Blood pressure completely normalized on nocturnal hemo

I’ve mentioned this before as part of other postings, but it’s becoming more and more remarkable. I wonder if anyone else has had this experience after a while on daily nocturnal hemo?

I first started home hemo doing short daily. After the first couple of weeks, my doctor decided I could see how I would do without any BP meds, so we stopped it. My BP ended up more or less at a good level for hemodialysis, about in the 140/90 area, sometimes a bit more, sometimes a bit less. But it bottomed out at that point, resisting going lower by lowering dry weight.

Now, I’ve been on nocturnal for a couple of months. Still no BP meds. My BP is now maybe even getting a little too low for comfort. I’m consistently around 120/65, doing up to about 125/70 by dialysis time. I haven’t had BP like this, even medicated with 4 BP meds, since the 1980’s when I was still more than a dozen years away from needing dialysis. And even with an increase in dry weight of 1 kg, it’s still in that range.

At first, I was a little concerned that my BP might drop too much while I slept overnight, but it doesn’t seem to be a problem. I’ve taken the opportunity to check it a number of times, and it seems to hold at 120/65 or so, both during and after the treatment. So, it seems to be Ok. On regular hemo and short daily, I used to have rebound hypertension after the treatment, which would last a few hours. No sign of that now whatsoever.

It’s remarkable because I eat salt, not tons of it, but normal amounts (just doing what the dialysis unit has told me to do). I have salty soups, salt my food at the table, etc. In addition, I’m drinking virtually without limit. In fact, instead of ensuring I don’t drink too much, now it’s the exact opposite - I have to ensure I’m drinking enough every day. I don’t know exactly what it is about daily nocturnal which does this, but I just assume it’s simply more closely mimicking normal kidney function than any other kind of treatment. I find it so exciting because since 1988 at least, I was a guy whose blood pressure could not be adequately controlled no matter how many drugs I took.

Regular in-centre hemo since 2002
Short daily home hemo since March this year
Daily nocturnal hemo (7 hours, 6 nights per week) since June
I use a Fresenius “baby” 2008K dialysis machine

It is remarkable how daily hemo has a big impact on blood pressure…

Back in the years when I dialyzed in center I had a blood pressure as a high as 190/90 and I was only a teenager… the blood pressure was just too high for quite a long while till I collapsed with a stroke…(luckily I survived)

Even before starting daily hemo my pressure was high, but after only 3 months of daily short my blood pressure stabilized to normal, as low as 80/50 and as high as 120/80

Recently a new trainee stopped 5 blood pressure medicines!

This is one of the biggest benefits of daily short/daily nocturnal over in-center 3x a week…

However, I think sometimes it can get too low if not adding enough salt to the diet and even enough fluid intake.

Have you ever had dialysis with a pressure of 79/55 and your feeling well with no down symptoms?

Hi Gus

Yes, while doing in-centre hemo, I did have very low BP occasionally on treatment without any adverse effects at all (like 80/55). The nurses would see the BP shown on the machine’s display (taken at 30 min intervals), re-measure BP and ask me if I felt Ok. I have never had an actual hypotensive episode in 3 yrs of dialysis like other people all around me.

Almost invariably though, even on those days, my post-tx BP would be around 160/90 or more. I always guessed it was the saline used for rinseback which caused it, but I guess there might have been some kind of sympathetic nervous system activation also.

Before I started dialysis, it wasn’t unusual at all for me to be in the range of about 200/110. It took 4 BP meds to get even close to 150/90 in those days. 160 to 170/110 was more my range.

Yes, it does not have to be nocturnal, I’m also completely off b/p meds, although mine was never quite as bad as you guys. I actually have too low a b/p. I’ve noticed when my b/p is down in the 80’s over 40’s and 50’s that my heart rate is too high, but when it is 100’s over 70’s I feel better and my heart rate is at least down to the 90’s.

This has been my biggest problem since starting dialysis, low b/p and rapid heart rate. My neph isn’t bothered by it, and my weight doesn’t seem to be the influencing factor, sometimes my b/p is great when I am at my lowest weight and sometimes it is low when I have a lot of fluid to take off, it has me stumped. I have little energy and stamina with the high heart rate 100-140 and low bp, but feel great when it is more in a normal range.

Even more amazing than normalization of blood pressure without BP medications as a consequence of nocturnal dialysis is reversal of left ventricular hypertrophy.


My husband’s pressure is on the low side also but the cardiologist wants it as low as he can tolerate without being symtomatic. Last week he started taking actos for his diabeties and that with his coreg in the morning. Boy was that a tough morning. We were entering our monthly clinic when I thought he was going to pass out! The nurses saw him and sat him down and started working on him. His BP was 60/40 So we upped his dryweight 1 k and changed the time of his coreg to later in the am.
That seems to be doing the trick FOR NOW anyway.
My husband is always an adventure! But I love him 41 yrs together and still counting!

I’m not giving end of treatment numbers, but also beginning treatment, all day treatment. Also my weight just doesn’t seem to matter, I added a couple of kilos to see and it varied from good to bad just as it did at the lower weight. I’m currently playing around with adding more salt to my diet since my sodium is almost always low, but my neph says that isn’t it. However, I honestly don’t trust my neph’s opinion so we will see.

Everything was pretty good for today’s treatment, we’ll see what it all is tomorrow.

As long as you’re dialyzing daily, I don’t see how it’s going to hurt to eat more salt. Basically, the only thing it will do is to make you retain more water if you’re still urinating, or if not, you will be thirstier and so you will end up drinking more. You’ll see what it does to your pre-treatment weight pretty easily. Your BP will probably be at least a little higher. For me, it takes a lot of salt to have any appreciable effect, like 5 points up on the BP. So far, I’m up from a dry weight of 55.5 to 56.8, and I still have absolutely no sign of any swelling.

I’m not a health professional though, so, I’m just throwing this out for discussion.

When Ralp’s BP is low at home I just give him a dill pickle or 2 and that brings up the pressure.

[b]I use olives – one olive = 3 points of systolic blood pressure!


How about a BIG bowl of cheetos and a mug of your favorite beer? :stuck_out_tongue:
… joingly…har har har

Perhaps some Saladitos?.. :idea:

Sorry Gus, I hate cheetos. Love olives though so might give that a try. My b/p was great this am, and then dropped to 79/50, oddly AFTER drinking a big glass of ice water. Life is fun isn’t it!!

I drink a glass of beer, and I sprinkle salt on it (a practice I had to stop years ago, but I’ve revived recently).

Might a Canadian thing though :slight_smile:

Since I’ve been on daily dialysis, I’ve eaten real French Fries with lots of salt on them, and even that hasn’t raised my blood pressure much before my next daily treatment.


AaahhhHH, so you really drink eh? Don’t you think your Doc is reading this? :stuck_out_tongue: jokingly…

French fries yummy! I like the seasoned curly fries or the chili cheese fries, now that’s salty…YeOOwww… :twisted:

They are the ones who suggested a Coke a day to raise my phosphorus. I figure a beer is healthier than a Coke :slight_smile:


Take one beer and call me in the morning." According to a recent study cited in the British Medical Journal, men who drink one beer daily, or almost daily, are at lower risk for myocardial infarction than men who don’t drink alcohol at all. The reverse side of that finding, as often is seen in such studies, is that the benefit is lost in those who drink two or more beers each day.


Milk does more than your body good–it may also lower your blood pressure. A study published in the September 2000 issue of Women’s Health in Primary Care showed that increased consumption of dairy products may lead to lower systolic and diastolic blood pressure rates. Because there were only slight differences between those with high and those with low consumption, more research will be needed before we’ll be able to say, “milk does your body and your heart good.”

Or even worse…

Sticks, stones and cola might break your bones? A study published in the Archives of Pediatric & Adolescent Medicine showed a great increase in the incidence of bone fractures linked to the consumption of carbonated beverages. Physically active soda drinkers are at even higher risk for bone breaks. The high phosphorous content of soft drinks might cause secondary hyperparathyroidism, leading to bone loss.