Kidney Function

[KICKSTART]

Ok probably a strange question considering how long i've been on PD. How is your kidney function measured ? I can remember many years ago , right at the start it being mentioned, but not for many years now! Do they still keep track of it once dialysis has started ? Is it possible for it to recover slightly ? The reason i'm asking is ..nearly 3 yrs into dialysis and i'm still passing urine really well ! I know for most this stops (doesn't it?) Surely this has to do with kidney function? or is it just toxins that clear out that count?

[Bajanne]

Not a strange question, since I have been asking the same myself.  After two years I still urinate, and I recently got to wondering about my kidney function.  I will ask my neph when I get the chance.

[Ken Shelmerdine]

I think the whole kidney function measurement system is misleading. The function of the kidneys is to filter unwanted substances and wastes out of the blood, to produce urine, and to keep haemoglobin at the correct level. % Kidney fuction is a measurement of filtration only and not an indication of overall function. My kidney function is 7% and yet I still have full urine output and 100% haemoglobin.

 Also puzzling when they say that if your potassium levels are normal that it's usually because it's flushed away in urine which would indicate that as long as you are peeing normally then the kidneys are also correctly processing potassium.

[KICKSTART]

Glad its not only me thats confused then!

[Rerun]

There is a GFR calculator that takes your age, gender, race and creatinine level to produce your percent of function.  After you start dialysis your creatinine is brought down by the machine.  So, I don't think that would be very accurate.  If your creatinine is all of a sudden "normal" then I would question wheather or not you should be on dialysis.  Be thankful you are still getting rid of fluid.  There probably isn't any toxins in the fluid though.  That is left in your blood stream.

http://www.nkdep.nih.gov/professionals/gfr_calculators/orig_con.htm

[George Jung]

My function recovered SLIGHTLY.  For a while I had very little output, having average gains of around 3-4 kilos which 6 months in (to dialysis) started a downward trend.  I have not gone in over a kilo more than my dry weight in a couple of months now.  In my testing at UNC I had mentioned this and they (a neph) ordered a 24hr urine sample.  It turns out that they estimate my GFR (function) to be at 10-15%.  Right at the point where someone would be consider to be put on dialysis and to pursue a transplant.  I am continuing with my treatments but I think I will take a Saturday off and enjoy a long weekend.

[angela515]

When I went on dialysis in 1999, I did not urinate at all... zero.. niltch.. nada.

When I went on dialysis in 2004-Jan 2007, I urinated... all the way up to transplant... it all depends on how much function is left, but it's not uncommon to still urinate.

[stauffenberg]

My urine production was a normal amount for the first five years of dialysis, during which time I never had to have any fluid removed.  But when the decline began, it fairly quickly, over a period of about a year, went to zero, which is when the real suffering with constant thirst because of fluid restrictions began.

It does rarely happen that there is spontaneous recovery of renal function which allows patients to stop dialysis.  Statistics vary, but a thirty year survey at my hospital showed a spontaneous recovery rate of just under 1%.

Since glomerular filtration rate is rarely measured in patients once they are on dialysis, the best data usually available to patients are the creatinine levels before and after dialysis.  If the renal function is significantly improved, the results will show up there in a persistent pre-dialysis level below the dialysis range.

[Ken Shelmerdine]

There is a GFR calculator that takes your age, gender, race and creatinine level to produce your percent of function.  After you start dialysis your creatinine is brought down by the machine.  So, I don't think that would be very accurate.  If your creatinine is all of a sudden "normal" then I would question wheather or not you should be on dialysis.  Be thankful you are still getting rid of fluid.  There probably isn't any toxins in the fluid though.  That is left in your blood stream.

http://www.nkdep.nih.gov/professionals/gfr_calculators/orig_con.htm

Rerun I agree with what you have said. It's just that when you are told that your kidney function is so low when you have absolutely so symptoms that you are conscious of, you tend to assume that a big change in your energy levels and wellbeing is very imminent.

The perception is that everything your kidneys do is at a very low level so on hearing that kind of news you suddenly become very foreboding about the future. They didn't tell me that this % is the filtration rate only and that for as long as urine output and haemoglobin levels stayed constant then I would continue to be asymptomatic.

Of course this could start to deteriorate at any time, I know that, but I would have appreciated being a bit less freaked out out by a proper explanation similar to what I've just outlined.

[fluffy]

the amount of urine passed is dependant on the concentration of pd fluid you use. if you use 1.5 its mostly gonna take out toxins

if you use alot of 2.5 or 4.25 you'll pretty much stop peeing and all your liquid will filter into the pd fluid to be drained out later
thats just from my experience

[goofynina]

the amount of urine passed is dependant on the concentration of pd fluid you use. if you use 1.5 its mostly gonna take out toxins

if you use alot of 2.5 or 4.25 you'll pretty much stop peeing and all your liquid will filter into the pd fluid to be drained out later
thats just from my experience

Verrrry interesting, i had never heard that before, i have no kidney function and i am using 2 - 2.5% and 1- 4.25%  that is good to know, thanks Fluffy 

[fluffy]

i could be wrong, its just the way it sdeemed to me.i remember when id missed some pd exchanges id start to pee again. anyway now that im off pd i'll find out if my theory is right or if my kidneys are just shot to hell :p