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