Creatinine & hospital with buttonholes

Hi everyone.
I have 2 questions:

  1. I do home dialysis 5-6 days/week and my creatinine is over 9.0. I drew my labs this month after 6 days of dialysis. With that much dialysis, shouldn’t it be lower?

  2. I am having major surgery in 2 weeks. I have finally created my buttonholes which are working fine. While in the hospital, I may not be in shape to do my own buttonholes for a day or two. What have some of you done in this situation?


Re creatinine, when I was on 3x dialysis my creat. was 11-12. When I switched to 6x SDD it went down to about 9. When I optimized my 6x SDD by adding more volume to my tx., it went to 6 and when I went to nocturnal it went to 4. These are all results from the 6th tx.

As far as what I would do about putting in my needles if I was in the hospital, I can’t answer that as I’ve never been in the hospital one single time. Since I started self-needling with buttonholes 3 yrs ago., I have not missed putting in my own needles ever. I guess I’d either have to be in dire pain, unconscious or dead not to put em in lol and it just hasn’t happened. But seriously, if I couldn’t do it because I was out of it, I guess a nurse would have to do it- what other choices would there be?

Wendy, I have a rule: nobody cannulates me – period. I’'ve been doing HHD since February 2003 and have been hospitlized several times, once for 11 days and wad delirious from a high fever… Throughout every treatment, and my neph arranged for daily ass my schedule is currently 6xWeek, I’ve always self-cannulated. Since I first started HDD with the hospital, they have an inventory of BH needles so I don;t have to bring my own. When I travel, I always take three treatment’s worth of fistula needles b/c I can’t be sure a hospital would have any if I needed to be admitted. But my rule would still apply that nobody will cannulate me. I have let nurses pull needles at the end of a treatment, but never stick me.

That’s what I was hoping to hear…


Jane, Do you remember how much more volume you added to get your creatinine down to 6? thanks for the info.

When I first started on NxStage I was assessed at a much lower volume then I am at now. But after those in the NxStageUsers listserve figured out some things about optimizing the tx, I brought our findings to my neph and gradually worked my way up to 10L more per tx when I was on SDD. I would highly suggest you join the listserve and check out the threads on optimizing the tx and related topics ( i.e volume driven therapy, flow fraction, NxStage Primer) as you will see the process we went through as a group to get our answers. A number of us were started at a too low volume and were left there, when NxStage’s literature states to reassess after the break in period. Getting the correct scrip is very essential. You will see your labs optimize in numerous ways and experience more well being when you have the correct volume. Being pro-active will get you there. The listserv is a private site for patients and caregivers. The new forum ( is a public site. You can sign up for both sites at the forum.