Fluid Overload :( Please read.

[Bill Peckham]

Thanks monrein. After you all sign off on this (Zach? Peter? Anna?) I'll say it is a peer reviewed paper.

[Bill Peckham]

Good timing from RenalWEB today. MedScape today has an article up, http://www.medscape.com/viewarticle/749178 you have to register to read it but registration is free. I'll post a copy in the News thread. http://ihatedialysis.com/forum/index.php?topic=24326.0
Salt and Inactivity: A Recipe for Cognitive Decline


Imagine what sodium modeling or a poorly calibrated machine does to cognitive function, the article looks at dietary sodium.

[Meinuk]

Thanks monrein. After you all sign off on this (Zach? Peter? Anna?) I'll say it is a peer reviewed paper.

I'd publish it.

hmmm

Sodium Modeling: Why am I so Thirsty?

[Bill Peckham]

Thanks monrein. After you all sign off on this (Zach? Peter? Anna?) I'll say it is a peer reviewed paper.

I'd publish it.

hmmm

Sodium Modeling: Why am I so Thirsty?

A graphic novel? Can anyone draw?

[Genlando]

Since all the smart folks have already weighed in, I'm almost to embarrassed to throw in my  : I had a similar problem with fluid overload when I was first diagnosed with kidney failure. My cardiologist put me on lasix and a beta-blocker. The cardiologist  theorized that my body had gotten trapped in a never-ending loop: my heart had gotten enlarged by fluid overload caused by my kidneys failing; in turn, my enlarged heart couldn't efficiently move my blood around, which resulted in (you guessed it!) FLUID OVERLOAD!  Lather, rinse and repeat. 

By taking the two-pronged approach, I started feeling better within a few days; by the time I went back for my 6-months visit with the cardiologist, he said that my heart was almost back to normal size.  Of course, it sucks that I've got to take a beta-blocker still, but it's worth it to not walk around with an extra gallon or so of water sloshing about in my chest...

If Alewis' DH is already on a beta-blocker, then I apologize for dipping in...

[Meinuk]

Since all the smart folks have already weighed in,

Genlando, I hope that you were joking about that, because I learn something from EVERY post here at IHD - and I want to read everything that everyone has to say..  How else am I going to be able to really get an idea of what is going on if only a few people write about something? 

And I think that you bring up a great point about alternative fluid management.

I hope that you aren't counting me in that "Smart People" group, 'cause if you are, there is a 14 year old in the house who will beg to differ.  (something about me being unable to finish a sentence coherently was her gripe at breakfast this morning)

Re: BetaBlockers and Lasix, They are great if you still have some residual kidney function for excess fluid. I don't know about if you don't produce urine.

Actually, Beta Blockers are quite impressive when you look at them.  http://en.wikipedia.org/wiki/Beta_blocker

Beta blockers block the action of endogenous catecholamines (epinephrine (adrenaline) and norepinephrine (noradrenaline) in particular), on β-adrenergic receptors, part of the sympathetic nervous system which mediates the "fight or flight" response.[7][8]

Essentially, the beta blockers relax you at the nerve level, and the Lasix stimulates your kidneys to flush out as much fluid as possible.  Now, I always assume that the lasix only works with urine output, but with someone who does not make urine, is it an effective way to move fluid into the blood compartment?

The key question is, Genlando, were you still making residual urine at the time?  Did the lasix make you pee?  Or did you have all of your fluid removed via dialysis.

I am curious.

And as for the graphic novel, yes, I firmly believe that using pictures to tell a story (or impart an idea) is a great way to simplify complex theories.  I think that anyone with artistic ability should contact Bill and maybe we'd see the first combined IHD/DSEN Dialyzor published article.  The story/explanation needs to get out there.

[Genlando]

The key question is, Genlando, were you still making residual urine at the time?  Did the lasix make you pee?  Or did you have all of your fluid removed via dialysis.

I am curious.

Yes, I had and still have residual kidney function.  In fact, I still produce at least a liter of urine in 24 hours.  I'm still taking the Lasix and beta blocker (Coreg), although I had to drastically reduce the dosage of the Coreg once I started on the NxStage.

[Bill Peckham]

I ran my explanation of sodium profiling by one of the docs on the C-TEP and I'll need to put his feedback into a post - basically, maybe sodium modeling can be used well in certain ways to good effect but it is for sure a very 'hot' topic in doc circles. In Europe they may be combining it with UFR modeling to good effect. I'll look for more info when I am at RenalWeek in November.

But still my take away is unless your doc writes and gets published papers about sodium modeling and she supervises your treatment directly, after doing an independent quality check on the machine, I wouldn't do it.

When I have some time I'll continue the discussion. I'd also like to go back and edit the posts for typos and clarity but it has been so long not sure if it would be alright in this case. Moderators?