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Author Topic: Fistula question  (Read 10120 times)
Alex C.
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« Reply #25 on: August 12, 2015, 05:11:42 AM »
Just out of curiosity, what sort of rate and venous pressures do people have? I run at 450 (with 15 gauge sharps), and my venous is always about 240-260, for 3:45 time a session:
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Simon Dog
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« Reply #26 on: August 12, 2015, 05:33:12 AM »
Quote from: Alex C. on August 12, 2015, 05:11:42 AM
Just out of curiosity, what sort of rate and venous pressures do people have? I run at 450 (with 15 gauge sharps), and my venous is always about 240-260, for 3:45 time a session:
Rule of thumb is about 1/2 the blood rate speed.   I run right around 200 at 450 w/15 gauge blunts, but that's only temporary - start nocturnal in a couple of weeks and will be running the pump at 250 - 300.

Flipping the needle can reduce pressures a bit, but needs to be avoided with sharps unless absolute necessary since you would be spinning a very sharp cookie cutter.    It's less of a problem with blunts.
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justagirl2325
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« Reply #27 on: August 12, 2015, 06:12:27 AM »
My husband runs at 400 speed and his venous hovers around 130-170 for a four hour session (Baxter AK-96)

If he switches back to nocturnal, the pump speed will drop to 360.  But he might not, he says he feels better with his current schedule with four hours in the evening and then a good night's sleep after that. 

He just started back to work last Friday after almost a year off :)

*edited speed to 400 (typo)
« Last Edit: August 12, 2015, 08:37:58 AM by justagirl2325 » Logged
Vt Big Rig
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« Reply #28 on: August 12, 2015, 06:38:58 AM »
I also run at 450 with 15 gauge sharps. Pressures run about 200. Sometimes higher but usually drop down a little. I think we alarm at around 250.

Others will chime in that 450 is much too fast. Conflicting opinions. Never do know which way to go but I spoke with neph about it. He listened; but advised to stay there.
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VT Big Rig
Diagnosed - October 2012
Started with NxStage - April 2015
6 Fistula grams in 5 months,  New upper fistula Oct 2015, But now old one working fine, until August 2016 and it stopped, tried an angio, still no good
Started on new fistula .
God Bless my wife and care partner for her help
Sugarlump
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10 years on and off dialysis
« Reply #29 on: August 12, 2015, 06:58:40 AM »
Because i am using groin line til fistula matures we can only get 250-280 speed over 3-3.5 hours.
The pressures are usually A 190-210 and V 240-270.
Far less efficient than my fistula was but 4 times a week helps.
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10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
obsidianom
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« Reply #30 on: August 12, 2015, 07:58:27 AM »
I have written extensively about the dangers of fast pump speeds. Dr Agar has written on this .

See my posts March 15 , 2014 on" Don't flog the fistula. "

http://www.ncbi.nlm.nih.gov/pubmed/23448433#       This article discuses flow dynamics on the venous needle at higher speeds.
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My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
obsidianom
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« Reply #31 on: August 12, 2015, 08:01:02 AM »
DONT FLOG THE FISTULA----PLEASE!!!!    I tried to link it but failed Go back to March 15, 2014

by obsidianom
« Last Edit: August 12, 2015, 08:03:43 AM by obsidianom » Logged
My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
Simon Dog
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« Reply #32 on: August 12, 2015, 12:18:15 PM »
Quote from: obsidianom on August 12, 2015, 08:01:02 AM
DONT FLOG THE FISTULA----PLEASE!!!!    I tried to link it but failed Go back to March 15, 2014

by obsidianom
I get to stop flogging my fistula in 2 weeks.
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noahvale
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« Reply #33 on: August 12, 2015, 08:50:03 PM »
*
« Last Edit: September 23, 2015, 08:59:29 AM by noahvale » Logged
noahvale
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« Reply #34 on: August 12, 2015, 09:22:19 PM »
^
« Last Edit: September 23, 2015, 08:58:54 AM by noahvale » Logged
Sugarlump
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10 years on and off dialysis
« Reply #35 on: August 12, 2015, 11:24:58 PM »
Quote from: cassandra on August 11, 2015, 03:21:13 PM
No info about next steps, I suppose 'they' will discuss 'me' in their next group session.
I think I will first go on a holiday as long as my fistula works, and follow Noah's 'strategy' by dialysing slower speeds and longer. I'm still trying to get nocturnal sorted and than that would leave me even more living hours really  ;D

Love, Cas

 :cuddle; Defo take a holiday now!!!
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10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
cassandra
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When all else fails run in circles, shout loudly
« Reply #36 on: August 13, 2015, 03:53:46 AM »
Thank you everyone, I love you all  ;D and I hope you're all well


 Love, Cas.     :cheer:
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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
2020 start Gambro AK96

       still on waitinglist, still ok I think
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