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Author Topic: bp much lower then normal, should I be concerned?  (Read 2156 times)
sullidog
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« on: July 31, 2011, 06:18:51 PM »

My bp usually ranges from 130 to 140 as the top number and upper 80's to lower to middle 90's for the bottom. Over the past couple of months my bp has not gotten above 112 and the bottom number stays to the upper 60's to 70's. I feel fine but I wonder why the sudden change? I've not changed anything in my diet, nor am I on any bp meds nor do they pull fluid off. This is not just at dialysis, this is also at home. Should I be concerned or not until something happens. I've asked my nurses and they tell me that's low, but didn't seemed concerned. I just think it's weird that it would drop like that and stay like that. I've also eaten salty foods like popcorn and no change
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
del
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del and willowtreewren meet

« Reply #1 on: July 31, 2011, 06:30:22 PM »

Have you gained weight and need your dry weight upped???  It happens. Low b/p is always a symptom for hubby when he needs his weight upped.
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Ang
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« Reply #2 on: July 31, 2011, 07:25:54 PM »

make noises till someone gives you a satisfactory answer.
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Bill Peckham
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« Reply #3 on: July 31, 2011, 09:34:29 PM »

Your nephrologist should do a dry weight evaluation e.g. lying/sitting/standing BP, observation of neck veins and skin elasticity


Do you take any BP meds?



Are you getting lightheaded if you stand up quickly? Cramps? Do you seem to fatigue quicker? Those can be signs of dehydration. I'd definitely be looking to raise my dry weight to get my BP up even without symptoms. I went to get on last week and had a 90 over 60 BP after a long sweaty day at work. I gave myself a liter of saline and set the UFR to remove .5 for the run ... we can still get dehydrated. What's the weather been like in your area?
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
sullidog
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« Reply #4 on: August 01, 2011, 06:57:49 PM »

Hi Bill,
I don't have a dry wait as I urinate a lot still so they only pull the amount that is required to clean the blood. My vascular surgeon is thinking that's why my thrill isn't strong all the time do to my bp. It's been hot and humid here in ohio. My standing bp is actually above 112 it's the sitting that stays below it. I haven't taken one lying down yet but will and see what it is. My heartrates are in the 80's.
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
sullidog
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« Reply #5 on: August 01, 2011, 07:00:08 PM »

I also want to add my hemoglobin is an 8 even, could that also cause a bp to be low? Oh and to answer about standing up, no I don't get lightheaded. About my hemoglobin being so low, it's because they didn't restart my epo when they were suppose to, but that's a rant for a whole different topic
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
Bill Peckham
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« Reply #6 on: August 01, 2011, 08:03:54 PM »

So one idea that is totally unvetted, it's just a thought, so take it with a grain (or two) of salt, maybe your sodium balance has changed.

Here's my thinking: After you start dialysis you begin controlling your sodium intake at an improving rate - assuming that as you get use to a low sodium diet, it gets easier to follow, salt tastes less good, so your sodium intake continue to go down. Summer comes along and you sweat more, loosing some sodium. This changes the sodium balance in the body, which causes your body to  start to give up fluid more easily and is allowing you to achieve a kind of chronic dehydration.

I think this can happen to people who dialyze more frequently particularly overnight (like me) but maybe it can also be an issue for those with output.

One thing is certain, a low blood pressure is a bigger problem for dialyzors than a high blood pressure. The data shows that a high blood pressure can be cardio protective for people on dialysis, a BP as high as 170/140 is "better" than a bp of 110/70. In the study I'm thinking of, I saw the data presented at the Annual Dialysis Conference last year in Seattle I think, better means a significant mortality advantage. This low BP is definitely something you need to address.
« Last Edit: August 01, 2011, 08:08:02 PM by Bill Peckham » Logged

http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
Riki
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« Reply #7 on: August 01, 2011, 10:36:35 PM »

my bp fluctuates.  I'll have a period where it's really high for a few weeks, then it'll drop and stay low for a few weeks.  It did this even when I was on PD.  I remember a few years ago, I spent a few weeks with a bp of about 90/70.  At the time, I appeared to be the only one concerned about it.  It eventually relegated itself back to where it normally ran.

I had a low bp in dialysis today, with symptoms, even with a crapload of extra fluid on, so who knows?

oh, and when I need to go to salty foods to bring it up, I usually go with ramen noodles.  They only take a minute to make in the microwave, and the soup stock is pure salt
« Last Edit: August 01, 2011, 10:39:03 PM by Riki » Logged

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« Reply #8 on: August 01, 2011, 10:48:41 PM »

Did you see this recent news article?
Low blood pressure during dialysis increases risk of clots http://ihatedialysis.com/forum/index.php?topic=23907.0
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Admin for IHateDialysis 2008 - 2014, retired.
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