oh guy’s just reading your stories is freaking me out, and we’re only into our third week of dialysis. i know that at some point andy {hubby} wil eventually encounter some problems, but i never thought there were so many. to every one who has a problem i really hope that you can work it out so you can get on with dialysis. please take care.
You’ll be right helen. Dialysis does bring up alot of problems, but not everyone is the same. The more dialysis your husband can do, the better. Do they offer nocturnal or short daily dialysis where you are?
I do think for most people low blood pressure is a sign of too much fluid being removed and it is easy to adjust your weight for a few days and see if that is the problem. I too had an echo and was pleased to learn that my heart is actually in great shape. I saw a cardiologist and he says he doesn’t think ithas to do with myheart (luckily), but something else is causing the problem. I am going to ask for a trial of the medication to raise my b/p and if he refuses then I am going to insist on a referral to a pulmonologist.
It is actually reassuring to know it isn’t a weak left heart or otherwise heart related.
And Helen, this is a pain, but doesn’t affect dialysis. I do NOT crash, I just have little energy due to the low b/p and offsetting high pulse rate as my system tries to get my b/p up. These boards have been around for over two years and if you ever have the time to read them all you will see very few if any “emergencies” by these home patients. Most of what is talked about are what ifs, or questions/comments from people who aren’t even on home treatment. Sure bad stuff can happen, but heck you can get run over by a truck crossing the street too, so should you never cross a street?
Cathy
home hemo 9/04
Just for curiosity sake…have those of you who have low blood pressure had a recent review of your medications to see if any of them have the side effect of low blood pressure or if possibly two drugs are interacting with one another to cause the problem. Your doctor, nurse or pharmacist could review your meds with you or you could look them up using Google and look on the company website for the package insert.
In my case, I went off 100% of my meds and slowly started adding them back, I take, iron, sensipar, calcitriol, paxil, lovastatin, kidney vitamin, and on an as needed basis vicodin (PKD). Didn’t have any effect.
Cathy
Hi Cathy,
I don’t recall you mentioning this problem before. Is it only since you’ve switched to NxStage?
Pierre
No, it has been since starting dialysis. It got much better when I started NxStage, but then went back down about a month ago. I keep hoping it will get better again, it was so nice those first few months to again have energy and the ability to take long walks and get chores done without needing to sit down.
Cathy
Vol. 104, No. 3, 2006
Free Abstract Article (Fulltext) Article (PDF 93 KB)
Original Paper
Audit of the Effect of Dialysate Sodium Concentration on Inter-Dialytic Weight Gains and Blood Pressure Control in Chronic Haemodialysis Patients
Andrew Davenport
Consultant Renal Physician/Honorary Senior Lecturer, Royal Free and University College Hospital Medical School, Centre for Nephrology, Royal Free Hospital, London, UK
Address of Corresponding Author
Nephron Clinical Practice 2006;104:c120-c125 (DOI: 10.1159/000094544)
Key Words
Dialysate
Sodium
Blood pressure
Abstract
Background/Aims: Over the last three decades the standard dialysate sodium concentration has increased from 136 to 140 mmol/l (mEq/l) today. There has been great debate as to whether a reduction in dialysate sodium alone can lead to improved blood pressure control, and reduced inter-dialytic weight gain. Methods: An audit was performed in 469 maintenance regular haemodialysis patients who dialysed in seven different centres under the care of one university medical school. Results: Those centres which predominantly used a dialysate sodium of 140 mmol/l (mEq/l) had increased inter-dialytic weight gains, with more difficult blood pressure control, as not only did a greater percentage of patients require anti-hypertensive medication, but also more were prescribed multiple classes of anti-hypertensive agents. There was no difference in the frequency of symptomatic intra-dialytic hypotension. Conclusions: A reduction in dialysate sodium was associated with lower inter-dialytic weight gains, without any additional intra-dialytic hypotensive episodes. Those patients in whom the difference between the time-averaged dialysate sodium concentration and the midweek pre-dialysis serum sodium was positive result had increased inter-dialytic weight gains, compared to those with a negative value. Reduced dialysate sodium alone was not effective in controlling blood pressure without additional proper dietary sodium restriction.
Copyright © 2006 S. Karger AG, Basel