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  • Dialysis and Appetite

    When I am having my dialysis session, I get very hungry. All I can think about is what I am going to eat when my session is through. Also, my appetite is ravenous the rest of the day as well.

    I have been on dialysis for about 6 months now. I always got hungry during dialysis, but recently my appetite after dialysis is almost uncontrollable. I have even gained a few pounds after having lost 115 pounds after starting dialysis.

    Anyone have a similar experience? Anyone have some ideas on how I can cope with this?

    Left arm fistula June 2011
    Start dialysis July 2013

  • #2
    Hello pmstern,

    I started HHD training and dialysis in July 2012 while still healthy and not suffering any physical symptoms of ESRD. My appetite was adequate but not necessarily robust. I did loose a few pounds from my already just below 25.0 BMI but stable weight over the course of the weeks of training. The only change in my appetite was a renewed desire for "seconds" during the dinner meal. I usually dialyze shortly after a meal, mostly dinners during the week and will frequently have a dessert and water or perhaps a hot herbal tea. I have not noticed any uptick in my hunger during treatment.

    My albumin levels fluctuate between a low of 3.9 to a high of 4.2, with a fairly frequent 4.0 minimum, indicative of adequate/not excessive protein intake. Hemoglobin levels hug the 12.0 max for hemodialysis patients on a once monthly 2000 IU dose of IV Epogen. I've recently had to stop the EPO and IV Iron as my Hgb reached a 12.3, even on the once monthly EPO dosing.

    As a PKD patient, I still produce adequate urine, and thus no fluid retention issues. My adequacy of dialysis has been excellent on 5X weekly treatments, which total about 160 liters/week against my prescription of 150 liters/week. The NxStage Pureflow SL SAK's will make about 64 liters of dialysate, and I use all of it in spite of my 30 liter/treatment prescription.

    I was told during HHD training, that more dialysis is always better. The extra treatment time/liters processed amounts to about 7% over the 150 liter/week prescription and 28% over my minimum adequacy of 125 liter/week (25 liter/treatment) prescription. I elected to treat at the 150 liter/week level to avoid potentially wasting up to 14 liters of dialysate per SAK produced or 35 liters/week. Considering that I am paying for the water and the energy to produce the dialysate, I can't buy into a "scrap rate" of nearly 22%! Instead, I'll spend that additional time on the machine and reap the associated therapeutic benefits, thank you very much.

    It helps that I am processing 80 of the weekly 160 liters of dialysate during 2X nocturnal treatments, leaving me with 2X, 24 liter daily treatments and a single 32 liter daily treatment to complete my HHD treatment week.


    • #3
      Bec. of diabetes, I bring a sandwich and a fruit to eat during dialysis. This helps my hunger a little. During the day, I don't feel hungry. It's amazing to me to be literally starving after dialysis. A snack will curb some of the hunger pains.


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