stabilize.

3) the stop, start approach to taking off fluid. Used on diabetics who release fluid from tissue to plasma at a slower rate than non diabetics. The stop in UF allows fluid from the tissue to move into the plasma. If you kept taking off fluid then you would cause the blood volume to drop and the BP would crash.

Wow an amazingly awesome and INFORMATIVE post!! I would love to read MORE of THESE!! 

[Panda_9]

When I was having low BP problems I tried profile 5 which was UF at 100ml/hr for 30 mins then 950ml/hr for 30 mins and so on. It did make a difference. However I am surprised that I held up during the 950ml UFR.

[kitkatz]

We have the new Fresenius machines.  I tried profile 3 the other day.  I like the profiel that takes it all off at the beginning and lets the body recover at the end of the run.

[Zach]

We have the new Fresenius machines.  I tried profile 3 the other day.  I like the profiel that takes it all off at the beginning and lets the body recover at the end of the run.

Same here.   

[angieskidney]

We have the new Fresenius machines.  I tried profile 3 the other day.  I like the profiel that takes it all off at the beginning and lets the body recover at the end of the run.

That's the one I want to try but they don't wanna let me play with my settings without the Neph saying which one to do and give the ok after looking at enough BP drops over a 2 month time period.

[tubes]

We just go the new fresenius machines about 3 weeks ago.  Previous to that we were using a brand called Braun.
I always was coming into the unit with 3-4 kilos on.  My blood pressure would be a little high sometimes but would lower by the end of treatment.  Lately, after the new machines I was coming in with 1-2 kilos on.  Now the past week and a half I've come in under 1 kilo and my blood pressure is sky high.  It is still high even after dialysis.  I think today it was 146/113....I think, thats afterwards.
That just seems crazy to me.  I can't believe how little I put on and still have high blood pressure.  All I've had today to drink is half a bottle of mt dew.
I think 3-4 kilos in pretty normal for most people.  Every now and again I hear my nurses talking and I've heard people coming in with 8-12 kilos.  I don't see how someone can do that during the weekend, on the weekend maybe.

[glitter]

my husband used to gain 3-4 during the week, and 5 -7 on the weekends...he was miserable. Then he found out if he goes outside and works very hard for a few hours every day, then works out for another hour, he sweats enough to double what he can drink and he goes in at 1.5-2.5 during the week, and 3-4 for the weekend. And we will have the prettiest lawn on the block!!

[nextnoel]

And we will have the prettiest lawn on the block!!

Talk about a silver (or in this case, green) lining!

[Duane]

under 4 is  good for me, working on 2.5. I'm in an apartment building so i miss sitting back and admiring the lawn i used to cut and trim, now it looks bad after 16yrs., well it looked bad the very next yr.

[julian230]

a weigh around 45.6 kg  between that a 50, sometimes 60kg  , how much water do you think I should be drinking during the week / weekend? Also , If I ate nothing , and only drank water... wouldn't that mean I have more freedom in drinking what I want because my weight wouldn't go up so much? Totally opposite of my quesiton  on the other board, but if someone could answer it , that would be cool,

[RichardMEL]

a weigh around 45.6 kg  between that a 50, sometimes 60kg  , how much water do you think I should be drinking during the week / weekend? Also , If I ate nothing , and only drank water... wouldn't that mean I have more freedom in drinking what I want because my weight wouldn't go up so much? Totally opposite of my quesiton  on the other board, but if someone could answer it , that would be cool,

Am I reading this right? Your dry weight is 45.6kg but sometimes you weigh in between 50-60kg?? No that can't be right That would be like 10+kg gain!

As for your second question.. isn't that kind of moot.. if you don't eat you'll waste away (and if your IDW really is 45.6 that's pretty darn lean for a strapping young lad?!) well you won't get enough nutrients in to keep you going. I suppose if you missed the odd meal (not recommended) you wouldn't put on as much, but remember this just means over time you'd probably lose body weight (as opposed to fluid weight) which probably isn't good for you in the longer run when the aim is to maintain a healthy IDW. I understand what you're saying (trust me I would do anything I could to be able to drink more!!! ) but this would not be a healthy way to approach it IMHO.

[Trikkechickk]

If you are working out, you need the calories and the protein to maintain/build muscle mass.  Otherwise your body will start "cannibalizing" muscles for calories & protein.

BTW Nepro makes a great post-workout recovery drink!