#4 — Risks of low phosphates

Please post questions/comments here.

Thanks for starting all the threads for review. I don’t know about others, but as I stated in another thread, I missed info here and there from trying to follow chat and propose some questions while trying to listen to the presentation at the same time. On the subject of phos, did anyone bring out how those using NxStage nocturnally get enough phos. if diet alone does not bring the level up?

Hi Jane, I remember that Pat Colongione noted that NxStage doesn’t make it possible to add phosphorus to the dialysate, so Ralph is eating cheese and drinking chocolate milk. It’s not hard to get extra phosphorus in the diet when you are able to eat normally. What’s hard is to LIMIT phosphorus. So, rather than add it to the dialysate, it may well make sense to add healthy foods back into the diet, like nuts, whole grains, and dairy.

I’m sorry, but perhaps you shouldn’t be watching the chat window and concentrating on the presentation. The good doctor wasn’t typing his presentation, but speaking to the slides.

On the subject of adding phosphorus if too low from doing nocturnal on NxStage, in addition to adding it via diet (which is preferable to me) one can also get phosphorus supplements. But since my phosphorus went low, I can now enjoy food and drink I had cut back in my diet. I can now enjoy colas, which I had totally cut out for over 5½ years. Cheese — bring it on! Etc, etc, etc.

Let’s not get snarky!

Jane, one word: chocolate! :smiley:

[QUOTE=Dori Schatell;17452]Let’s not get snarky!

Jane, one word: chocolate! :-D[/QUOTE]

Dori, thanks for settling me down. It’s been one of those mornings.

Yea ya got to settle Rich down now and then.
I just got Ralph’s mid months Phos. and it is up to 2,8 YAAAAAH.
So I guess all that little pieces of chocolate and cheese help.
Even those he is diabetic we just adjust his insulin for the chocolate.
Although from what I gathered that Mary S said it would be addressed at the end of the extended trials.
Not sure if that is right or not but I think that is what she ment.
Last night was really great.
Can’t wait for the next one!!!

Pat, since we’re both familiar with the CAR-171, we know that has the port for the infusion of heparin. Perhaps, and I haven’t learned this from being on the UAP (so I’m not spilling any beans), NxStage might be considering putting something extra in. However, it would be easy enough for those doing nocturnal to change syringes at the end of the treatment and infuse a phos. additive.

I would love it if we had a dietitians’ corner at HDC. As far as phos supplements, wonder if nocturnal patients who need supplementation have a problem absorbing phos in oral form. It seems there must be a reason why I have often read that nocturnal patients said they had to add phos to their dialysate. Probably I will have to call and speak with a nurse of a nocturnal program to get an answer to this.

I hope I am one of the fortunate ones who can simply consume more phos foods when I go nocturnal. Joking aside, I am trying to figure out what healthy phos choices would be instead of going heavy on the ice cream, pizza, cheese and chocolate. I’m thinking now that it might of been a blessing that I couldn’t eat too much of that stuff before. I did eat it in moderation. But when I am free to eat what I want, I’m going organic and healthy this time as I don’t want to trade in the old set of problems for a new set. In fact, I’m concerned about the medical ppl as many of them tell me they exist on junk food.

I think that’s true, Jane. Unfortunately, I never see so many unhealthy people as there seem to be at nursing conventions! I wish that weren’t true, but in hospitals, patients’ families are constantly bringing in treats for the staff–usually pizzas, cupcakes, cookies, and other junk. That’s why I mentioned nuts and whole grains first.

As far as a dietitian, I don’t know of any who would volunteer, and we don’t currently have a budget to pay for someone’s time. We’d need someone from a large program who sees lots of folks on PD and daily & nocturnal HD–and they tend to be really busy.