Coming in as an ‘Expert Patient’
Dori has mentioned checking bloods during treatment.
What I haven’t heard mentioned yet, apart from profiling is blood flow rate and dialysate flow rate. AND dialyser size.
A good doc or renal nurse should take these into account. (note that in the UK techs are what i think you call mechanics, and our junior nurses may be called healthcare assistants, trained to do the dialysis and needling but not senior/managment level).
Like most we have different bands of nurse experience and training.
I can’t tolerate a dialysate of less than 2K (potassium), and don’t tolerate larger dialyser sizes (equivalent of Fres 800) so use a 1.5 K dialysate, FX600 kidney and a dialysate flow rate of 600… This, for a person who weighs 60 KG is adequate, providing I keep an eye on dietary intake a fluid. I do home dialysis at 4 hours 4 times a week on one of the ‘beasts’ of Fresenius (which I’ve named ‘You Bastard’ after the Pratchett mathematician.
I know my potassium drops to around 2 if I have a ‘low K tank’ which is itself dangerous.
So take ALL the possible variables back to the doc and see if tweaking doesn’t help. I know some units are excitedly stroppy about personalising prescriptions, but a 1 size fits all our patients REALLY doesn’t work.
Dialysate concentrate and blood flow rate.
Dialysate Concentrate and Dialyser size.
Amount of fluid gain between sessions… Really important. I can’t tolerate more than 2,8 tops but usually gain is 2 or less between sessions.
And pre dialysis blood and amount of clearance.
Be informed, be safe, be healthy…
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