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  • Question for someone to answer.

    My father-in-law said they removed no fluid off of him at all this week due to his low body weight-he's wasting away to nothing at 6'3" and 153 LBS. He said all they are doing now his hooking him up and cleaning his blood. Is this possible and doesn't it indicate that the treatments are more than likely close to being stopped?

  • #2
    Re: Question for someone to answer.

    Hi , i have been doing home hemo i dont have any fluid taken off, i only have the blood cleaning.i have no extra fluid to take off.

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    • #3
      Re: Question for someone to answer.

      Hi pepelepew63 - It may be good news as it is quite possible for a fortunate few to continue producing urine while on dialysis. This is known as Residual Renal Function and is quite a benefit to the overall health of the patient. Does your father -in-law show signs of edema such as swollen ankles, belly and/or legs? If not, and he is producing urine, it is quite possible that fluid removal is not necessary. If he is still producing urine (RRF) he can help to continue to urinate by keeping his blood pressure down, following all prescribed medications and continued dialysis times. Please make certain that the nurses check his ankles for swelling and check his lungs for fluid each and every treatment to ensure a thorough assessment of his condition. Not every patient has to have fluid removed every treatment and some patients, such as myself and jeanettea, never at all. God bless.

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      • #4
        Re: Question for someone to answer.

        By the way, regarding his low body weight - Is he relatively new to dialysis? If so, it may take a while for him to begin to get his appetite back. New patients have uremia and are anemic which cause a loss of appetite. The uremia causes us to have nausea and an aversion to meat in particular. As he is treated for the anemia with Procrit (Epo injections) and toxins are removed from his system through dialysis he should begin to regain his appetite.

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        • #5
          Re: Question for someone to answer.

          It is very possible to remove toxins without removing fluid. As long as the patient is not showing signs of retaining fluids (swelling, edema, fluid in the lungs) it is not necessary to remove fluid. I am sure the dialysis center will reassess his need for fluid removal on a frequent basis.
          To the stars through difficulty!

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          • #6
            Re: Question for someone to answer.

            For almost a month my father had no,or very little fluid taken off during his dialysis treatments. My dad does still urinate(not as frequently as before dialysis). My dad was having difficulty breathing at night but would be fine the next day. The dialysis team changed my fathers dry weight due to him loosing weight. His shortness of breath has subsided and seems to be doing well. He usually gets 2 liters taken off now. I don't fully understand how they know when to lower or raise his dry weight.

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            • #7
              Re: Question for someone to answer.

              Determining dry weight seems to be as much art as science. At my unit they ask the patients if they believe they have been eating a lot more or less if there is a weight gain or loss above the normal fluid retention. For the more frail patients they also ask caregivers. If it appears that there has been a real gain or loss they tinker with the dry weight over a period of a few treatments to come up with a new dry weight. Part of this is a "challenge" in which they raise or lower the dry weight for a given treatment to see how the patient responds.
              To the stars through difficulty!

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              • #8
                Re: Question for someone to answer.

                I just wanted to add that I had my dry weight changed recently and it made all the difference in the world. I am now able to get off of the dialysis machine without using extra saline because of my feeling nauseous and about to blackout all the time and my blood pressure would drop way under 100 on the top and bottom. There was one Technician who helped me figure this out. I have been at this dialysis center for almost two years and this Technician was the only one who took out time to adjust my dry weight so that I would not be feeling so nauseous when I got off the machine. It took him about a week or so to figure this out.

                There was something else this Technician told me which I think is very important for any dialysis patient to know. He told me that I was not suppose to be feeling nauseous and weak at the end of my dialysis treatments. I was shocked because I never knew this until now. I was so used to seeing basically all the patients at my dialysis center looking very weak and exhausted at the end of their dialysis treatments. I thanked this Technician for assisting me with this. I even wrote him a Letter of Appreciation for this and gave a copy to the Facility Administrator (FA). The FA thanked me for having done this for him. I am even urinating more often now than ever.

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                • #9
                  Re: Question for someone to answer.

                  Superduper is right. You should not feel bad effects from dialysis such as nausea, weakness, headache, cramping, etc. If you do, something is wrong and things need to be adjusted. Certainly people will have bad side effects once in a while, but you should tell your dialysis team right away so that adjustments can be made. If you are feeling bad side effects on a regular basis then you need to visit with your nephrologist about your underlying dialysis prescription which includes your dry weight, the type of acid bath to be used in the machine, and other factors. Technicians are often allowed to adjust dry weight within certain limits as a part of the overall prescription, but if the technician says that it is not possible ask to speak to the charge nurse and/or your nephrologist about it.
                  To the stars through difficulty!

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                  • #10
                    Re: Question for someone to answer.

                    It would depend if there is fluid output and how much fluid is on the body. I got to know my machine so well (even though in center) and would tell them when I felt my dry weight needed to be readjusted. I went by how I felt, how my blood pressure reacted, how much I drank between dialysis times (always kept track so I knew how much I should be needing to take off since I no longer peed) and calculated my ice (as fluids .. ice I calculated to be approximately .. if a glass was 100% full of ice then it was 50% of water when melted .. which in a 200ml cup would mean I was having 100ml of ice).

                    Then after I had my kidney transplant (my most recent one) I still needed dialysis for almost 2 months so I needed to do dialysis in my city in center again. They wanted to take fluid off me (my city is not the best) and I had to tell them "NO FLUID OFF" as I am a transplant recipient. Just clean my blood. Took them awhile as they didn't want to take None off .. but I told them let me be responsible for it and I would sign any papers. I asked to speak to the Nephrologist and explained to him and he put it on the file so they stopped taking fluid off.

                    What my point is is that everyone is different and more details need to be given to know why someone would not be having any fluid taken off. I would not panic and think "it is near the end" as if he is not having any fluid retention then it would seem there is no need to take off the extra fluid if there isn't any. Just need to clean the blood in that case.

                    It sounds like however that you are talking about someone whose health has not been the best so it makes me wonder Pepe Le Pew if your father-in-law is not drinking enough between sessions for them to even take any fluid off. Has he not been feeling well lately?
                    Angie
                    Kidney KornerDialysis Ethics Forum Kidney PixAwareness Shirts KidneySpace Donor Search
                    I will be walking a Kidney Walk in Ontario Canada Sept 18th 2011
                    • Peritoneal Dialysis = 4 yrs
                    • Hemo Dialysis (in center) = 2 yrs
                    • 2 kidney transplants = 1990 - 2001 & 2007 to present

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                    • #11
                      Re: Question for someone to answer.

                      I would like to know if Davita have a risk management team, if so, who does it usually consist of.

                      Chefnancy, I just wanted to let you know that I did write to the Regional Director and he orally responded back to me via the telephne about my complaint. Is this the proper procedure for Guest Services? I thought I needed something in writing.

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                      • #12
                        Re: Question for someone to answer.

                        hay is chefnancy back was that her posting

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                        • #13
                          Re: Question for someone to answer.

                          Originally posted by gregory.lance@sbcglobal.n View Post
                          hay is chefnancy back was that her posting

                          I am not sure why this posting is showing like this but the posting is mine, Suprduper, and I am still awaiting Chefnancy response or whomever can answer my question. Thanks.

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                          • #14
                            Re: Question for someone to answer.

                            Suprdupr, I can't answer your questions as I know nothing about how dialysis centers work or what to do if one has a problem. Chefnancy has not posted for over a week and we are all very concerned for her. The Lord keeps bringing her to my mind often and I pray. I'm very worried about her. Please keep her in your prayers.
                            My Writings

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                            • #15
                              Re: Question for someone to answer.

                              Originally posted by Cassie View Post
                              Suprdupr, I can't answer your questions as I know nothing about how dialysis centers work or what to do if one has a problem. Chefnancy has not posted for over a week and we are all very concerned for her. The Lord keeps bringing her to my mind often and I pray. I'm very worried about her. Please keep her in your prayers.

                              Thanks Cassie, I will keep her in my prayers also. In the meantime, I will look for answers elsewhere.

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