Subscribe to this Thread…
Results 1 to 5 of 5

Thread: Capd

  1. #1
    Junior Member
    Join Date
    Mar 2006
    Posts
    6

    Capd

    My father started home peritoneal diaylsis las week and is retaining fluids, feet swelling, weight gain. It seems to me the more he put in and the longer it dwells the more fluid he retains. I am getting scared; how much fluid can he retain without damaging his heart? This does not seem to be working. We put in a 2500 cc 2.5 dextrose solutionlas nite and only got out 1800cc this morning. I called nurse and she said use a 4.5% one time today. I cannot sleep for worrying. I have charted and everyday it gets worse. When will they say enough? What does the DR think? Today with a 2.5 we only got out 2400 then 2300 next one. Just gets worse. Can someone offer a solution. He is not taking in a lot of fluids or much salt. I think he regrets this choice. He is physically worse off since we began this dialysis.

  2. #2
    Jenne
    Guest
    I do PD. But I am not a nurse, but here's a few questions I need to ask:

    Is your father doing 3 exchanges during the day and one (1) exchange overnight? If not, that may explain his foot swelling (edema). Is he doing complete fills according to instructions? Is he draining completely? How long does he let the dialysis solution remain (dwell time) in his peritoneum? Here is a sample of what I did when I did my exchanges manually; I now do my PD with a cycler:

    8:00 a.m.
    Drain and fill with 1.5% solution (He may feel abdominal cramps when totally empty after about 20 minutes)

    1:30 p.m.
    Drain and fill with 1.5% solution

    7:00 p.m.
    Drain and fill with 1.5% solution

    12:00 midnight (this is the overnight dwell time)
    Drain and fill with 1.5% solution

    A quick way to get the fluid off is to use a 2.5% solution, let it dwell the appropriate time, then do a 4.25% solution. You should see a dramatic reduction in the fluid build-up. It's important in the future to not skip treatments. Once you've gotten the edema under control, everyday, check his feet for swelling, and then alternate using a 2.5 and 4.25 solution if there is a noticeable swelling. Caution: don't use the 4.25 too often, as it will definitely remove a LOT (maybe even too much) of fluid. He could become dehydrated. Please monitor his sodium intake. Also, if the dialysate remains too long in the peritoneum, some of the solution, because it is glucose (sugar), may absorb into his body. He would slowly start to gain weight. That is a possible cause of why you are getting less out than what was put in.

    I hope this helps.

    Jenne

  3. #3
    jbkm99
    Guest

    I have done pd for just over 1 yr. When I first started I used a 4.25 and a 2.5 each night because of the swelling and high blood presure. Once those went down I switched to 2-2.5 per night. I do 4 exchanges each night with 2500ml going in. I also had to try keeping 2000ml in during the day to get better results on my 3 month clearances. I did not like keeping fluid in. The most important thing is to talk to the dr and take your meds as prescribed. It gets better it may take some time. It took about 11/2 yrs. to control my bp. I now use 2-1.5 because my swelling and bp are very low. I will be glad to answer any questions I can for you but I am only a patient not a dr or nurse.

  4. #4
    Member
    Join Date
    Mar 2006
    Posts
    72

    low ultrafiltartion

    well if u father performs three to four exchange a day then his ultrafiltraion should b around 1.5 to 2 litre a day{ultrafiltration means if u infuse 2 lt then if u drain out 2.5 lt then ultrafiltration is 0.5lt}.
    dont worry its too early ur father is only one week on dialysis.dont use 4.25% bag as it destroys the peritonium fast.u can use one bag daily for some day.use 2.5% bags daily
    what u should do is to measure how much water he is taking both direct and indirect,then his urine output.
    he can take as much water as his previous day ultrafiltration whatever it may b plus his urineoutput plus 200ml more water.this is the formula.
    if he has high blood pressure then restrict hi ssalt intake 4gm a day.it can b e2gm also.
    measure his weight daily.whats his albumin /if its low then it also causes swelling.
    dont worry these are early days an everyone faces such problems.
    contact me on shivashanker.prasad@gmail.com


    QUOTE=dads girl]My father started home peritoneal diaylsis las week and is retaining fluids, feet swelling, weight gain. It seems to me the more he put in and the longer it dwells the more fluid he retains. I am getting scared; how much fluid can he retain without damaging his heart? This does not seem to be working. We put in a 2500 cc 2.5 dextrose solutionlas nite and only got out 1800cc this morning. I called nurse and she said use a 4.5% one time today. I cannot sleep for worrying. I have charted and everyday it gets worse. When will they say enough? What does the DR think? Today with a 2.5 we only got out 2400 then 2300 next one. Just gets worse. Can someone offer a solution. He is not taking in a lot of fluids or much salt. I think he regrets this choice. He is physically worse off since we began this dialysis.[/QUOTE]

  5. #5
    PdPt
    Guest
    it dwells in there too long. you didn't say what kind of pd, is he on ccpd or capd? he needs to break the long dwell and do another exchange.
    because dialysate dwells in there, pulls the fluid from his body to peritoneum cavity, but now peritoneum cavity has more fluid than rest of his body, lets say this happened in 2 hrs, this is when he needs to another exchange to drain this fluid and put fresh dialysate in there. if not, the fluid will go back to where it came from and he will retain the fluid.
    Seems like he just needs to do 1 or 2 more exchanges. another thing, if he is new to pd, he shouldnt be using 4.5, that's too strong for a beginner.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •