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  • just started dialysis last week, why so much water?

    I am new to dialysis, and I understand as my kidneys fail, I will start to retain fluid. As of now, just starting dialysis last week, I am thinking seriously about not going back. I do not retain fluid at this time, they tried to take 3400 and just about made me pass out, had cramping, is this normal for the first, second or third time? Today, they took 500, and I can't understand why I weigh less afterwards. If anyone can shed some light on the situation for me, I would greatly appreciate it...losing 5 lbs in 3 days just doesn't seem right to me...

  • #2
    Press your thumb against the front of the shin bone just a couple of inches above the ankle. Hold the pressure for at least 20 seconds.

    When you remove your thumb does it leave a 'dent' in the flesh lasting for a minute or more?

    If so then you are holding water, it may not seem like a lot, but it is there.

    In the hotter weather we sweat off a volume of water that in cooler weather the kidneys have to remove. As the kidney function reduces cause by which-ever affliction causes yours, this amount of water continues to accumulate, sometimes taking hours, or days, to reach a level that become apparent.

    This is one of the reasons for dialysis, to remove the excess water from your body.

    On PD the Dr's can adjust the number of exchanges, the volume of the exchange, and the % of the solution to adjust the volume of water being removed. Any lightheadedness must be communicated to your Dr and Nurse so they can decide what adjustment may be needed.

    It is also very important to control your fluid intake, try to maintain your daily intake the same every day. Remember it is not only what you drink but also the fluid content of the foods you eat.

    Your Nurse and dietician can be very helpful with your questions. Talk truthfully and freely. They are not there to judge, but to help you understand and cope successfully.

    I was carrying over 30 lbs, and lost it in my first week on PD. I still have a very small amount of that shin 'depression' when squeezed but it is nothing like before. I'm thrilled.


    • #3
      You are retaining water between treatments. It doesn't mean just in your legs. It could be in your stomach area and midriff areas. Also, they might be finding your dry weight which is what your weight would be if not holding liquid. As soon as you feel cramps or feel funny, you should tell the techs and then they will adjust the machine. I started out at 91.5 K which is 201 lbs (I think) and then was put up to 93.5 which around 205 lbs. It took a few treatments to find this out. Since they raised the weight I have had not cramps or restless legs at night. I have lost some weight so I have been as low as 90 at the end of the treatment and feel fine. My nerph told me to tell the tech as soon as I feel cramps or faint. Usually, I feel a queasy feeling, a little warm and then if I don't call the techs, I see blue dots. The machine takes the BP every 30 minutes which is checked by the techs so if there is a change between that time, you need to call a tech over and let them know asap.


      • #4
        New to dialysis, still relatively miserable. Have lost about 25 lbs prior to starting, but dietician & techs pushing my dry weight below this reduced weight. I have no edema or signs of fluid overload. Most of the time I start to cramp in the last 30-45 min of treatment, when I need the extra fluid to control these symptoms they always complain. I'm not a wimp, but they don't feel my pain. Also I'm very irritable & depressed, not sure if this is dialysis related.


        • #5
          You need to tell your doctor that the techs are complaining when you go through this. You should also know that it is your right to have them stay at the dry weight that does not give you cramps. My doctor is there every two weeks. I can tell him anything and he tells the nurse and techs what he wants. When I had this problem two times and the doc. came in the next Wed. He raised my dry weight. Now I have been on dialysis three months and don't have that problem. In fact, I have lost a lb and told them to go down one k and they did. I still feel fine. I don't hold a lot of liquid because I still pee. Therefore, taking 2.5 k off each time three times a week isn't bad. Others are a lot more but the techs know my dry weight and I know how much I have lost. Between the two we work as a team. When I lost that lb. I told the doctor and he told them to drop the dry weight. You need to working as a team because it is your health and your right to feel better. Others might tell you where to call if there is a problem. A social worker comes and asks me each month if I have a problem that needs to be addressed. Use the people there to help you as a team. Stay positive and ask questions of the doctor when he comes in.


          • #6
            Hello! Ive been on dialysis for about 17 years now and I remember those days! Once piece of advice I can give you about being in the clinic (im a home pt now aout 9 years) is youre gonna have to pay attention to whats going on with your body. If you are cramping like tht, especially not retaining a lot of fluid, your weight my be fluxuation or either they havent found your true dry weight. However, if you are consistantly cramping with the fact tht you know youre not retianing tht much fluid....tell them to BACK OFF! Its YOUR care and YOU know how you feel. Yes, they are caregivers and are there to "protect" you (or whatever) but thye dont know what CRAMPING feels like and they can also make error bc theyre human. When I was in the clinic, it didnt take me long to stick myself, adjust my own UF, chart my own things, wipe my own chair down, put my own supplies on my chux, pull my own needles (BOTH might I add), and more. I was tired of waiting on them to do what they needed to do. Part of me was impatient bc they were taking off another patient so I thought I'd do what I could til they got to me, and I was tired of getting sick. You have to be a lil rebellious in the clinic. Not TOO much but when you know and learn your body, and blood pressures tht come with different feelings, let them know to turn the UF down/off, or give fluid....and dont feel any type of way about it. I know its draining as well. Those cramps get serious. Good luck and blessing to you Mr. Brady!


            • #7
              CharlieB53, Something I found out about pressures in the last week. I am going through a transposition of the fistula is a few days. Being on dialysis four months, I have had a lot of issues with a very deep fistula, having fistulagrams as well. I found out that when they were trying to make sure the fistula was mature, they put the pressure up real high. Above 450 and I heard one tech come a check to ask why so high. They told me when I questioned it too that is how they know the fistula is mature and there should be no problems. The head nurse talked to the doctor and had them do some extra tests to make sure all was ready. Anyways....That night I had a terrible headache and ringing in my ears that was really annoying. Leg cramps the next day too. So I told the tech when I went in and was told that it doesn't have to be that high now that they knew for sure the fistula is strong. They had it at 350 last night and I feel great today as well.
              So....I though that this might help you. I agree with Nappy_Myricle It is your body and sometimes you just have to know a lot. Ask questions of the doctor....question the techs.


              • #8
                You've got to take charge of your care. You have to learn everything there is to know about your treatment and question things you don't know. You will soon learn that your knowledge is better than the techs/nurses. Develop a strong relationship with your nephrologist and show him/her you are willing to learn and they will gladly reciprocate.


                • #9
                  It's quite simple. It's your body and you are responsible. Every patient is different on what their tolerances are and what they can handle. I carry a mirror with me every day I'm in dialysis. I use this to view the machine. I check pump speed, fluid withdrawal, blood pressure, time remaining, and why the machine is alarming.

                  I have found several mistakes made by the nurses. I have them correct the mistake. These machines are dangerous if set up wrong. I have never been denied a request to the nurse. In fact, they are very busy at our clinic, and they appreciate my help.


                  • #10
                    While I was on dialysis I would measure out my fluid and keep a written check on how much fluid I drank between treatments. I would also watch my salt intake as salt will make you retain fluid.
                    I know this didn't answer your question, nut maybe it helped in some way as to how to control your fluid intake.


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